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Hospices can continue to rely on contract nurses because an ongoing nurse shortage is preventing providers from meeting their staffing needs, the Centers for Medicare & Medicaid Services announced in a recent memorandum to state survey agencies.

Under normal conditions, only direct hospice employees are allowed to provide “core services” such as nursing, the memo states. However, hospices may utilize contracted staff when facing “extraordinary circumstances.” The Bureau of Labor Statistics has identified a nurse shortage, which CMS already has been considering an extraordinary circumstance. Hospices that are struggling with hiring already have been turning to contracted nurses, and this will remain an option at least through Sept. 30, 2016, under the extension.

In order to qualify, hospices must provide written notification to their State Survey Agency and meet various requirements. For example, they must furnish evidence that they have made a good faith effort to hire nurses directly, and must show that their wages and benefits are competitive for their area. The provider also must have a robust program in place to ensure that the contracted nurses are trained in the “hospice philosophy.”

CMS does not anticipate that hospices in every part of the country will be affected by the nurse shortage, according to the memo. The measure also does not apply to counseling and medical social services.

Click here to access the complete document, dated Oct. 3.