L. The hospice inpatient
facility shall ensure the following:
1. the
facility meets appropriate licensing, regulatory, and certification
requirements;
2. the facility has
an acceptable, written all hazards risk assessment and emergency preparedness
plan. The plan shall include:
a. the
frequency/schedule for periodically rehearsing the plan with the
staff;
b. the assignment of
personnel for specific responsibilities;
c. the procedures for prompt identification
and transfer of patients and records to an appropriate facility;
i. in the event of an evacuation, the
facility shall have a method to release patient information consistent with the
HIPAA Privacy Rule;
d.
fire and/or other emergency drills, in accordance with the LSC;
e. procedures covering persons in the
facility and in the community in cases of all hazards (i.e., hurricanes,
tornadoes, floods); and
f.
arrangements with community resources in the event of a disaster;
3. the facility shall design and
equip areas for the comfort and privacy of each patient and family members. The
facility shall have the following:
a.
physical space for private patient/family visiting;
b. accommodations for family members to
remain with the patient throughout the night;
c. accommodations for family privacy after a
patient's death;
d. decor which is
homelike in design and function; and
e. patients shall be permitted to receive
visitors at any hour, including small children;
4. patient rooms are designed and equipped
for adequate nursing care and the comfort and privacy of patients. Each
patients room shall:
a. be equipped with
toilet and bathing facilities;
b.
be equipped with a lavatory in each patient's toilet room or in each
bedroom;
c. be at or above grade
level;
d. contain room decor that
is homelike and non-institutional in design and function. Room furnishings for
each patient shall include a bed with side rails, a bedside stand, an
over-the-bed table, an individual reading light easily accessible to each
patient and a comfortable chair. The patient shall be permitted to bring
personal items of furniture or furnishings into their rooms unless medically
inappropriate;
e. have closet space
that provides security and privacy for clothing and personal
belongings;
f. contain no more than
4 beds;
g. measure at least 100
square feet for a single patient room or 80 square feet for each patient for a
multi patient room; and
h. be
equipped with a device for calling the staff member on duty. A call bell or
other communication mechanism shall be placed within easy reach of the patient
and shall be functioning properly. A call bell shall be provided in each
patient toilet, bath, and shower room;
5. the hospice inpatient facility shall:
a. provide an adequate supply of hot water at
all times for patient use;
b. have
plumbing fixtures with control valves that automatically regulate the
temperature of the hot water used by patients; and
c. designate a staff member responsible for
monitoring and logging water temperatures at least monthly. This person is
responsible for reporting any problems to the administrator;
6. the hospice inpatient facility
shall have available at all times a quantity of linen essential for proper care
and comfort of patients. Linens are handled, stored, processed, and transported
in such a manner as to prevent the spread of infection. The facility shall have
a clean linen storage area;
a. the linen
supply shall be adequate to accommodate the number of beds and the number of
incontinent patients on a daily basis, including week-ends and
holidays;
b. soiled linen and
clothing shall be collected and enclosed in suitable bags or containers in well
ventilated areas, separate from clean linen and not permitted to accumulate in
the facility;
c. the hospice
inpatient facility shall have policies and procedures that address:
i. frequency of linen changes;
ii. storage of clean linen; and
iii. storage of soiled linen;
7. the hospice
inpatient facility shall make provisions for isolating patients with infectious
diseases. The hospice should institute the most current recommendations of The
Centers for Disease Control and Prevention (CDC) relative to the specific
infection(s) and communicable disease(s). The hospice provisions for isolating
patients with infectious diseases shall include:
a. definition of nosocomial infections and
communicable diseases;
b. measures
for assessing and identifying patients and health care workers at risk for
infections and communicable diseases;
c. measures for prevention of infections,
especially those associated with immunosuppressed patients and other factors
which compromise a patients resistance to infection;
d. measures for prevention of communicable
disease outbreaks, especially tuberculosis;
e. provision of a safe environment consistent
with the current CDC recommendations for the identified infection and/or
communicable disease;
f. isolation
procedures and requirements for infected or immunosuppressed
patients;
g. use and techniques for
universal precautions;
h. methods
for monitoring and evaluating practice of asepsis;
i. care of contaminated laundry, i.e.,
clearly marked bags and separate handling procedures;
j. care of dishes and utensils, i.e., clearly
marked and handled separately;
k.
use of any necessary gowns, gloves or masks posted and observed by staff,
visitors, and anyone else in contact with the patient; and
l. techniques for hand washing, respiratory
protection, asepsis sterilization, disinfection, needle disposal, solid waste
disposal, as well as any other means for limiting the spread of
contagion;
m. orientation of all
new hospice personnel to infections, to communicable diseases and to the
infection control program; and
n.
employee health policies regarding infectious diseases, and when infected or
ill employees shall not render direct patient care;
8. the hospice inpatient facility should
isolate infected patients only to the degree needed to isolate the infecting
organism. The method should be the least restrictive possible while maintaining
the integrity of the process and the dignity of the patient;
9. the hospice inpatient facility shall
provide the following:
a. storage for
administrative supplies;
b. hand
washing facilities located convenient to each nurses station and medication
distribution station;
c. charting
facilities for staff at each nurses' station;
d. a "clean" workroom which contains a work
counter, sink, storage facilities and covered waste receptacles;
e. a "soiled" workroom for receiving and
cleanup of equipment;
f. parking
for stretchers and wheelchairs in an area out of the path of normal traffic and
of adequate size for the facility;
g. a janitor's closet which contains a floor
receptor with mop hooks over the sink and storage space for housekeeping
equipment and supplies;
h. a
multi-purpose lounge or lounges shall be provided suitable and furnished for:
reception, recreation, dining, visitation, group social activities, and
worship. Such lounge or lounges shall be located convenient to the patient
rooms designed to be served;
i. a
conference and consultation room shall be provided which is suitable and
furnished for family privacy, including conjugal visit rooms, clergy
visitations, counseling, and viewing of a deceased patient's body during
bereavement. The conference and consultation room shall be located convenient
to the patient rooms it is designed to serve;
j. public telephone and restrooms shall be
provided.