Hospice/Nursing Home Interface
Guidelines for Care Coordination for Hospice Patients
Who Reside in Nursing Homes
PDF Version of Guidelines
(PDF, 76 KB)
Jointly prepared by the Hospice Organization and
Palliative Experts (HOPE) of Wisconsin; Wisconsin Department of Health Services
(DHS), Division of Supportive Living (DSL), Division of
Quality Assurance (DQA); The Wisconsin Health Care Association; and The
Wisconsin Association of Homes and Services for the Aging
Second edition - October 2001
TABLE OF CONTENTS
Section I - Introduction and Background
Section II - Regulatory References
Section III - Contract Considerations
Section IV - Clinical Protocol Development
Section V - Guidelines for Inservice/Education Planning
Section VI - Conclusion and Acknowledgments
SECTION I - INTRODUCTION AND BACKGROUND
Persons who are eligible to access their hospice entitlement have the
right to receive those services in their primary place of residence.
For some persons, their chosen "home" is a skilled nursing
facility. This document serves as guidelines for hospice and skilled
nursing home providers when jointly serving hospice patients who choose to
reside in skilled nursing facilities.
The collaboration of hospice and skilled nursing facility providers
takes careful planning. In 1995, a task force consisting of
representatives of the hospice and nursing home industries published the
first edition of this document. The Division of Quality Assurance,
State of Wisconsin, reviewed the copies of the guidelines, and found it
did not conflict with the intent of hospice and nursing home
regulations. The first edition was widely distributed on a state and
national basis.
Since 1995, the hospice and nursing home industry has learned a great
deal about developing and refining the process to maximize the expertise
available through a collaborative partnership. Based on our
collective experience, the second edition of the Guidelines for Care
Coordination for for Hospice Patients Who Reside in Skilled Nursing Homes
Facilities was created. Hospice and nursing home provider
representatives edited this second edition of the guidelines.
The Wisconsin Department of Health Services, Division of
Supportive Living, Division of Quality Assurance, assisted in reviewing and
editing the guidelines. These guidelines are not a regulatory requirement,
but it is consistent with federal and state regulations if properly
implemented. It is intended as a tool for quality improvement that
providers can integrate into their policies, procedures and clinical
practice. The document is not a "blueprint" for providers. The
guidelines offer a framework to structure joint relationships to promote
regulatory compliance and the mission of both hospice and nursing home
providers in service to a common patient and their family at the
end-of-life.
The Hospice Organization and Palliative Experts (HOPE) of Wisconsin has
made this edition of the Guidelines available to providers for
reproduction as needed. This guideline will also be made available on the
Department of Health Services (DHS) web site at: http://www.dhs.wisconsin.gov/rl_DSL/Hospice/HospiceIntro.htm
SECTION II - REGULATORY REFERENCES
Protocols and guidelines outlined in this document were developed with
consideration for existing state and federal regulations.
References include:
-
Wisconsin Statutes, Chapter 50
(exit DHS)
-
Wisconsin Administrative Code,
Chapter HFS
131 (exit DHS), Hospices
-
Wisconsin Administrative Code,
Chapter HFS
132 (exit DHS), Nursing Home Rules
-
Division of Quality Assurance Memo BQC 96-025, "Waiver of Chapter
HSS132, Wisconsin Administrative Code, for Nursing Home Residents
Electing Hospice Services."
-
42 Code of Federal Regulation
(exit DHS) (CFR) Part 418, Hospice
-
Social Security Act Section 1861(dd)
-
Centers for Medicare and Medicaid Services (CMS), formerly known as
Health Care Financing Administration (HCFA), State Operations
Manual
(exit DHS)
(Transmittal 265, dated 12/1994 and transmittal 23, dated 12/8/2000)
and Appendix M, Hospice Survey Procedures and Interpretive Guidelines.
-
42 CFR Part
483 (exit DHS), Medicare and Medicaid; Requirements for Long
Term Care Facilities
-
HCFA Long Term Care Resident Assessment Instrument User’s
Manual (exit DHFS),
Version 2.0 (Wisconsin Edited: April 1998/October 1999/August 2000)
PSL-3109
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