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.
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
Olympia, Northwest Washington, and East of the Cascades:
Send a request for authorization using the Referral Request tool.
Or, contact Review Services
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
2921 Naches Ave S.W. Renton, WA 98057
- Hospice Information for Medicare Part D Form (WORD)
- Instructions for Providers Completing the Form (PDF)
- NCPDP Instructions for Hospice Status (PDF)
The hospice provider provides preauthorized general inpatient care and respite hospice services in accordance with the Medical Coverage Agreement, if applicable, and/or the plan of care, as developed and amended as needed by the attending physician, the Kaiser Permanente Hospice Medical Director, and the Hospice Interdisciplinary Team.
Any such general inpatient care and respite care shall be provided under the following terms and conditions:
- Services will be made available to Kaiser Permanente hospice patients twenty-four (24) hours a day, seven (7) days a week, three hundred sixty-five (365) days a year. The hospice provider shall make its best efforts to offer bed availability to Kaiser Permanente hospice as needed. If available and as appropriate, Kaiser Permanente hospice patients requiring inpatient general care shall be provided all services and items required to be provided by Medicare Part A regulations to skilled nursing facility patients.
- General inpatient and/or respite care includes all emergency care, nursing care, and other professional services, dietary services, housekeeping services, laboratory services, radiology, respiratory, pharmacy services, and other ancillary services. The hospice provider will have oxygen and durable medical equipment available for Kaiser Permanente hospice patients as needed.
- The hospice provider ensures that staffing includes a registered nurse who is available twenty-four (24) hours per day to provide direct patient care, which is deemed acceptable by Kaiser Permanente Hospice, subject to its review.
- The hospice provider ensures that each Kaiser Permanente hospice patient receives treatments, medications, and diet as prescribed, and is kept comfortable, clean, well groomed, and protected from accident, injury and infection, all in accordance with procedures which have been reviewed and approved for these purposes by Kaiser Permanente Hospice.
- The hospice provider ensures that its staff observes, records, and reports to appropriate member(s) of the Hospice Interdisciplinary Team, on a regular basis, and in accordance with procedures established by Kaiser Permanente Hospice and the hospice provider, the Kaiser Permanente Hospice patient’s response to treatment and any changes in his/her condition.
- The hospice provider provides access and unrestricted visiting privileges (including visits by children of all ages) for Kaiser Permanente hospice patients twenty-four (24) hours a day, three hundred sixty-five (365) days a year.
- The hospice provider will allow members of the Hospice Interdisciplinary Team, as identified in the plan of care, to attend, counsel, treat (if they have skilled nursing facility privileges), and serve Kaiser Permanente hospice patients who are hospitalized. The hospice provider will allow members of the Hospice Interdisciplinary Team to document in the facility medical record.
- The hospice provider will make its best efforts to provide physical space for private visiting between Kaiser Permanente hospice patients and their families, and accommodations for family members to remain with the Kaiser Permanente hospice patient throughout the night and for family privacy after a Kaiser Permanente hospice patient’s death. Décor which is homelike in design and function is allowed in the Kaiser Permanente hospice patient’s room if they are in accordance with the hospice provider’s safety policies.
- The hospice provider agrees that no Kaiser Permanente hospice patient shall be involved in research or participate in or otherwise be subject to any experimental or investigation procedures conducted by the hospice provider unless an authorized representative of Kaiser Permanente and the Kaiser Permanente hospice patient have given prior written authorization.
- The hospice provider is not required to render services or to take part in processing of claims for any services which would violate its religious or ethical principles.
- The hospice provider is jointly responsible with Kaiser Permanente for all discharge planning with approval of plan by the hospice nurse. Discharge plans shall be initiated prior to admission to a skilled nursing facility.
- Upon mutual agreement and consent of both Kaiser Permanente and the hospice provider, Kaiser Permanente hospice patients will be considered for discharge when they have completed their respite stay or no longer require general inpatient care (medical condition improved and continuous skilled care no longer needed); they request transfer to home; or they are unable or unwilling to cooperate with the hospice provider in meeting Kaiser Permanente hospice goals and objectives.
- Kaiser Permanente Hospice will arrange for the transfer home, including the scheduling of ambulance, if necessary.
- At the time of transfer, the hospice provider will send with the Kaiser Permanente hospice patient a transfer summary, the patient’s own medications, and his/her medication profile.
- If discharge occurs by death, the hospice provider will notify the Hospice Program or the on-call visiting nurse immediately so that coordination of bereavement services may begin. Kaiser Permanente Hospice will retain responsibility for bereavement services.
- At the request of Kaiser Permanente Hospice, a copy of the Kaiser Permanente hospice patient’s medical record shall be provided to Kaiser Permanente Hospice at the time of the Kaiser Permanente hospice patient’s discharge from the hospice provider or at other times as may be requested by Kaiser Permanente Hospice in order to exercise its professional or fiscal management responsibilities. A copy of the discharge summary shall be sent to Kaiser Permanente Hospice in a timely manner following Kaiser Permanente hospice patient’s discharge, but in no event shall payment be made to the hospice provider for services rendered prior to receipt of the discharge summary by Kaiser Permanente Hospice.