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Hospice Form Contract Templates

Business Associate Agreement

$250.00   

General Inpatient Care

$250.00  

Inpatient Respite Care

$250.00   

Skilled Nursing Facility / Nursing Facility Resident

$250.00  

Medical Director

$250.00   

ENTIRE SET OF 6 CONTRACTS

$1,250.00

Hospice Physician

$250.00  

Compliant contracts are an essential component of the Office of Inspector General's (OIG) recommendations for an effective compliance program. The hospice experts at Weatherbee Resources and Arent Fox, LLP, a healthcare law firm, have created 6 Hospice Form Contract templates that allow the hospice provider and/or its legal counsel to customize each contract to include any state, federal, accreditation, or best practice language. 

 

Click here to read disclaimer information and see an abbreviated sample contract (non-editable / non-printable).

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  • Business Associate Agreement

The Business Associate Agreement (BAA) is a legal document between a healthcare provider and a contractor/vendor (e.g., pharmacy provider, medical equipment supplier, etc.) intended to communicate the parties' obligation to safeguard Protected Health Information (PHI). This legal contract satisfies Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations when the contractor/vendor has access to a hospice's PHI. This contract creates a bond of liability between the parties who create, transmit, or receive information and/or documentation that contains PHI.​

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  • General Inpatient Care Contract

General Inpatient (GIP) care and services are available to hospice patients for short-term acute or chronic pain management or other symptom crisis, provided in an inpatient facility when a patient's care cannot be managed in an alternate setting. The Centers for Medicare and Medicaid Services (CMS) has long expressed concerns about possible misuse of GIP such as: care being billed for but not provided, long lengths of stay, and beneficiaries receiving care unnecessarily. Therefore, it is vital that General Inpatient Care contracts are written in a manner compliant with state and federal regulations and contain each parties' individual and collective responsibilities related to patient care in order to avoid the risk of noncompliant practices and negative payment implications.​

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  • Inpatient Respite Care Contract

CMS defines respite care as, "... short-term inpatient care provided to the individual only when necessary to relieve the family members or the person caring for the individual at home." Weatherbee's Inpatient Respite Care contract aligns the hospice's Respite Care policies with Respite facility's procedures to ensure both parties meet the Respite needs of the patient/family, while ensuring mutual adherence to the patient's palliative Plan of Care established by the hospice.​

 

  • Skilled Nursing Facility / Nursing Facility Resident Contract

A Skilled Nursing Facility (SNF) or Nursing Facility (NF) provides medically necessary professional services from nurses, physical and occupational therapists, speech pathologists, and audiologists to hospice patients, based on the needs identified in the patient's Plan of Care. Skilled nursing facilities provide round-the-clock assistance with patients' care needs and activities of daily living. There are numerous federal regulations and OIG recommendations regarding what hospices, SNFs, and NFs must do to demonstrate compliance and receive payment from Medicare and/or Medicaid programs. Weatherbee's SNF/NF contract includes the parties' individual and collective responsibilities related to patient care while ensuring compliance with state and federal regulations.​

 

  • Medical Director and Hospice Physician Contracts  (2 separate contracts)

The Hospice Medical Director and Physician member(s) of the interdisciplinary group (Hospice Physician), in conjunction with the patient's attending physician, are responsible for the palliation and management of the needs of the hospice patient. Weatherbee's contracts for the Medical Director and Hospice Physician outline the administrative and patient care responsibilities of the physician as well as other compliance-specific elements designed to promote the highest quality of patient care.​

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When purchased individually or as a full set, each contract is an electronic, downloadable product. An email will be sent to the purchaser with instructions for downloading and accessing the contract(s). The contracts are drafted in Microsoft® Office Word format, which can be edited and/or customized to meet the unique needs of a hospice provider.

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HCN members receive a 10% discount only if the six (6) contracts are purchased as a set. Call (866) 969-7124 to verify HCN membership and order.

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Purchasers of this Hospice Form Contract are permitted to use the contractual language contained herein for one location only; pricing is available for hospices with multiple locations. No part of this contract may be reproduced in any form or by any means, electronic of mechanical including photocopying, recording or by and information storage and retrieval system and shared with third parties, without prior written permission fo Weatherbee Resources and Arent Fox, LLP. To license the Hospice Form Contract template(s) for use at more than one location, please contact Weatherbee Resources at (866) 969-7124 or email info@weatherbeeresources.com

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