Del. Medical Assistance Program Hospice Provider Specific Policy Manual § 2.3

2.3.1 Continuous Home Care is to be provided only during a period of crisis. A period

of crisis is a period in which a patient requires continuous care which is primarily

nursing care to achieve palliation or management of acute medical symptoms.

Nursing care must be provided by either a registered nurse or a licensed

practical nurse and a nurse must be providing care for more than half of the

period of care. A minimum of 8 hours of care must be provided during a 24-hour

day that begins and ends at midnight. This care need not be continuous, i.e., 4

hours could be provided in the morning and another 4 hours provided in the

evening of that day. Homemaker and aide services may also be provided to

supplement the nursing care. Continuous home care is covered when it is

provided to maintain an individual at home during a medical crisis. If less skilled

care is needed on a continuous basis to enable the person to remain at home,

this is covered as routine home care.

2.3.2 Respite care is short-term inpatient care provided to the individual only when

necessary to relieve the family members or other persons caring for the

individual at home. Respite care may be provided only on an occasional basis

and may not be reimbursed for more than five consecutive days at a time.

Respite care may not be provided when the hospice patient is a nursing home

resident.

2.3.3 Bereavement counseling consists of counseling services provided to the

individual’s family after the individual’s death. Bereavement counseling is a

required hospice service but it is not reimbursable.