Hospice

A hospice is a public agency or private organization or a subdivision of either that is primarily engaged in providing care to terminally ill individuals.  

A hospice can be in a home in the community, or a nursing facility.  Hospice provides services to meet the physical, psychosocial, social, and spiritual needs of a terminally ill individual and the individual’s family or other caregivers. 

Hospice Eligibility

• A member must be diagnosed with a terminal illness by a hospice or attending physician.
• The physician certifies, in writing, that the terminal illness will result in a projected life expectancy of six months or less if the disease follows its normal course. 
• A hospice can be at a member’s home, if they have full Medicaid eligibility, or it can be in a facility, if the member is active on Medicaid and residing in a Medicaid licensed and certified facility.

Care Services

Hospice services may be provided in a home in the community or in a nursing facility.  Any of the following services may be provided based on the needs of the hospice member and caregivers.

• Nursing
• Physician services
• Spiritual counseling
• Dietary counseling
• Bereavement counseling
• Hospice Aide
• Homemaker
• Volunteer Services
• Occupational Therapy
• Speech Therapy
• Physical Therapy
• Drugs & Biologicals (related to the terminal illness)
• Medical Equipment
• Short Term Inpatient Care
• Inpatient Respite

Interdisciplinary Team & Care Plan

Each hospice member will be part of a hospice Interdisciplinary Team (IDT). Hospice provider staff assigned to the hospice IDT are the physician, registered nurse, social worker; and pastoral or other counselor. 

The IDT professional staff must provide the care and services offered by the hospice; and the IDT must supervise the care and the services provided to the member. The IDT develops a hospice Plan of Care (POC) that meets the member’s needs. The POC is updated as frequently as the member’s condition requires; but no less than every 15 calendar days.  

Hospice Reimbursement

A hospice provider is reimbursed a daily rate for each day that a member is eligible for hospice. There are four categories of daily rates dependent upon the type of care that the member needs on each day:

1. Routine
2. Continuous
3. Inpatient Respite
4. General Inpatient Care

Hospice Rate Sheets

Daily rates are fixed rates that are updated annually in accordance with the posted schedule. The schedule includes both a tab for Iowa Hospice Wage Indexes and Rates, and also a tab that shows Out-of-State Hospice Wage Indexes and Rates. View current hospice rates.

For more information on the most current rates, please view our Informational Letter.