HOPE Guidance Manual v1.02, Item A0215

Timepoint(s) Item Completed

Admission (ADM)

Item-Specific Instructions

• Code 01, Patient's Home/Residence, if the patient received hospice care in their home/residence at

the time of admission.

o This would include a patient receiving hospice care in the private home/residence of a family

member or caregiver.

• Code 02, Assisted Living Facility, if the patient received hospice care in an ALF at the time of

admission.

• Code 03, Nursing Long-Term Care (LTC) or Non-Skilled

Nursing Facility (NF), if the patient received hospice care in a

LTC or NF at the time of admission.

• Code 04, Skilled Nursing Facility (SNF), if the patient

received hospice care in a SNF at the time of admission.

• Code 05, Inpatient Hospital, if the patient received hospice

care in an Inpatient Hospital at the time of admission.

• Code 06, Inpatient Hospice Facility (General Inpatient

[GIP]), if the patient received hospice care in an Inpatient

Hospice Facility, e.g., GIP at the time of admission.

• Code 07, Long Term Care Hospital (LTCH), if the patient received hospice care in an LTCH at the

time of admission.

• Code 08, Inpatient Psychiatric Facility, if the patient received hospice care in an Inpatient

Psychiatric Facility at the time of admission.

• Code 09, Hospice Home Care (Routine Home Care [RHC]) Provided in a Hospice Facility,

if the patient received hospice home care (Routine Hospice Care level or RHC) provided in a hospice

residence or inpatient hospice facility at the time of admission.

• Code 99, Not listed (none of the above), if the patient received hospice care in a location not

listed.

Coding Tips

• Codes for Item A0215 are structured to match sites of service found on Medicare claims.

o Because the site of service must be identified on Medicare claims for the initial level of care billed,

identifying the site of service the same way when completing this item can reduce the administrative

burden for the hospice.

• For purposes of completing Item A0215, SNF is not synonymous with nursing facility.

• If a beneficiary is in a nursing facility but does not meet the SNF criteria above, use the code for nursing

long-term care (LTC) (also known as NF or non-skilled nursing facility).

Examples

1. The patient was admitted to an inpatient hospice facility from the community for aggressive pain

management and end-of-life care.

Coding: Code 06, Inpatient Hospice Facility.

Rationale: The patient was receiving hospice care in an Inpatient Hospice Facility at the GIP level of

care at the time of admission.

2. A patient with late-stage pancreatic cancer was unable to return home due to no available caregiver.

They were admitted from the hospital directly to an available bed at the local hospice house. At the time

DEFINITION

SKILLED NURSING

FACILITY (SNF, swing bed)

A nursing facility with staff

and equipment for the

provision of skilled nursing

services, skilled rehabilitative

services, and/or other related

health services.

of admission, the patient’s condition is poor. Their symptoms are well managed, and they do not meet

the GIP level of care requirements. They are placed on RHC level of care at the hospice house.

Coding: Code 09, Hospice Home Care (Routine Home Care (RHC)) Provided in a Hospice Facility.

Rationale: Although the patient resides in the hospice house, they are receiving hospice home care

services (RHC level) at the time of the admission.