Wis. ForwardHealth Online Handbook, Hospice, Topic #1157

When a resident of a Medicaid-enrolled SNF (skilled nursing facility) elects to receive hospice care services, the hospice must

contract with that facility to provide the member's room and board and the hospice assumes responsibility for the management of

the individual's hospice care.

An "active" nursing home authorization segment will be end dated systematically when the hospice benefit is added on the

member's enrollment file. The end date of the nursing home authorization segment will be one day prior to the effective date of the

member's enrollment in the Hospice Benefit.

Room and board includes assistance in activities of daily living and personal care, socializing activities, administration of

medications, maintaining cleanliness of the member's room, and supervising and assisting in the use of DME (durable medical

equipment) and prescribed therapies. In this situation, Wisconsin Medicaid will reimburse the hospice for room and board charges

and the hospice will pay the nursing facility.

Each day that room and board is provided must be billed using the room and board revenue code. Routine and continuous care

hospice services may be billed, as appropriate, on the same DOS (date of service) that nursing home room and board is billed.

Wisconsin Medicaid will reimburse the hospice 95% of the nursing home's current SNF rate for each DOS on which room and

board is provided.

Room and board for an SNF resident is not reimbursed for the same DOS as inpatient respite or general inpatient care.