A hospice may contract out for some elements of its services. However, the core services, as set forth in s. 400.609(1), with the exception of physician services, shall be provided directly by the hospice. Any contract entered into between a hospice and a health care facility or service provider must specify that the hospice retains the responsibility for planning, coordinating, and prescribing hospice care and services for the hospice patient and family. A hospice that contracts for any hospice service is prohibited from charging fees for services provided directly by the hospice care team that duplicate contractual services provided to the patient and family.(1) A contract for hospice services, including inpatient services, must:(a) Identify the nature and scope of services to be provided.
(b) Require that direct patient care shall be maintained, supervised, and coordinated by the hospice care team.
(c) Limit the services to be provided to only those expressly authorized by the hospice in writing.
(d) Delineate the roles of hospice staff and contract staff in the admission process and patient assessment.
(e) Identify methods for ensuring continuity of hospice care.
(f) Plan for joint quality assurance.
(g) Specify the written documentation, including patient records, required of contract staff.
(h) Specify qualifications of persons providing the contract services.
(i) Specify the effective dates for the contract.
(2) With respect to contractual arrangements for inpatient hospice care:(a) Licensed beds designated for inpatient hospice care through contract between an existing health care facility and a hospice shall not be required to be delicensed from one type of health care in order to enter into a contract with a hospice, nor shall the physical plant of any facility licensed pursuant to chapter 395 or part II of this chapter be required to be altered, except that a homelike atmosphere may be required.
(b) Hospices contracting for inpatient care beds shall not be required to obtain an additional certificate of need for the number of such designated beds. Such beds shall remain licensed to the health care facility and be subject to the appropriate inspections.
(c) Staffing standards for inpatient hospice care provided through a contract may not exceed the staffing standards required under the license held by the contractee.
(d) Under no circumstances may a hospice place a patient requiring inpatient care in a health care facility that is under a moratorium, has had its license revoked, or has a conditional license, accreditation, or rating. However, a hospice may continue to provide care or initiate care for a terminally ill person already residing in such a facility.
