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eligibility, face-to-face encounters, hospice, nurse practitioners, recertification



  1. English, Tracy Cain DNP, ARNP, FNP-BC, CHPN
  2. Mazanec, Polly PhD, ACNP-BC, AOCN, ACHPN, FPCN


The Medicare hospice benefit provides quality end-of-life care for those with a prognosis of 6 months or less to live and their families. The utilization of the benefit has increased since its implementation in 1982. Eligibility requirements and conditions of participation guide the admission and recertification of patients enrolled in hospice care. The face-to-face (FTF) requirement for hospice recertification is a major revision of the conditions of participation as of 2011. The FTF recertification process was established to deter unsubstantiated benefits for those who do not qualify for hospice care and prevent Medicare fraud. Ultimately, this process is designed to enhance the quality and delivery of hospice care to those who need it most. Hospices, practitioners, patients, and caregivers are collaborating to comply with these requirements. Nurses play an important role in the ongoing assessment and reassessment of patient status. Nurse practitioners are essential providers who can assess and document the findings relevant to the FTF recertification process. This article describes the benefits and challenges of the FTF requirement and the role nursing plays in this relatively new provision. Regulation recommendations are presented for ease of compliance.