Hospice services in the nursing home setting continue to be an area of surveyor focus, particularly related to coordination of care, communication between the nursing home and hospice provider, and maintaining current hospice documentation within the resident record. CMS guidance under F849 emphasizes that the nursing home and hospice must work together to ensure the resident’s care plan is coordinated, current, internally consistent, and reflective of the resident’s changing needs.
Surveyors are reviewing whether facilities maintain the most current hospice documentation in the resident record and whether staff can demonstrate ongoing communication and coordination with the hospice provider. Deficiencies are often identified when facilities are unable to produce updated hospice plans of care.
Under §483.70(n)(3)(iv), the facility’s designated interdisciplinary team member is responsible for obtaining and maintaining hospice documentation, including:
Surveyors are instructed to use the Hospice and End of Life Care and Services Critical Element (CE) Pathway along with the interpretive guidelines to determine compliance. Surveyors may review the record to determine whether the coordinated plan of care remains current and accurately reflects both the hospice services and the services being provided by the nursing home. Guidance specifically states that the coordinated plan of care must be current and internally consistent to ensure resident needs are met at all times.