Ind. IHCP Hospice Services Provider Reference Module, Section 6, Continuous Home Hospice Care

Continuous home hospice care is provided only during a period of crisis. A period of crisis occurs when a

patient requires continuous care, primarily nursing care, to achieve palliation and management of acute

medical symptoms. A minimum of eight hours of care must be provided during a 24-hour day that begins

and ends at midnight. A registered nurse or a licensed practical nurse must provide care for more than half

the total period of care. This care need not be continuous and uninterrupted. If le ss skilled care is needed on

a continuous basis to enable the member to remain at home, this service is covered as routine home hospice

care.

Delivered in the Home

The continuous home care rate is divided by 24 hours to arrive at an hourly rate. For every hour or part of

an hour of continuous care furnished in the home (any residential setting other than a nursing facility), the

hourly rate is reimbursed to the hospice provider for up to 24 hours a day.

Delivered in a Nursing Facility

The continuous home care rate for services delivered in a nursing facility is divided by 24 hours to arrive at

an hourly rate. For every hour or part of an hour of continuous care furnished, the hourly rate is reimbursed

to the hospice provider up to 24 hours a day.

In addition, the hospice provider is paid an additional room and board per diem at 95% of the single

nursing facility case-mix rate to cover costs incurred by the contracted nursing facility.