On August 26, 2013, 42 CFR 483.75(t) will go into effect and place new requirements for contracts between hospice providers and nursing facilities.
Often times the provisions regulating the services a nursing facility must provide and the services a hospice provider must provide do not overlap or conflict. There is only problem when a nursing home resident elects to receive services from a hospice provider. Then there is usually some overlap between the services provided by the nursing facility and the services provided by hospice. The Centers for Medicare and Medicaid Services (CMS) issued a ruling in late June that addressed this issue.
The ruling requires that when nursing facilities contract with hospice providers, the contract must be in writing and specifically detail the roles and responsibility of each entity. This is to ensure that the resident is receiving all necessary services, but not receiving any duplicate or conflicting services. This will establish better quality and consistency of care for the residents. Also, the contract will have to lay out communication and coordination processes to ensure that each group is maintaining their end. The new rule did establish that the nursing home facility’s interdisciplinary team will act as the point of contact for the hospice care.
CMS expects these changes to have an initial impact of $437 per facility and then $232 after it is implemented. CMS did not determine this to be a significant impact.
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