We wanted to reach out to you in light of the new long-term care
regulations and questions you may have about your current nursing
facility services agreement. As you may be aware, on June 27, 2013,
new long term care facility regulations were
released regarding care coordination between the facility and
hospice when a resident receives hospice services. These
regulations impose responsibilities on facilities similar to those
hospices must follow at 42 C.F.R. 418.112, including the specific
requirements for the written agreement between a facility and
hospice. Importantly, with these regulations CMS also codified that
facilities are not required to contract for hospice services for
their residents, but must arrange for a transfer to another
facility if requested by a resident.
Since your nursing home partners may have questions regarding your
current agreements, we wanted to inform you that the template
Nursing Facility Services Agreement from our Hospice and Nursing
Home/Assisted Living Contracting Toolkit currently addresses the
requirements in these new regulations. Therefore, if you are using
the template, it should not need to be updated prior to the August
26, 2013 implementation of the new regulations. This is consistent
with CMS's expectations explained in commentary to the rule, in
which CMS indicated that long term care facilities "that
currently have relationships with hospice providers should already
have these written agreements in place" as the specific
contractual requirements at 42 C.F.R. 418.112 "are equivalent
to" the new specific requirements for facilities.
While our template Nursing Facility Services Agreement
contemplates these new regulations, we are in the process of
updating the Hospice and Nursing Facility/Assisted Living
Contracting Toolkit to add several new agreements and discuss this
and other recent developments in hospice-nursing home
relationships, such as the nursing facility interpretive guidelines for
end-of-life care. We are also in the process of updating our
Medical Director & Physician Contracting Toolkit and our
Medicare Hospice Appeals Toolkit. We will provide ordering
information as these toolkit updates are available.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.