'Extraordinary' nursing shortage forces CMS to extend staffing exemption for hospice

Hospice agencies hit by the ongoing nursing shortage can continue using contracted staff due to “extraordinary circumstances,” the Centers for Medicare & Medicaid Services has announced.

The Bureau of Labor Statistics forecast that the nursing shortage will persist through 2024, despite “faster than average” job growth rate in the industry, CMS said in a memo sent to state survey agency directors on Friday.

Regulations typically require that “core services” provided by hospice agencies be carried out directly by hospice employees, except under “extraordinary circumstances” when hospice providers may use contracted staff to supplement their own employees, CMS said. That “extraordinary” exemption will now be extended through Sept. 30, 2018.

“CMS finds that it is necessary to continue to allow hospice agencies to elect this exemption to contract for nurses if the agency can demonstrate that the nursing shortage is creating an extraordinary circumstance that prevents it from hiring an adequate number of nurses directly,” the memo reads.

A previous exemption, announced in 2014, was set to run through Sept. 30 of this year. The exemption does not include counseling services or medical social services, CMS noted.