We wanted to reach out to you in light of the new long-term care regulations and questions you may have about your current nursing facility services agreement. As you may be aware, on June 27, 2013, new long term care facility regulations were released regarding care coordination between the facility and hospice when a resident receives hospice services. These regulations impose responsibilities on facilities similar to those hospices must follow at 42 C.F.R. 418.112, including the specific requirements for the written agreement between a facility and hospice. Importantly, with these regulations CMS also codified that facilities are not required to contract for hospice services for their residents, but must arrange for a transfer to another facility if requested by a resident. 

Since your nursing home partners may have questions regarding your current agreements, we wanted to inform you that the template Nursing Facility Services Agreement from our Hospice and Nursing Home/Assisted Living Contracting Toolkit currently addresses the requirements in these new regulations. Therefore, if you are using the template, it should not need to be updated prior to the August 26, 2013 implementation of the new regulations. This is consistent with CMS's expectations explained in commentary to the rule, in which CMS indicated that long term care facilities "that currently have relationships with hospice providers should already have these written agreements in place" as the specific contractual requirements at 42 C.F.R. 418.112 "are equivalent to" the new specific requirements for facilities. 

While our template Nursing Facility Services Agreement contemplates these new regulations, we are in the process of updating the Hospice and Nursing Facility/Assisted Living Contracting Toolkit to add several new agreements and discuss this and other recent developments in hospice-nursing home relationships, such as the nursing facility interpretive guidelines for end-of-life care. We are also in the process of updating our Medical Director & Physician Contracting Toolkit and our Medicare Hospice Appeals Toolkit. We will provide ordering information as these toolkit updates are available. For information regarding these toolkits and other resources or to sign up to receive hospice-related alerts, please visit our Hospice and Palliative Care Practice Group website and follow us on Facebook and Twitter