Hospice Care and Nursing Facility Relationships
By Victor Montour
End of life care is critically important in the skilled nursing facility. A good hospice partner should play an important role in quality end of life care. The relationship between the hospice and the nursing facility must be defined by the medical needs of the patient.
The government is now taking aggressive action against hospices and nursing facilities that request or provide illegal compensation to influence referrals. Doing so is a direct violation of the federal anti-kickback statute (AKS) and the Federal False Claims Act (FCA). The government is now using both laws to identify, prosecute and penalize hospices and nursing facilities based on a wide range of practices that are viewed as providing incentives to the nursing facilities. Some of these practices may include.
- A hospice providing staff at its own expense to the nursing facilities to perform duties that otherwise is performed by the nursing facility staff.
- Hospices providing services at the request of the nursing facility instead of according to the medical needs of the hospice patient.
- Nursing facilities requesting and hospices providing services that are not considered hospices services, such as around the clock non-skilled companionship type services.
- Hospice offering or providing free goods or services to nursing home staff, such as gift cards or lunches.
The potential consequences of violating the AKS or FCA are immediate, severe and could threaten the continued viability of many nursing facilities and hospices. The government can suspend Medicare payments to nursing facilities and hospices if there is a “credible allegation of fraud” such as an alleged AKS or FCA violation. The nursing facility and the hospice that engage in practices that violate the AKS and FCA can be prosecuted and given severe penalties.
Hospices and nursing facilities are under increased scrutiny. Under the new regulations nursing facilities must ensure and be able to show that the services they provide to resident hospice patients are consistent with the level of care that would be provided before hospice care was started. We have seen at Front Range Hospice the annual survey process that nursing facilities receive from the state and how they are now including a detailed review of patients on hospice services.
Front Range Hospice works hard to eliminate the risk of becoming an AKS or FCA statistic by avoiding the practices described earlier in this blog and any other practices not mentioned that one could interpret as a violation of the AKS or FCA laws.
If you would like more information about Front Range Hospice or Hospice Care in a nursing facility please call 303-957-3101 or 970-776-8080 or email us at email@example.com
Watch out for our next blog: Terminal Prognosis