UT · guidance
Utah Medicaid Provider Manual, Hospice Care Services § 8-2
Nursing Facilities or Intermediate Care Facilities for people with Intellectual Disabilities (ICFs/IS)
When an individual residing in a nursing facility or ICF/ID elects hospice care, the
hospice and the facility must enter into a written agreement which defines the
roles and responsibilities of each entity. The hospice agency is responsible for
professional management of the member’s hospice care and the facility agrees
to provide room and board. Room and board include all services typically
administered in a nursing facility, including assistance in the activities of daily
living, in socializing activities, administration of medication, maintaining the
cleanliness of a member’s room, and supervising and assisting in the use of
durable medical equipment and prescribed therapies.
An agreement between the hospice agency and the nursing facility must include
the requirements found in 42 CFR 418.112.
For a member receiving hospice care, while residing in a nursing facility, it is the
responsibility of the hospice agency to notify the nursing facility of a hospice
revocation per 42 CFR 418.28. The notice must be in writing and the hospice
agency must provide it to the nursing facility on or before the revocation date.
Hospice agencies are reimbursed in accordance with the methodology found in
the State Plan for members residing in nursing facilities and ICF/ID.
The hospice agency will receive its routine daily rate plus an allowance for the
facility’s room and board:
• For adults, the room and board allowance is 95% of the facility’s Medicaid
per diem rate for each hospice member in that facility. If there is no per
diem rate available for the facility, the room and board allowance is 95%
of the statewide average.
• For EPSDT members, reimbursement is 100% of the Medicaid per diem
rate. If there is no per diem rate available for the facility, the room and
board allowance is 100% of the statewide average.
The hospice agency receives Medicaid’s payment and must, in turn, reimburse
the facility for room and board. The facility cannot bill Medicaid separately.
Provenance
- Source
- medicaid-documents.dhhs.utah.gov
- Retrieved
- 2026-10-02
- Edition
- mpm-hospice-2026-01-01
- Content hash
f68375ede289970c9313a97eddf56c9fe1bac3293b62dfd32cf456acca459394
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.