RG – Facility Based Care (SNF, NF and ALF)
Hospice services are provided in the patient’s residence, including the patient’s home, where the hospice team provides care to the patient, supported by the patient’s primary caregiver. A patient’s residence could also include an Assisted Living Facility (ALF). The ALF provides custodial care to the patient, while the hospice team is responsible for managing the care related to the patient’s terminal illness.
Contracts with Assisted Living Facilities. ALFs are regulated on a state level and the requirement for a contractual agreement between an ALF and a hospice vary from state to state. NHPCO recommends hospice providers secure a contractual agreement with an ALF partner even if there is no state requirement to do so.
NHPCO Member Resources and Compliance Guides
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- Q-Codes (Applicable to Medicare, not necessarily Medicaid; check with your state Medicaid requirements)
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Regulations
Nothing applicable at this time
Subregulatory Guidance
Nothing applicable at this time
Other Resources
Nothing applicable at this time
Cross Reference
Nothing applicable at this time
Alerts/Newsbriefs/Newsline
Nothing applicable at this time
Education
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- Webinars/On-Line Learning/Conferences
Nothing applicable at this time
- Podcasts
Nothing applicable at this time
- Webinars/On-Line Learning/Conferences
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Marketplace
Nothing applicable at this time
Other Resources
Hospice services in a Skilled Nursing Facility/Nursing Facility are provided in facilities where a hospice has a contractual relationship specifying the services to be provided and the manner in which the facility and hospice staff communicate to ensure the needs of residents are addressed and met 24 hours a day. While the facility retains responsibility for the custodial needs of its residents, the hospice is responsible for maintaining professional management of the resident’s hospice services in accordance with the hospice plan of care and the hospice conditions of participation.
NHPCO Member Resources and Compliance Guides
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- Partnership in Care (November 2024)
- Hospice Q-Codes
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Regulations
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- Hospice Care Code of Federal Regulations 42CFR 418
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Subpart D §418.112
Subregulatory Guidance
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- Medicare Benefit Policy Manual Chapter 9-Coverage of Hospice Services Medicare Benefit Policy Manual (cms.gov)
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20.3 Election by Skilled Nursing Facility (SNF) and Nursing Facilities (NFs) Residents and Dually Eligible Beneficiaries
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- State Operations Manual SOM - Chapter 2 - The Certification Process
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2089 – Survey Requirements When the Hospice Provides Care to Residents of a SNF/NF or ICF/IID
Other Resources
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- Nursing Facility Surveyor Guidance on Hospice. To access the most up-to-date version of this document, go to the CMS website and download the LTC Survey Pathways folder. Other nursing home survey information is available as well.
- Room & Board Statute under Social Security
- Hospice and End of Life Care and Services Critical Element Pathway (Find the most up-to-date document at CMS website. Select LTC Survey Pathways then CMS-20073 Hospice and End of Life)
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Cross Reference to other categories