See ACES Screens and Online Pages for an example of pages or screens used in this chapter.
Hospice provides a terminally ill client a variety of treatment alternatives while in their home, medical institution, nursing facility including a hospice care center or an alternate living facility. For more information on Hospice as a Home and Community Based Services (HCBS) or Program, see Apple Health eligibility manual - Hospice - Index
A person who is eligible for a Categorically Needy (CN) or Medically Needy (MN) medical program is eligible to receive hospice care. Apple Health eligibility manual - Hospice - Overview
To add Hospice services to a client that is already active on CN or MN medical, take the following actions:
Clients electing Hospice as a program in an institutional setting and are not receiving any other higher priority services should be screened for Categorically Needy - PACE or Institutional Hospice - SSI Recipients (L31) or Categorically Needy - PACE or Hospice - SSI Related (L32). For more information, see Categorically Needy - PACE or Institutional Hospice - SSI Recipients (L31) or Categorically Needy - PACE or Hospice - SSI Related (L32).
Clients electing Hospice as a program in a NON-Institutional setting and are not receiving any other higher priority services should be screened on Categorically Needy LTC in a Medical Facility - SSI Related (L02) medical. For more information see Categorically Needy LTC in a Medical Facility - SSI Related (L02).
To enter Hospice as a short stay, see Short Stay.
Participation in the cost of care for hospice services received in a medical facility is determined according to the Apple Health eligibility manual - WAC 182-513-1380 Determining a person’s financial participation in the cost of care for long-term care (LTC) services. The participation is assigned to the hospice provider, not the medical facility, unless the medical facility is a Hospice Care Center (HC).
Participation for hospice services received in a client’s home is determined according to the Apple Health eligibility manual - WAC 182-515-1505 Home and community services (HCS) authorized home and community based (HCB) waiver services. If the client has both HCS Waiver and hospice services coded concurrently, ACES assigns the participation to the HCS Waiver provider.
See ACES Screens and Online Pages for an example of pages or screens used in this chapter.