[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR418.56]



[Page 918]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 418_HOSPICE CARE--Table of Contents

 

      Subpart C_Conditions of Participation_General Provisions and 

                             Administration

 

Sec. 418.56  Condition of participation--Professional management.



    Subject to the conditions of participation pertaining to services in 

Sec. Sec. 418.80 and 418.90, a hospice may arrange for another 

individual or entity to furnish services to the hospice's patients. If 

services are provided under arrangement, the hospice must meet the 

following standards:

    (a) Standard: Continuity of care. The hospice program assures the 

continuity of patient/family care in home, outpatient, and inpatient 

settings.

    (b) Standard: Written agreement. The hospice has a legally binding 

written agreement for the provision of arranged services. The agreement 

includes at least the following:

    (1) Identification of the services to be provided.

    (2) A stipulation that services may be provided only with the 

express authorization of the hospice.

    (3) The manner in which the contracted services are coordinated, 

supervised, and evaluated by the hospice.

    (4) The delineation of the role(s) of the hospice and the contractor 

in the admission process, patient/family assessment, and the 

interdisciplinary group care conferences.

    (5) Requirements for documenting that services are furnished in 

accordance with the agreement.

    (6) The qualifications of the personnel providing the services.

    (c) Standard: Professional management responsibility. The hospice 

retains professional management responsibility for those services and 

ensures that they are furnished in a safe and effective manner by 

persons meeting the qualifications of this part, and in accordance with 

the patient's plan of care and the other requirements of this part.

    (d) Standard: Financial responsibility. The hospice retains 

responsibility for payment for services.

    (e) Standard: Inpatient care. The hospice ensures that inpatient 

care is furnished only in a facility which meets the requirements in 

Sec. 418.98 and its arrangement for inpatient care is described in a 

legally binding written agreement that meets the requirements of 

paragraph (b) and that also specifies, at a minimum--

    (1) That the hospice furnishes to the inpatient provider a copy of 

the patient's plan of care and specifies the inpatient services to be 

furnished;

    (2) That the inpatient provider has established policies consistent 

with those of the hospice and agrees to abide by the patient care 

protocols established by the hospice for its patients;

    (3) That the medical record includes a record of all inpatient 

services and events and that a copy of the discharge summary and, if 

requested, a copy of the medical record are provided to the hospice;

    (4) The party responsible for the implementation of the provisions 

of the agreement; and

    (5) That the hospice retains responsibility for appropriate hospice 

care training of the personnel who provide the care under the agreement.



[48 FR 56026, Dec. 16, 1983; 48 FR 57282, Dec. 29, 1983]