Home Health & Hospice Week

Note these key revisions in Chapter 2.

The Centers for Medicare & Medicaid Services released a plethora of changes to the nursing home RAI Manual last month — don’t let substantive revisions to hospice benefit instructions get lost in the mix.

Your nursing home partners may appreciate a heads up letting them know about the hospice-related changes. On page 21 (Section 2.6) of the updated RAI Manual v1.12 released on Sept. 15, CMS clarifies how to handle hospice election: “If a resident is admitted on the hospice benefit (i.e. the resident is coming into the facility having already elected hospice), or elects hospice on or prior to the ARD of the Admission assessment, the facility should complete the Admission assessment, checking the Hospice Care item, O0100K. Completing an Admission assessment followed by a SCSA is not required. Where hospice election occurs after the Admission assessment ARD but prior to its completion, facilities may choose to adjust the ARD to the date of hospice election so that only an SCSA is not required.”

And on page 22 (Section 2.6), CMS added a bullet point and revises another under “Assessment Management Requirements and Tips for Significant Change in Status Assessments,” which begins on page 20: “If a resident is admitted on the hospice benefit but decides to discontinue it prior to the ARD of the Admission assessment, the facility should complete the Admission assessment, checking the Hospice Care item, O0100K. Completing an Admission assessment followed by a SCSA is not required. Where hospice revocation occurs after the Admission assessment ARD but prior to its completion, facilities may choose to adjust the ARD to the date of hospice revocation so that only the Admission assessment is required. In such situations, an SCSA is not required.

“The ARD must be less than or equal to 14 days after the IDT’s determination that the criteria for a SCSA are met (determination date + 14 calendar days).”

Resources: To access the RAI Manual v1.12 replacement pages and change tables, go to

www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html. Scroll down to the bottom of the web page and click on the links in the “Downloads” section.