A recipient's room and board is covered through the hospice benefit under the following circumstances:

1. (1) If a recipient is receiving routine home care in an inpatient hospice; or

2. (2) If a recipient is receiving routine home care or continuous home care in a skilled nursing facility, ICF-IID, or swing bed.

   For a recipient receiving routine home care or continuous home care in a skilled nursing facility, ICF-IID, or swing bed, the hospice provider is paid 95% of the per diem rate that would have been paid to the facility. The facility is paid by the hospice provider pursuant to their written agreement as required by 42 C.F.R. § 418.112, as amended to January 1, 2010.

Source: 37 SDR 127, effective December 27, 2010; 40 SDR 122, effective January 8, 2014.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.