Home Health & Hospice Week

Start working on your nursing home contracts now.

Big changes are afoot for hospices serving patients in nursing homes, thanks to the newly finalized hospice conditions of participation.

One of the new CoPs applies only to hospices that service nursing home residents, which is a first, notes attorney Mary Michal with Reinhart Boerner Van Deuren in Madison, WI. The Centers for Medicare & Medicaid Services issued the new CoPs in the June 5 Federal Register.

"The interface between hospices and nursing homes is complicated and has been a subject of regulatory scrutiny for many years," notes Michal in a summary of the new regulation. "While the new CoPs do provide some specific bright-line rules for hospices to follow in their relationships with nursing homes, this continues to be a complex area," she warns.

Hospices will have to add language about the new requirements in their written agreements with nursing homes, "necessitating significant amendments to existing contracts," says the National Hospice and Palliative Care Organization in its rule summary.

Hot spots: Nursing home CoP changes center on coordination of care, the plan of care and professional management, among other items.

"The time to discuss these changes and negotiate new contract language is now," Michal urges. Contracts with nursing homes will probably take longer to negotiate than new medical director and pharmacist ones the CoPs also will require, she cautions.

Only fair: Hospices are eager for CMS to issue new CoPs for nursing homes that contain the same rules, notes hospice consultant Heather Wilson with Weatherbee Resources in Hyannis, MA. "Given the inconsistencies between this new COP and the SNF regulations, compliance is going to be really challenging," Wilson predicts.

CMS' nursing home CoP rule is in clearance, NHPCO's Judi Lund Person reports. "We are pleased with the new information on hospice care in the nursing home," Person tells Eli. But "we are anxious to have a companion rule in the nursing home conditions of participation."