Hospice Coordination Fees & Documentation Requirements

We’ve recently heard from the Long-Term Care Ombuds Office regarding adult family homes and assisted living facilities charging additional “coordination” fees for residents receiving hospice services.

We want to remind all AFH providers:

• For Medicaid residents, homes may not charge any additional “coordination” or similar fees related to hospice care.

• For private-pay residents, any charges must be fully disclosed and agreed to in advance, as outlined in your admission documents and the relevant WAC requirements below.

Documentation & Notification Requirements

Please ensure that your home’s documents are accurate and up to date:

• Notice of Rights and Services (Admission Agreement) — Must detail what is included in the resident’s rate and any separately billable services. Must be reviewed and re-signed every 24 months. (WAC 388-76-10530)

• Disclosure of Charges — Required upfront, outlining all current fees. (WAC 388-76-10540)

• Disclosure of Services — Must be provided to residents and submitted to the Department; updates must be filed 30 days prior to taking effect, unless it’s an emergency. (WAC 388-76-10532)

If you plan to add or adjust a charge after a resident is admitted, you must:

• Update all three documents (Notice of Rights and Services, Disclosure of Charges, Disclosure of Services).

• Provide proper written notice to residents in accordance with WAC 388-76-10535.