CMS Offers Exceptions Due To Nursing Shortage
Many hospices and their associations have notified CMS that the current shortage of nurses is having a significant impact on access to hospice services and that hospices have had to deny services to eligible patients because they do not have adequate staff to provide nursing services. Hospices have continued to request that CMS designate the current nursing shortage as an “extraordinary circumstance,” as referenced in the regulations at 42 CFR 418.64, in order to allow hospices affected by the shortage to utilize contracted nursing staff.
With the exception of physician services, a hospice must ensure that substantially all the “core services” are routinely provided directly by hospice employees. Nursing is a core hospice service. The regulations allow a hospice to use contracted staff, if necessary, to supplement hospice employees in order to meet the needs of patients during periods of peak patient loads or under extraordinary circumstances. If contracting is used, for “Core Services” (i.e. nursing) the hospice must maintain professional, financial, and administrative responsibility for the services.
The nursing shortage has been documented across the country. Due to this CMS is continuing a temporary measure to allow individual hospices to contract for nurses (i.e. Core Services) until September 30, 2014. Click on the following link to access the official memo from CMS.