Home health, palliative, and hospice services

In the Puget Sound region (excluding Olympia), the Kaiser Permanente Continuing Care Division provides home health services. In Olympia, Northwest Washington, and East of the Cascades, these services are available from contracted agencies.

Scope of services
Home health includes interdisciplinary home care services to members twenty-four (24) hours a day, seven (7) days a week. Home health covered services include:

• Skilled nursing services
• Physical, occupational and speech therapy services
• Medical social work services
• Home health aide services

Admission criteria
Kaiser Permanente's criteria for admission to home health services are based on the federal regulations for the Medicare home health benefit and MCG guidelines.

Arranging for services
If the member is in the hospital or skilled nursing facility, discharge planners in your area will arrange for home health services.

If the member is in your office, contact:

Puget Sound region:
Please submit a Home Health or Hospice referral via EPIC Order Entry.

Home Health and Hospice Referral Intake Office
206-326-4444
Toll-free: 1-800-332-5735

Olympia, Northwest Washington, and East of the Cascades:
Send a request for authorization using the Referral Request tool.
Or, contact Review Services
Toll-free: 1-888-289-1363
Fax: 1-888-282-2685

Contracted providers
Contracted providers are expected to follow the standards of care outlined in Home Care Services guideline.

In the Puget Sound region (excluding Olympia), the Kaiser Permanente Continuing Care Division provides hospice services. In Olympia, Northwest Washington, and East of the Cascades, these services are available from contracted agencies. The purpose is to make available short-term inpatient care for pain control and acute and chronic symptom management, continuous care in the home when needed for acute symptom management crises, and respite care via the hospice provider.

Scope of services
Hospice Services includes services made available to members twenty-four (24) hours a day, seven (7) days a week. Home health covered services include:

• Short-term inpatient care for pain control
• Acute and chronic symptom management
• Continuous care in the home when needed for acute symptom management crises
• Respite care via the hospice providers

Admission criteria
Kaiser Permanente members qualify for hospice care using the same criteria as the Medicare hospice benefit. Contracted hospice agencies must bill Medicare directly for Kaiser Permanente Medicare members receiving hospice care.

Arranging for services
If the member is in the hospital, discharge planners in your area will arrange for home health or hospice services.

If the member is in your office, contact:

Puget Sound region:
Please submit a Home Health or Hospice referral via EPIC Order Entry.

Home Health and Hospice Referral Intake Office
206-326-4444
Toll-free: 1-800-332-5735

Olympia, Northwest Washington, and East of the Cascades:
Send a request for authorization using the Referral Request tool.

Or, contact Review Services
Toll-free: 1-888-289-1363
Fax: 1-888-282-2685

Contracted providers
Contracted providers are expected to follow the standards of care outlined in the Hospice Care guideline.

Hospice information for Medicare Part D
The Hospice Information for Medicare Part D form is used by providers for documenting Part D coverage of drugs for members who are Medicare beneficiaries enrolled in hospice. This form facilitates coordination between Part D plans, hospices, and pharmacists. Two primary uses are to document that a drug is unrelated to a Medicare beneficiary member's terminal prognosis, and to convey the Medicare beneficiary member's change in hospice status.

When providers submit this form prospectively, it ensures that Kaiser Foundation Health Plan of Washington will be able to determine whether a drug is related or unrelated to the Medicare beneficiary member's terminal prognosis and, therefore, whether the drug is covered under Part D.

The form may also be used for contracted providers to communicate and update the medications list from the Medicare beneficiary member's plan of care.

Where to send the form
Kaiser Foundation Health Plan of Washington
Pharmacy Administration Help Desk
Mailstop: GSE-B2s-01
2921 Naches Ave S.W. Renton, WA 98057

Fax: 1-866-510-1765

• Hospice Information for Medicare Part D Form (WORD)
• Instructions for Providers Completing the Form (PDF)
• NCPDP Instructions for Hospice Status (PDF)