R.I. Medicaid Provider Manual, Hospice Services 300-20, DHS Responsibility

The Long Term Care Regional Offices are responsible for determinations and redeterminations of eligibility for Medical Assistance. The LTC offices are responsible for determining the patient’s contribution towards the cost of their care in a nursing facility. The LTC offices are also responsible to notify the patient of the contribution due from the patient towards the cost of their care in a nursing facility. The Office of Medical Review (OMR) of EOHHS is responsible for a level of care and disability determinations, if required, for any Long Term Care service and for the oversight and monitoring of said services.

For cases already active with LTC in a Nursing Facility, a Discharge and Admission Notice must be received by the LTC office, from both the Hospice Provider and the Nursing Facility. When an individual is admitted to Hospice Care, the nursing home provider payment is ended.

Upon receipt of notification from the Nursing Facility that the individual is no longer receiving Hospice Care but is still in residence at the facility, the provider payment will be reinstated.