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03/11/2020

CMS Releases Hospice Memo on COVID-19

Late Monday night, the Centers for Medicare & Medicaid Services provided guidance for hospice agencies on COVID-19. The guidance closely mirrors previous guidance provided to nursing homes on how to screen for and manage suspected cases of COVID-19, and is consistent with other messaging issued by public health authorities on management of the disease. The memo includes recommendations on monitoring the health status of patients, residents, visitors, volunteers, and staff under their care for signs and symptoms of COVID-19.

Much of the guidance pertains to hospice inpatient units, noting that hospices should screen visitors immediately upon arrival to hospice inpatient units, following the same four criteria used to identify potential COVID-19 cases:

  • International travel to a country with sustained community transmission,
  • Signs or symptoms of respiratory infection, such as fever, cough and sore throat,
  • Contact with someone with or under investigation for COVID-19 in the past 14 days, or
  • Residing in a community where community-based spread of COVID-19 is occurring.  

Unlike nursing home guidance, hospices should determine whether to conduct diagnostic testing versus presuming a positive, in coordination with the patient, family and local health authority. Additionally, the memo outlines protocol for individuals with known or suspected COVID-19 who reside at home.

The memo also gives guidance to surveyors who find a hospice does not have adequate supply of personal protective equipment (PPE) for reasons outside of their control.

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