Ind. IHCP Hospice Services Provider Reference Module, Section 1, Assisted Living Facility

Assisted living facilities that are registered with the FSSA as Housing with Services Establishments, and

that provide services such as room, meals and limited assistance with activities of daily living, are not

required to be licensed. In the state of Indiana, an assisted living facility that provides residential nursing

care or administers medications prescribed by a physician must be licensed as a residential care facility. .

Residential care facilities are licensed under Indiana Code IC 16-28 and may provide minimal care to

residents. IDOH regulations for residential rules are found on the Residential Care page at in.gov/health.

Hospice providers should provide all hospice services as though the patients are in their own home. If the

hospice is working with a licensed residential care facility, see the criteria found in 42 CFR 418.112(c).

The qualifications of staff available at the licensed residential care facility should be verified if staff

members are to administer medications.

Case-specific survey questions regarding hospice care should be directed to th e IDOH Acute Care Unit

at 317-233-7474. Case-specific issues regarding assisted living and residential care facilities should be

directed to the IDOH Long Term Care Unit at 317-233-7442.

IHCP hospice authorization is not required for dually eligible members residing in assisted living facilities

or receiving assisted living services under the Indiana PathWays for Aging (PathWays) Waiver or the

Health and Wellness (H&W) Waiver. Reimbursement requires the hospice to bill Medicare or Medicaid for

the hospice per diem. The assisted living facility is reimbursed by the member for room and board.