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Get Medicaid Hospice Form 2019-2024

Ntinued NOTIFICATION OF MEDICAID HOSPICE BENEFIT ELECTION F-1008 (08/2019) Page 2 of 2 SECTION III — COMPLETE FOR MEMBERS ENTERING A NURSING HOME AFTER HOSPICE ADMISSION The hospice and nursing home named below are in agreement that the hospice shall provide hospice services, while the nursing home shall provide room and board services as defined under COBRA, P.L. 99-272. “Room and board” includes the performance of personal care services, including assistance in the activities of dail.

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