CMS Finalizes Medicare/Medicaid Requirements for Long Term Care Facilities Providing Hospice Services
On June 27, 2013, CMS published a final rule that revises the requirements that an institution must meet to qualify as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program with regard to hospice services. 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. As in the October 22, 2010 proposed rule, the final rule provides that the LTC facility that arranges for the provision of hospice care under a written agreement must designate a member of the facility’s interdisciplinary team to be responsible for working with hospice representatives to coordinate care provided by the LTC facility and hospice staff to the resident. The final rule adds language to clarify, however, that the LTC representative must have a clinical background, function within their state scope of practice act, and have the ability to assess the resident or have access to someone that has the skills and capabilities to assess the resident. 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 rule is effective August 26, 2013.