CMS SOM App. M, Tag L667

The medical director or physician designee reviews the clinical information for each

hospice patient and provides written certification that it is anticipated that the

patient’s life expectancy is 6 months or less if the illness runs its normal course. The

physician must consider the following when making this determination:

(1) The primary terminal condition;

(2) Related diagnosis(es), if any;

(3) Current subjective and objective medical findings;

(4) Current medication and treatment orders; and

(5) Information about the medical management of any of the patient’s conditions

unrelated to the terminal illness.

Interpretive Guidelines §418.102(b)

• The medical director or physician designee (who is a hospice employee or

under contract with the hospice) has the responsibility for the medical

component of the hospice’s patient care program, including initial

certifications and recertification of terminal illness.