CMS Finalizes Rule for SNF/NF Written Agreement with Hospices
July 2, 2013 09:28 AM
On June 27, 2013, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register a final rule requiring long term care facilities - skilled nursing facilities (SNFs) and nursing facilities (NFs) - that choose to arrange for the provision of hospice care with one or more Medicare-certified hospices to enter into a written agreement: Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services.
This requirement closely mirrors a requirement included in the 2008 Hospice Conditions of Participation (CoP) requiring hospices to enter into written agreements with Medicare-certified SNFs and Medicaid-certified NFs when they provide hospice services to residents of those facilities. The proposed rule was published in October 2010.
The final rule reflects three changes of note over the proposed rule:
The regulation was originally issued - in proposed form - as §483.75(r). In the time between publication of the proposed rule and final additional regulations were implemented at §§483.75(r) and (s). As a result, CMS renumbered the rule as §483.75(t).
CMS has modified the regulation to ensure that long term care facilities (LTC) will immediately notify the hospice regarding the need to transfer a resident from the facility for any condition, not just for a condition related to the terminal condition, as was the case in the proposed rule.
CMS has revised the regulation to ensure that the LTC facility representative designated to work with the hospice has a clinical background. This was not specified in the proposed rule.
The final regulation is effective 60 days from publication - August 26, 2013.
Because hospices have had a longstanding requirement to have written agreements with SNFs and NFs in which they provide services, implementation of the rule may not have a dramatic impact on current hospice operations. Regardless, it is possible that facilities could begin review of their written agreements with hospices to ensure that they comply with the new requirements or have questions regarding the written agreements.