less than once every 12 months until such time that the entity is found by the State or local survey agency or approved accreditation agency to be in compliance with the requirements under this title for a period of 24 months. (iv) If a State and local survey agency or an approved accreditation agency identifies a deficiency of an entity as part of a standard survey conducted pursuant to this subparagraph, the agency shall notify the entity of the finding and provide the entity with (or provide access to) educational information on how to address the deficiency and prevent future deficiencies. Such educational information (or access to such information) shall be provided to the entity upon the completion of the site visit performed as part of the survey. Such educational information shall be standardized for purposes of both educating hospice programs and surveyors from local survey agencies and approved accreditation agencies. (v) The Secretary shall establish a process for joint training and education of State and local survey agencies, approved accreditation agencies, and hospice programs on a regular basis as changes to regulations, guidelines, and policies governing hospice program operations are implemented and used in standard surveys of participating hospice programs. . (c) Annual report of deficiencies (1) Study The Secretary of Health and Human Services (in this section referred to as the Secretary ) shall conduct an annual study on deficiencies by a hospice programs under the Medicare program. Such study shall include an analysis of ways to address such deficiencies. (2) Report Not later than January 1, 2021, the Secretary shall submit to Congress a report on the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Secretary determines appropriate. 3. Increasing compliance of quality standards for hospice care (a) Increasing payment reductions for failing To report quality measures Section 1814(i)(5)(A)(i) of the Social Security Act (