Hospice

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Hospice

Revised October 28, 2007

What is Hospice?

Who is eligible for Hospice care?

What medical coverage group do I use for a client who is eligible to receive Hospice care?

How do I change from L-track to C01 when a client elects Hospice?

How do I enter Hospice as a Short Stay?

How is Hospice participation determined?

What is Hospice?

Hospice provides a terminally ill client a variety of treatment alternatives that can be received at home, Hospice care center, or in a nursing facility. For more information, see EA-Z Manual Medical Assistance Programs - Hospice.

Who is eligible for Hospice care?

Terminally ill clients who meet the criteria in EZ-A Manual Medical Assistance Programs - Hospice may be eligible to receive Hospice care.

What medical coverage group do I use for a client who is eligible to receive Hospice care?

Use the appropriate program as defined in EZ-A Manual Medical Assistance Programs - Hospice, Clarifying Information (3) and (4).

How do I change from L-track to C01 when a client elects Hospice?

From the Assistance Unit>>Summary page in aces.online, add C01 program by following the steps in add a program. See Screening.

On the AMEN access the case in Option P – Processing for the month of change.

On the ADDRscreen, update the address as appropriate.

Update theAREP as appropriate.

STAT screen for the C01, update the required fields.

On the INST screen:

Enter the leave date/NAC information.

Add the new HCBS information.

Call DONE and commit the data. The L-track AU will close with the appropriate reason code.

On the AMENaccess the case in Option P – Processing for each month after the month of change.

On the ADDRscreen, update the address if appropriate.

Update theAREP screen as appropriate.

On the STAT screen for the C01, update the required fields.

On the STAT screen for the L-track AU, enter Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only.

On the DEM1 screen, update the living arrangement code to the appropriate code. See Help.

INSTscreen:

Delete the Facility information.

Enter the HCBS information.

Call DONE and commit the data. The L-track AU will close Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only.

On the AMENaccess the case in Option R – Interim/Hist Change for the ongoing month.

On the PEND screen, select the C01 to begin processing the pending AU.

On the STAT screen for the C01, update the required fields.

On the STAT screen for the L-track AU, enter Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only.

On the DEM1 screen, update the living arrangements if appropriate.

On the INST screen:

Delete the Facility information.

Enter the HCBS information.

Call DONE and commit the data. The L-track AU will close Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only.

How do I enter Hospice as a Short Stay?

To enter Hospice as a short stay, follow procedures inACES User Manual Medical Short Stay Chapter

How is Hospice participation determined?

Participation in the cost of care for hospice services received in a medical facility is determined according toEA-Z Manual WAC 388-513-1380 Determining a client's financial participation in the cost of care for long-term care (LTC) services

Unless the medical facility is a Hospice Care Center [HC], participation is assigned to the Hospice provider, not the medical facility, in this situation.

Participation for hospice services received in a client's home is determined according to EA-Z Manual WAC 388-515-1505 Waiver Services - HCS CNP (COPES/New Freedom/PACE/MMIP and WMIP) that describes rules used for the Community Options Program Entry System (COPES) program.

If the client has both COPES and Hospice services coded concurrently, ACES will assign the participation to the COPES provider.

Hospice
Revised October 28, 2007

What is Hospice? Who is eligible for Hospice care? What medical coverage group do I use for a client who is eligible to receive Hospice care? How do I change from L-track to C01 when a client elects Hospice? How do I enter Hospice as a Short Stay? How is Hospice participation determined?
What is Hospice? Hospice provides a terminally ill client a variety of treatment alternatives that can be received at home, Hospice care center, or in a nursing facility. For more information, see EA-Z Manual Medical Assistance Programs - Hospice. Who is eligible for Hospice care? Terminally ill clients who meet the criteria in EZ-A Manual Medical Assistance Programs - Hospice may be eligible to receive Hospice care. What medical coverage group do I use for a client who is eligible to receive Hospice care? Use the appropriate program as defined in EZ-A Manual Medical Assistance Programs - Hospice, Clarifying Information (3) and (4). How do I change from L-track to C01 when a client elects Hospice? From the Assistance Unit>>Summary page in aces.online, add C01 program by following the steps in add a program. See Screening. On the AMEN access the case in Option P – Processing for the month of change. On the ADDRscreen, update the address as appropriate. Update theAREP as appropriate. STAT screen for the C01, update the required fields. On the INST screen: Enter the leave date/NAC information. Add the new HCBS information. Call DONE and commit the data. The L-track AU will close with the appropriate reason code. On the AMENaccess the case in Option P – Processing for each month after the month of change. On the ADDRscreen, update the address if appropriate. Update theAREP screen as appropriate. On the STAT screen for the C01, update the required fields. On the STAT screen for the L-track AU, enter Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only. On the DEM1 screen, update the living arrangement code to the appropriate code. See Help. INSTscreen: Delete the Facility information. Enter the HCBS information. Call DONE and commit the data. The L-track AU will close Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only. On the AMENaccess the case in Option R – Interim/Hist Change for the ongoing month. On the PEND screen, select the C01 to begin processing the pending AU. On the STAT screen for the C01, update the required fields. On the STAT screen for the L-track AU, enter Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only. On the DEM1 screen, update the living arrangements if appropriate. On the INST screen: Delete the Facility information. Enter the HCBS information. Call DONE and commit the data. The L-track AU will close Reason Code 587 Already Eligible for Program in Different AU - For Administrative Use Only. How do I enter Hospice as a Short Stay? To enter Hospice as a short stay, follow procedures inACES User Manual Medical Short Stay Chapter How is Hospice participation determined? Participation in the cost of care for hospice services received in a medical facility is determined according toEA-Z Manual WAC 388-513-1380 Determining a client's financial participation in the cost of care for long-term care (LTC) services Unless the medical facility is a Hospice Care Center [HC], participation is assigned to the Hospice provider, not the medical facility, in this situation. Participation for hospice services received in a client's home is determined according to EA-Z Manual WAC 388-515-1505 Waiver Services - HCS CNP (COPES/New Freedom/PACE/MMIP and WMIP) that describes rules used for the Community Options Program Entry System (COPES) program. If the client has both COPES and Hospice services coded concurrently, ACES will assign the participation to the COPES provider.