CMS Final Rule on Hospice Care in Nursing Homes

On Thursday, June 27, 2013 CMS published the final rule regarding requirements for long term care facilities when they enter into an agreement with a hospice to offer hospice services to residents of the facility.

This final rule is the long awaited companion to §418.112 of the Hospice Conditions of Participation, published in June 2008, that set forth the requirements for hospices when hospice care is provided in a SNF/NF or ICF/MR. This newly published final rule outlines the parallel regulations for long term care facilities (LTC facilities) when hospice care is provided to a LTC facility resident. CMS intent was to make the facility rule (§483.75(t)) as consistent with the hospice rule (§418.112) as possible to provide “regulatory clarity for both providers to eliminate duplication of and/or missing services.”

CMS states that the purpose of this rule is to “ensure the coordination of care for LTC facility residents who elect hospice services. The coordination of care is anticipated to result in better outcomes related to quality of care and quality of life for residents. With appropriate coordination of care, we anticipate improved outcomes through more efficient coordination of care between the LTC facility staff and hospice staff, a decrease in duplication of services provided, and improved resident care.”

Resources about the new rule are available from CMS:

• Nursing Home Surveyor guidance in Appendix PP for F309, Quality of Care.
• Survey and Certification Letter 12-48 NH
• Nursing Home Surveyor guidance in Appendix PP for F155, Advance Directives

Members of the National Hospice and Palliative Care Organization will find additional resources to help providers ensure compliance with the new rule.