On June 27, 2013, CMS published its final rule for hospice agreements with long-term care (“LTC”) providers. LTC facilities are now required to have written agreements specifying what services the hospice and LTC provider will provide to nursing home residents receiving hospice care. This new Condition of Participation (CoP) aims to improve the quality and consistency of care between LTC and hospice providers by specifically defining responsibilities and roles. The agreement must be signed by authorized representatives for both the LTC facility and hospice before hospice care can be provided to patients. The effective date is August 26, 2013.

In a July 2011 report, the Office of Inspector General criticized the duplication of services that often resulted from the two entities’ overlapping care. The final rule emphasizes communication and coordination between the providers to avoid such duplication. Some provisions the agreement must address are:

• The services the hospice will provide

• The hospice’s responsibilities for determining the appropriate hospice plan of care

• The services the LTC facility will continue to provide

• A communication process to ensure residents’ needs are met 24 hours a day

In addition to these provisions, the final rule also increases patient transfer notification requirements for LTC facilities and requires the providers to have an interdisciplinary contact person within the facility to handle hospice patient care.

LTC and hospice providers should act immediately to comply with this CoP by August 26, 2013. Failure to do so can result in sanctions. Delineating roles may result in challenging operational issues and require both providers to internally review what the best method is for offering patient care.