Billing While the Recipient Is in the Hospital: What You Can and Cannot Claim

If your IHSS recipient goes into the hospital, you cannot be paid for the hours of the stay. You are paid only for hours you actually work. This guide explains the rule, where it comes from, and what to do so your timesheet stays accurate. It is general information, not legal advice, and your county decides how your case is handled.

The short answer

No. The IHSS training material on program integrity says: “A provider cannot be paid to take care of a recipient who is in the hospital, a nursing home or incarcerated.” The same material says missed hours cannot be made up later, and that claiming them is a fraudulent claim.

This is the same rule that applies to every timesheet: the hours you claim must be hours you actually worked. A day the recipient spends in the hospital is not a day of IHSS services in the home, so there is nothing to claim for those hours.

Why the hours are not billable

IHSS pays for services in the recipient's own home. California's program rules (CDSS Manual of Policies and Procedures, section 30-701) say that “own home” does not include an acute care hospital or a skilled nursing facility. The Notice of Action that counties send says the same thing in plain words: if you are hospitalized, you must be residing in your own home to be eligible for IHSS.

CDSS guidance on cases in hospital leave status (ACL 26-12) also says no service or payment is made during the stay. The county handles that status on its side. You do not need to manage it, but you do need to keep your own timesheet clean.

What to do when your recipient is admitted

• Tell the county IHSS office. Report the hospitalization to the recipient's social worker or the county IHSS office. Ask what they need from you.
• Do not enter hours for the stay. Leave the hospital days blank on the timesheet, on paper or in ESP. Enter only the hours you worked on the days you actually provided services.
• Keep your own record of the dates. Write down the admission date, the discharge date and who you spoke to at the county. A simple note is enough.
• Ask the county about the admission and discharge dates. The days around admission and discharge can be unclear. Do not guess. Ask your county how those days should be handled.
• Do not try to make the hours up later. Hours missed during the stay cannot be added to another day or another pay period.

What happens at discharge

Coming home from the hospital can mean new care needs. California law (Welfare and Institutions Code section 12309.1(a)(2)(A)) allows the county to authorize services at discharge, before the health care certification arrives, so the person can return home safely. If your recipient is being discharged, tell the county as early as you can and ask what services are authorized for the return home. Only the county can authorize them.

Submitting your timesheet

Submit your timesheet once all the hours for the period have been worked. Submitting early is fine when the hours are done and the entries are accurate. If a hospital stay falls inside the pay period, the hospital days stay blank. For the basics of filling out the form, see the guide to filling out an IHSS timesheet. As a secondary line, the SOC 846 you sign says to submit timesheets within two weeks of the end of the pay period, so do not let accurate timesheets sit.

Why this matters now

The California Attorney General's press release of October 22, 2026 announced 103 felony cases against IHSS providers for billing hospital and nursing facility stays. We mention it only as context for why this rule is being enforced. We cannot say what would happen in any one person's situation. Entering only the hours you worked, and asking the county when you are unsure, is the way to stay on the right side of the rule. For how timesheet problems are flagged more generally, see the guide to IHSS timesheet violations.

Common questions

Can I be paid for the days my recipient is in the hospital if I stay with them? No. The program integrity material says a provider cannot be paid to take care of a recipient who is in the hospital. Time spent at the hospital is not billable as IHSS hours. Ask your county if you have a specific question about your situation.

Can I make up the missed hours after my recipient comes home? No. Missed hours cannot be made up later, and claiming them is a fraudulent claim. Claim only the hours you actually work after the recipient is home.

Does this also apply to a nursing home or jail? Yes. The same rule covers a recipient who is in a nursing home or incarcerated. If your recipient moves to a facility, tell the county.

What about a live-in provider? The rule is the same. Living in the home does not create paid hours during a hospital stay. See the live-in provider rules guide for how paid hours work for live-in providers. If your recipient's appointments, not a stay, are the issue, see IHSS medical wait time.

Sources

• IHSS training material, “Program Integrity,” pages 62 to 63 (2024-25).
• CDSS Manual of Policies and Procedures, section 30-701 (definition of “own home”).
• CDSS All County Letter 12-55, page 18 (Notice of Action text).
• CDSS All County Letter 26-12, page 3 (hospital leave status).
• California Welfare and Institutions Code section 12309.1(a)(2)(A).
• The California Attorney General's press release of October 22, 2026 (context only).

This page is general information, not legal advice. Your county decides how your case is handled. IHSS Provider is independent and is not affiliated with CDSS or any county.