Question: Our facility is starting a palliative care program. Should the MDS team do a significant change assessment for all residents who go on palliative care, as is required for residents going on hospice? Should we do an SCSA for palliative care patients as their condition deteriorates toward the end of life?
Answer: "The requirements for SCSAs as they related to hospice apply only to a 'Medicare hospice or other structured hospice,'" advises Rena Shephard, MHA, RN, RACMT, C-NE, president and CEO of RRS Healthcare Consulting Services in San Diego. "The purpose of these hospice-related SCSAs is to ensure care planning collaboration with the hospice agency," Shephard says. "This requirement would not apply to a facility's palliative care program. The resident's care plan must be appropriate and up-to-date at all times, but it is not necessary to complete an SCSA as long as the terminal resident's decline is related to the expected course of the disease process."