Hospices

This page provides basic information about being certified as a Medicare and/or Medicaid hospice provider and includes links to applicable laws, regulations, and compliance information. 

A hospice is a public agency or private organization or a subdivision of either that is primarily engaged in providing care to terminally ill individuals, meets the conditions of participation for hospices, and has a valid Medicare provider agreement.

Hospice care is an approach to caring for terminally ill individuals that stresses palliative care (relief of pain and uncomfortable symptoms), as opposed to curative care. In addition to meeting the patient’s medical needs, hospice care addresses the physical, psychosocial, and spiritual needs of the patient, as well as the psychosocial needs of the patient’s family/caregiver. The emphasis of the hospice program is on keeping the hospice patient at home with family and friends as long as possible. 

Although some hospices are located as a part of a hospital, nursing home, and home health agency, hospices must meet specific Federal requirements and be separately certified and approved for Medicare participation.

A hospice may use contracted staff for core services only under extraordinary circumstances (i.e., to supplement hospice employees in order to meet patients’ needs during periods of peak patient load.)  If contracting is used, the hospice must continue to maintain professional, financial, and administrative responsibility for the services in accordance with current regulations and policy.

Survey protocols and Interpretive Guidelines are established to provide guidance to personnel conducting surveys. They serve to clarify and/or explain the intent of the regulations and all surveyors are required to use them in assessing compliance with Federal requirements. The purpose of the protocols and guidelines is to direct the surveyor’s attention to certain avenues for investigation in preparation for the survey, in conducting the survey, and in evaluation of the survey findings.

The hospice survey is conducted in accordance with the appropriate protocols and substantive requirements in the statute and regulations to determine whether a citation of non-compliance is appropriate. Deficiencies are based on a violation of the statute or regulations, which, in turn, is to be based on observations of the hospice’s performance or practices. 

The Interpretive Guidelines include three parts:

• The first part contains the survey tag number. 
• The second part contains the wording of the regulation. 
• The third part contains guidance to surveyors, including additional survey procedures and probes.