DOH Issues DAL to Extend Hospice Nursing Contract Exemption

The Department of Health (DOH) has issued Dear Administrator Letter (DAL) DHCBS 19-03 informing hospices that the Centers for Medicare and Medicaid Services (CMS) has extended its designation of the national nursing shortage as an “extraordinary circumstance” for an additional two years, through Sept. 30, 2020. This designation allows hospices that are unable to employ a sufficient number of nurses due to the national nursing shortage to utilize contracted staff in addition to their full-time nursing staff in order to meet the needs of their patients. This does NOT apply to counseling services, medical social services, and other core hospice services.

Per 42 CFR §418.64, in these intermittent and/or temporary situations, the hospice provider is allowed to utilize contract staff to supplement direct staff, and a waiver or exemption from CMS or DOH is not required. CMS is eliminating the previous requirement that hospices submit justification to the Department to qualify for the exemption based on the national nursing shortage. However, hospices continue to be required under 10 NYCRR §793.7(c) to notify DOH when there are extraordinary or other non-routine circumstances other than the national nursing shortage and nursing contracting is needed.

If you have any questions, or to notify the Department of the need to contract for nurses, please contact the Division of Home and Community Based Services at homecare@health.ny.gov.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871