This letter is a NEW update –
The Department of Aging and Disability Services (DADS) is re-issuing this letter to correct broken web links, correct outdated contact information and to update the requirements found in DADS rules at Texas Administrative Code (TAC), Title 40, Part 1, Chapter 97, Subchapter H, §97.880, Providing Hospice Care to a Resident of a Skilled Nursing Facility, Nursing Facility, or Intermediate Care Facility for Individuals with an Intellectual Disability (ICF/IID) or Related Conditions (between an ICF/IID and hospice provider).
DADS would like to remind providers of their roles and responsibilities when electing to contract for hospice services. DADS encourages providers to make this a good working relationship through ongoing education and communication. Long-term care and hospice providers may want to consider the federal Survey and Certification (S&C) 02-29, “Promising Practices for Implementing the Medicare Hospice Benefit for Nursing Home (NH) Resident” when entering into a contract. This letter includes links to state and federal references and resources. Please take time to read this letter to ensure that systems are in place for effective coordination of care.
Contracts
Can a Medicaid recipient elect hospice care if they are residing in an ICF/IID?
Yes, a Medicaid recipient living in an ICF/IID may elect to receive hospice care in an ICF/IID that has a contract with a Medicaid hospice provider.
Is an ICF/IID and hospice provider required to enter into contracts with each other?
Yes, 42 Code of Federal Regulations (CFR) §483.410(d)(1) (W117) requires an ICF/IID and an outside service provider (in this case a hospice) to enter into a written agreement with each other. Per 42 CFR §483.410(d)(2)(i), the written agreement must contain the responsibilities, functions, objectives, and other terms agreed to by both parties. The decision to enter into any particular contract is made by the parties to the contract, (i.e., by the ICF/IID and the hospice provider). Per 40 TAC §97.880, the agreement must be signed by both the hospice provider and the ICF/IID before hospice services are provided.
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