Del. Medical Assistance Program Hospice Provider Specific Policy Manual § 6.1

6.1.1 When hospice care is furnished to an individual residing in a nursing facility an

additional reimbursement is made to the hospice on routine home care and

continuous home care days to take into account the room and board furnished by

the facility.

• Payment for Room and Board in a Nursing Facility (NF) or Intermediate Care

Facility / Individuals with Intellectual Disability (ICF/IID) - For Medicaid

beneficiaries who elect to receive hospice care while residing in a nursing

facility or ICF/IID facility, in addition to the payment for routine care or

continuous care referenced above, the hospice provider will also be

reimbursed a per diem amount to cover room and board services provided by

the nursing facility or ICF/IID facility. This reimbursement rate is equal to 95

percent of the base rate that would have been paid to the facility under DMAP

policy.

• In this context, the term ‘room and board’ includes performance of personal

care services, including assistance in the activities of daily living, in

socializing activities, administration of medication, maintaining the cleanliness

of a resident’s room, and supervision and assisting in the use of durable

medical equipment and prescribed therapies.

6.1.2 It is the responsibility of the hospice organization to ensure that the hospice

patient is placed in an appropriately certified nursing facility bed. If Medicaid is

reimbursing hospice for nursing home room and board, the hospice patient must

be placed in a Medicaid certified bed.

6.1.3 All Medicaid members/applicants entering a Nursing Facility (NF) must be

processed through the Medicaid Pre Admission Screening/Central Intake Unit. It

is the responsibility of the hospice organization to contact this unit prior to

placement of a patient in a nursing home. This unit can be reached by dialing 1-

866-940-8963.