CMS rule targets coordination between hospices, LTC providers

The Centers for Medicare & Medicaid Services (CMS) proposed a rule in the Federal Register last month that would revise the requirements skilled nursing facilities need to qualify for Medicare and nursing facilities for Medicaid, ModernHealthcare.com reported. The rule targets how long-term care facilities arrange hospice care provisions with Medicare-certified hospice providers.

“We believe there is a lack of clear regulatory direction regarding the responsibilities of providers in caring for [long-term care] facility residents who receive hospice care from a Medicare-certified hospice provider, which could result in duplicative or missing services,” the CMS rule stated. “We believe this problem would be remedied by a regulatory requirement for a written agreement between the two types of entities when they are both involved in the care of a Medicare beneficiary.

“A written agreement would help ensure that required services are provided to beneficiaries and protect beneficiary health and safety, which could be endangered by a lack of coordination between hospice and LTC providers.”

Under the rule, when care is provided by a Medicare-certified hospice in an LTC facility, the LTC facility would be required to meet additional requirements specific to written agreements between the two entities. The LTC facility would then need to ensure that the hospice services meet professional standards and are timely. Authorized representatives from both the hospice and LTC facility would need to sign the agreement.

CMS is accepting comments on the proposed rule through Dec. 21.

CMS releases $13 million to fight abuse in LTC facilities

To combat abuse and neglect in the nation’s long-term care facilities, CMS awarded more than $13 million to six states to design comprehensive applicant criminal background check programs for jobs involving direct patient care.

“Elder abuse and neglect is tragic and intolerable,” said HHS Secretary Kathleen Sebelius. “Workers with a history of abuse or neglect should be identified and prevented from ever working with residents of these facilities.”

The new National Background Check Program, created with funds from the healthcare reform legislation, will help identify “best practices” for long-term care providers to determine whether a job seeker has any kind of criminal history or other disqualifying information that could make him or her unsuitable to work directly with residents.

The first round of states to participate in the program include: Alaska, Connecticut, Delaware, Florida, Missouri, and Rhode Island. They each will share a portion of $13.7 million. An additional 11 states applied and may be funded.

The new law set aside $160 million for the program, which is to run through September 2012, an amount sufficient to enable all states to participate.

The national background check for each prospective direct patient care employee must include a criminal history search of both state and federal abuse and neglect registries and databases, such as the Nurse Aide Registry or FBI files.

Long-term care facilities or providers covered under the new program include nursing facilities, home health agencies, hospice providers, long-term care hospitals, and intermediate care facilities for persons with mental retardation, and other entities that provide long-term care services.

‖ The 1.7 million Medicare beneficiaries in LTC facilities during 2006 cost the program $25 billion, with nearly 40% of that cost going toward hospitalization expenses, according to reports from the Kaiser Family Foundation ‖ HHS has released $68 million in grants to aid seniors, disabled persons, and caregivers in navigating long-term care options ‖

Long-Term Living 2010 November;59(11):12-13

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