On October 22, 2010, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule that would revise the requirements that an institution must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program. Specifically, the rule requires SNFs and NFs that chose to arrange for the provision of hospice care through an agreement with one or more Medicare-certified hospice providers to have in place a written agreement with the hospice that specifies the roles and responsibilities of each entity. The rule also clarifies that if a facility chooses not to arrange for the provision of hospice services at the facility through an agreement with a Medicare-certified hospice, it must assist the resident in transferring to a facility that will arrange for the provision of hospice services when a resident requests a transfer. The comment deadline is December 21, 2010.