CMS Proposes Changes to Survey Process Related to the Provision of Hospice Services

The Centers for Medicare and Medicaid Services (CMS) are in the process of drafting interpretive guidance and survey protocols regarding the provision of hospice services in nursing homes.  A new F-Tag, F525, is being created that looks at the provision or arrangement of hospice services for nursing home residents and focuses on the nature of the agreement between a nursing home and a hospice provider.  There is no requirement that a nursing home offer hospice services, but if an agreement does not exist between the nursing home and hospice provider, the nursing home must assist the resident in transferring to a facility that will arrange for hospice services when the resident requests such services. 

Guidance under F309 is being revised for the review of residents at or approaching the end of life.  The changes involve the inclusion of hospice care and also, as has been the case with CMS guidance, contains a detailed investigative protocol as well as guidance on deficiency categorization. 

Appendix P has been revised to include individuals receiving hospice services in the sample when a traditional survey is conducted.  In the QIS survey hospice residents are already included.

Contact:  Elliott Frost, efrost@leadingageny.org, 518-867-8832