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Facility Based Care (SNF, NF and ALF)

Regulatory & Compliance Center

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Introduction

Hospice care maybe provided wherever the patient calls home including SNF, NF, ALF and ICF/IID.

Care provided in SNF/NF and ICF/IID must be provided under a specific written agreement between the facility and the hospice.  This agreement includes a care coordination component and other specific requirements.

Most states have a NF Medicaid room and board pass through a hospice must follow.

This section provides resources on the different types of facilities, contracting, partnerships, risk areas and Q codes.

Assisted Living Facility (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 Assisted Living Facility 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. Assisted Living facilities 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 that 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

      • Q-Codes (Applicable to Medicare, not necessarily Medicaid check with your state Medicaid)

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

      • Webinars/On-Line Learning/Conferences
        Nothing applicable at this time
      • Podcasts
        Nothing applicable at this time

Marketplace
Nothing applicable at this time

Other Resources

Skilled Nursing Facilities (SNF), Nursing Facility (NF) and ICF/IID

Hospice services in a Skilled Nursing Facility/Nursing facility are provided in facilities where a hospice has a contractual relationship that specifies the services that will be provided and the manner in which the facility and hospice staff communicate to ensure that 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

Regulations

      • Hospice Care Code of Federal Regulations 42CFR 418

Subpart D §418.112

Subregulatory Guidance

20.3 Election by Skilled Nursing Facility (SNF) and Nursing Facilities (NFs) Residents and Dually Eligible Beneficiaries

2089 – Survey Requirements When the Hospice Provides Care to Residents of a SNF/NF or ICF/IID

Other Resources

Cross Reference to other categories

Marketplace

      • The Essential Hospice-Facility Contracting Resource (pdf)
        The Essential Hospice-Facility Contracting Resource: Inpatient, Respite, Nursing Home and Assisted Living Arrangements. The Essential Hospice-Facility Contracting Resource is a must-have for every hospice. The additional insights and contracting tips equip you to strategically respond to the changing regulatory landscape—while saving you time, resources and money.

Have a question or find a broken link? Email us at Regulatory@NHPCO.org.