CMS SOM App. M, Tag L767

continue to furnish 24 hour room and board care, meeting the personal care and

nursing needs that would have been provided by the primary caregiver at home at

the same level of care provided before hospice care was elected.

Interpretive Guidelines §418.112(c)(4):

In entering into an agreement with each other, each provider retains responsibility for the

quality and appropriateness of the care it provides in accordance with their respective

laws and regulations. Both providers must comply with their applicable

conditions/requirements for participation in Medicare/Medicaid. The facility’s services

must be consistent with the plan of care developed in coordination with the hospice, (the

hospice patient residing in a facility should not experience any lack of services or

personal care because of his/her status as a hospice patient); and the facility must offer

the same services to its residents who have elected the hospice benefit as it furnishes to

its residents who have not elected the hospice benefit. If a patient is receiving services

from a Medicare/Medicaid certified nursing facility or ICF/IID, and the facility was

advised of concerns by the hospice and failed to address and/or resolve issues related to

coordination of care or implementation of appropriate services, the hospice surveyor will

refer the concerns as a complaint to the State Agency responsible for oversight of the

facility identifying the specific patient(s) involved and the concerns identified.