MDS Alert

What Do You Think?:

Do Nursing Homes and Hospices Need a Single Plan of Care for Residents Receiving Medicare Hospice Care?

Answer: "While the hospice and facility need to develop a coordinated plan of care, it does not need to be in a single document," says attorney Meg Pekarse, with Reinhart Boerner Van Deuren in Madison, Wis. "CMS has provided guidance indicating that the plan of care can be separated into different sections -- one maintained by the facility and the other maintained by the hospice. Each party is required to update their portion of the care plan in accordance with their applicable legal requirements."

The hospice and nursing home should review and share their care plan updates with one another, Pekarske adds. "If done correctly, it should be clear to any one reviewing the documents, such as surveyors, the role and responsibilities" of the hospice and nursing home.

Tip: Cherry Meier, RN, MSN, instructs hospice nurses at her organization to meet with the MDS coordinator upon the patient's admission and talk about the care plan. "That way, the hospice [and nursing facility] are on the same page from the beginning," says Meier, with VITAS Healthcare Corp. in Flat Rock, N.C.

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