CMS Issues Extension for Hospices Hiring Contract Nurses

The Centers for Medicare & Medicaid Services (CMS) has extended the period of time hospices can hire contract nurses as long as they qualify for an “extraordinary circumstance” exemption, the agency announced in a memorandum recently.

Under normal circumstances, a hospice must ensure that all core services — including nursing — are provided directly by hospice employees. However, a continued nationwide shortage in nurses has led to hospices using contracted nursing staff to fill a void in services.

Findings from the Bureau of Labor Statistics continue to forecast a shortage of nurses through 2022, with a job growth rate that is faster than the average: 19%, compared to 11% for all occupations.


So through Sept. 30, 2016, if a hospice can demonstrate that the staffing shortage is creating an extraordinary circumstance that prevents it from hiring an adequate number of nurses directly, it will be allowed to contract for nurses, CMS states.

In order to qualify for an extraordinary circumstance exemption, a hospice must notify the State Survey Agency (SA) responsible for licensing and certification that it intends to elect an exception under the extraordinary circumstance authority.

Written notification must be provided to the SA when the hospice believes the nursing shortage has affected its ability to hire nurses directly, and it must estimate the number of nurses it will need to employ under contract.


CMS will re-evaluate the employment market for nurses prior to Sept. 30, 2016, to see if this policy should be further extended.

To read the CMS memorandum, click here.

Written by Emily Study

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