Compilation of Rules and Regulations of the State of Georgia
Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH
Chapter 111-8 - HEALTHCARE FACILITY REGULATION
Subject 111-8-37 - RULE AND REGULATIONS FOR HOSPICES
Rule 111-8-37-.03 - Definitions

(a) "Administrator" means the person, by whatever title used, to whom the governing body has delegated the responsibility for the day-to-day administration of the hospice, including the implementation of the policies and procedures adopted by the governing body.

(b) "Advanced and progressive disease" means a serious life-threatening medical condition which is irreversible and which will continue indefinitely, where there is no reasonable hope of recovery, but where the patient's medical prognosis is one in which there is a life expectancy of up to two years. The term does not include terminally ill patients as defined in paragraph (ee) of this rule.

(c) "Attending physician" means the physician identified by the hospice patient or the patient's representative as having primary responsibility for the hospice patient's medical care and who is licensed to practice medicine in this state.

(d) "Bereavement services" means the supportive services provided to the family unit to assist it in coping with the patient's death, including follow-up assessment and assistance through the first year after death.

(e) "Clergy" means an individual representative of a specific spiritual belief who has documentation of ordination or commission by a recognized faith group and who has completed at least one unit of clinical pastoral education from a nationally recognized provider.

(f) "Counseling" means those techniques used to help persons learn how to solve problems and make decisions related to personal growth, vocation, family, social, and other interpersonal concerns.

(g) "Department" means the Georgia Department of Community Health.

(h) "Dietitian" means a specialist in the study of nutrition who is licensed as required by O.C.G.A. § 43-11A-1et seq., the "Dietetics Practice Act."

(i) "Family unit" means the terminally ill person or person with an advanced and progressive disease and his or her family, which may include spouse, children, siblings, parents, and other relatives with significant personal ties to the patient.

(j) "Governing body" means the board of directors, trustees, partnership, corporation, association, or person or group of persons who maintain and control the operation of the hospice and who are legally responsible for its operation.

(k) "Home care" means hospice care primarily delivered in the residence of the hospice patient, whether that place is the patient's permanent or temporary residence. A hospice patient who considers his or her residence to be a licensed assisted living community, licensed nursing home, licensed intermediate care home, licensed personal care home, or residential hospice setting is considered to be receiving home care while a resident of that facility.

(l) "Hospice" means a public agency or private organization or unit of either providing to persons terminally ill and to their families, regardless of ability to pay, a centrally administered and autonomous continuum of palliative and supportive care, directed and coordinated by the hospice care team primarily in the patient's home but also on an outpatient and short-term inpatient basis and which is classified as a hospice by the Department. In addition, such public agency or private organization or unit of either may also provide palliative care to persons with advanced and progressive diseases and to their families, directed and coordinated by the hospice care team.

(m) "Hospice care" means both regularly scheduled care and care available on a 24 hour on-call basis, consisting of medical, nursing, social, spiritual, volunteer, and bereavement services substantially all of which are provided to the patient and to the patient's family regardless of ability to pay under a written care plan established and periodically reviewed by the patient's attending physician, by the medical director of the hospice program, and by the hospice care team.

(n) "Hospice care team" means an interdisciplinary working unit composed of members of the various helping professions (who may donate their professional services), including but not limited to: a physician licensed or authorized to practice in this state, a registered professional nurse, a social worker, a member of the clergy or other counselors, and volunteers who provide hospice care.

(o) "Inpatient care" means short-term, 24-hour medically supervised care for the purpose of adjusting and monitoring the terminally ill patient's medications for pain control or managing acute or chronic symptoms that cannot be managed in another setting. Inpatient care is provided within the confines of a licensed hospital, a licensed skilled nursing facility, or a licensed inpatient hospice facility.

(p) "Inpatient hospice facility" means a facility that is licensed to provide acute inpatient care for hospice patients in beds that are not included in the certified bed capacity of another licensed facility.

(q) "License" means a license issued by the Department to the governing body to operate a hospice.

(r) "Medical director" means a physician licensed in this state who is a member of the hospice care team and is responsible for the direction and quality of the medical component of the care rendered by the hospice to patients.

(s) "Palliative care" means those interventions by the hospice care team which are intended to achieve relief from, reduction of, or elimination of pain and of other physical, emotional, social, or spiritual symptoms of distress to achieve the best quality of life for the patients and their families.

(t) "Patient" means a terminally ill individual receiving the hospice continuum of services, regardless of ability to pay and also means an individual with an advanced and progressive disease.

(u) "Patient representative" means an individual who, under applicable laws, has the authority to act on behalf of the patient where the patient is incapable of making decisions related to health care.

(v) "Personal care services" means assistance with activities of daily living, personal care, ambulation and exercise; provision of household services essential to health care at home; assistance with self-administration of medication; and preparation of meals.

(w) "Physician" means an individual who is licensed to practice medicine in this state by the Georgia Composite Medical Board.

(x) "Primary caregiver" means a person or entity designated in writing by the patient or the patient's representative who agrees to give and/or arrange for continuing support and care and who may advocate on behalf of the patient.

(y) "Professional counselor" means a person licensed or certified as a professional counselor or associate professional counselor as required by O.C.G.A. § 43-10A-1et seq., the "Professional Counselors, Social Workers, and Marriage and Family Therapists Licensing Law."

(z) "Registered nurse" means an individual who is currently licensed to practice nursing under the provisions of Article 1 of Chapter 26 of Title 43 of the Official Code of Georgia Annotated.

(aa) "Residential hospice facility" means a small home-like residential facility or unit that is a part of a licensed hospice program, designed, staffed, and organized to provide non-acute hospice care, 24-hours per day, seven days per week, under the supervision of the hospice physician and hospice registered nurses to terminally ill hospice patients and their family units.

(bb) "Respite care" means short-term inpatient or residential care provided for the patient to provide relief for that patient's family unit from the stress of providing care.

(cc) "Restraint" means any manual, physical, or mechanical method, device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body or head freely, not including devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of a patient for the purpose of conducting routine physical examinations or tests, or to protect the patient from falling out of bed, or to permit the patient to participate in activities without the risk of physical harm (this does not include a physical escort); or a drug or medication when it is used as a restriction to manage the patient's behavior or restrict the patient's freedom of movement and is not a standard treatment or dosage for the patient's condition.

(dd) "Social worker" means an individual who is qualified by education, training, and experience and licensed as required by law to perform social work for hospice patients and their family units.

(ee) "Terminally ill" means that the individual is experiencing an illness for which therapeutic intervention directed toward cure of the disease is no longer appropriate, and the patient's medical prognosis is one in which there is a life expectancy of six months or less.

(ff) "Volunteer" means a lay or professional person who provides, without compensation, support and assistance to the patient and the patient's family under the supervision of a member of the hospice staff unit in accordance with the plan of care developed by the hospice care team.