US · guidance
CMS SOM App. M, Tag L823
§418.110(b)(2) - If at least one patient in the hospice facility is receiving general
inpatient care, then each shift must include a registered nurse who provides direct
patient care.
Interpretive Guidelines §418.110(b)(2)
The general inpatient care provided in a facility for pain control or acute or chronic
symptom management, which cannot be managed in other settings, is a different level of
care than respite care. It is not automatically necessary to have an RN assigned to every
shift to provide direct patient care if the only hospice patients in a facility are receiving
the respite or routine levels of care. Staffing for a facility solely providing the respite or
routine home care levels of care to hospice patients should be based on each patient’s
care needs. The requirements for nursing services for respite care are located at
§418.108(b)(2).
History
Rev. 210; Issued:02-03-23; Effective:02-03-23; Implementation:02-03-23
Provenance
- Source
- cms.gov
- Retrieved
- 2026-07-22
- Edition
- som-2026-07-22
- Content hash
d9025b32f746757bef5f689c8a392ecd71431eea14238bc4b14ee8e609e63ebc
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