Current through Rules and Regulations filed through September 23, 2024
(1)
Admissions. The hospice must not admit any patients unless the hospice believes that it is capable of meeting the care needs of the patients. The hospice must have written criteria that address the eligibility for admission into home hospice care, residential, or inpatient hospice care and palliative care for persons with advanced and progressive diseases, if such palliative care is offered.
(2)
Terminally Ill Patient Admissions for Home Care. The hospice program offered to terminally ill patients in their homes must admit only patients that meet the following minimum criteria:
(a) The patient has a referral from a physician who has personally evaluated the patient and diagnosed the patient as terminally ill, where the medical prognosis is less than six months of life if the terminal illness takes its normal course, and in need of hospice care;
(b) The patient has received from the hospice an initial assessment, performed by an appropriate representative of the hospice care team, that reflects a reasonable expectation that the patient's medical, nursing, and psychological needs can be met adequately by the hospice and further reflects that the patient has a need for and can benefit from hospice care;
(c) The patient has been given a description of the scope of services and has personally or through an authorized patient representative given informed consent in writing to receive hospice care;
(d) The patient has been certified in writing by the hospice to have an anticipated life expectancy of six months or less if the terminal illness takes its normal course;
(e) The patient lives within the hospices service area; and
(f) The patient has identified a primary caregiver. In the absence of a primary caregiver, the hospice must develop a detailed plan for meeting the daily care and safety needs of the patient.
(g) The hospice must ensure the development of an initial plan of care, within 24 hours of admission to the hospice, based on the initial assessment and with appropriate input from a physician or registered nurse to meet the immediate needs of the patient.
(h) The hospice must ensure that no terminally ill patient is excluded from participation in or denied benefits of any hospice care because of an inability to pay for such hospice care.
(3)
Inpatient Hospice Admissions. Hospices must admit to acute inpatient hospice care only those terminally ill patients who meet the following criteria:
(a) The patient has an order from a physician to be transferred to inpatient status and requires any of the following:
1.Nursing care supervised by a registered nurse that cannot feasibly be provided in another hospice setting;
2.Procedures that are necessary for pain control or acute or chronic symptom management;
3.Medication adjustment, observation, or other stabilizing treatment; or
4.Psycho-social monitoring; or
(b) Respite care.
(4)
Residential Hospice Admissions. In addition to the home care admissions, hospices that elect to offer residential services must admit to a residential facility only those terminally ill patients who do not require acute management of symptoms or stabilization in an inpatient care setting and who meet the following criteria:
(a) The patient lacks a sufficient number of capable and willing caregivers; or
(b) The patient's care needs are too complex and difficult for non-medical caregivers to perform confidently; or
(c) The patient's primary home is not suitable or available and/or the home cannot be adapted to meet the patient's needs; or
(d) The patient has no other home available or desires not to live at home.
(5)
Palliative Care Admission Requirements. Hospices that elect to provide palliative care to persons with advanced and progressive diseases in any setting, other than an inpatient or residential hospice, must admit only those persons who meet the following criteria:
(a) have an order from a physician indicating the patient has an advanced and progressive disease;
(b) request the intervention of a hospice care team to alleviate suffering and achieve relief from physical, emotional or spiritual symptoms of distress to achieve the best quality of life for the person and his or her family; and
(c) have stated needs that the hospice believes it has the capability to meet.
(6)
Discharge Requirements.
(a) Once a hospice admits a patient who is terminally ill for hospice care, the hospice at its discretion must not discharge the patient unless either the patient freely and voluntary requests the discharge or the hospice determines that an involuntary discharge is necessary in accordance with these rules.
(b) No hospice is permitted to require or demand that a terminally ill patient request voluntary discharge from the hospice or require or demand a hospice patient to execute a request for voluntary discharge from the hospice as a condition for admission or continued care.
(c) In situations where the hospice identifies issues where the safety of the terminally ill patient, the patient's family unit, or a hospice staff member or volunteer is compromised, the hospice must make every effort to resolve the issues before considering the option of involuntary discharge.
1.All such efforts for resolution by the hospice must be documented in the patient's record.
2.If involuntary discharge is the elected option, the hospice must give no less than 14 days' notice of discharge to the terminally ill patient and the patient's representative, except in cases of imminent danger or immediate peril to the terminally ill patient, other terminally ill patients, or staff.
3.The hospice must notify the Department of the pending involuntary discharge of a terminally ill patient at the time of patient notification.
(d) No terminally ill patient receiving hospice care may be discharged due to inability to pay for the hospice services.
(e) No hospice is permitted to discontinue hospice care for a terminally ill patient, nor discharge or transfer the patient, during a period of coordinated or approved appropriate hospital admission for the treatment of conditions related to the patient's terminal illness or any other condition.
(f) Hospices must assist in coordinating continued care should any hospice patient be transferred or discharged from the hospice.
O.C.G.A. §§
31-7-170et seq.
