Current through Register Vol. 51, No. 19, September 20, 2024
A. The hospice care
program shall maintain sufficient health care professionals and volunteers to
meet patient care needs.
B. The
hospice care program shall identify an interdisciplinary care team with
responsibility for ensuring continuous assessment of the patient's and family's
needs and implementation of an integrated plan of care. The hospice care
program shall ensure that:
(1) A qualified
health care professional coordinates the activities of the interdisciplinary
care team;
(2) The number of
individuals who perform interdisciplinary team services is consistent with the
needs of patients and their families and the type of services provided by the
hospice care program; and
(3) Each
interdisciplinary care team consists of at least:
(a) The patient's attending
physician,
(b) A physician with
training in palliative care,
(c) A
registered nurse with demonstrated experience in pain and symptom management
and the performance of physical assessments,
(d) A master's degree-prepared social worker
with clinical experience in counseling and casework for the terminally
ill,
(e) A volunteer, or
volunteers, supervised by an individual with management experience in a hospice
care program, and
(f) A spiritual
care counselor or counselors with education and experience in pastoral
counseling.
C. An interdisciplinary care team may include
additional specialized team members needed to meet specific needs of patients
as outlined in the patient's plan of care. Specialized team members may include
allied therapists, art and music therapists, registered dietitians or licensed
nutritionists, pharmacists, or nursing assistants.
D. Specialized team members may be employees,
volunteers, or contractual staff.
E. Personnel Records. For all employees,
volunteers, and contractual staff, the administrator shall ensure that there
is:
(1) An accurate, complete, and current
personnel record that includes:
(a)
Verification of required licenses or certification,
(b) A signed conflict of interest
statement,
(c) Written performance
reviews,
(d) Documentation of all
required training; and
(2) A job description for each
position.
F. Outside
Agreements. If a hospice care program utilizes the services of an outside
entity to provide certain hospice services, the hospice care program shall
enter into a written agreement with that entity which includes at a minimum:
(1) The service or services to be
provided;
(2) The roles, rights,
and responsibilities of the contracting entity;
(3) The roles, rights, and responsibilities
of the hospice care program; and
(4) A plan to ensure that any individual
providing services under this section shall have at least comparable training
to that required by this regulation.
G. Orientation and Training.
(1) The hospice care program shall ensure
that all licensed staff receive orientation and training, which includes at a
minimum:
(a) The purpose and philosophy of
hospice care;
(b) The skills
necessary to provide for the physical care of the patient;
(c) The skills necessary to provide for the
psychosocial and spiritual needs of the patient and family; and
(d) The need and importance of maintaining
professional boundaries with the patient and the patient's family.
(2) The hospice care program shall
have written criteria and a clear process for recruiting, selecting, and
supervising volunteers, ensuring that:
(a) Any
volunteer who provides direct patient care receives appropriate orientation and
at least 16 hours of training which includes, at a minimum:
(i) The purpose and philosophy of hospice
care,
(ii) The role of the
volunteer in hospice,
(iii)
Concepts of death and dying,
(iv)
Communication skills,
(v) Care and
comfort measures,
(vi) The
physical, psychosocial, and spiritual issues related to death and
dying,
(vii) The concept of the
hospice family,
(viii) Patient
rights,
(ix)
Confidentiality,
(x)
Bereavement,
(xi) Infection
control,
(xii) Safety,
and
(xiii) Stress management;
and
(b) A volunteer,
other than those specified in §G(2)(a) of this regulation, receives
appropriate orientation regarding the volunteer's role in the hospice care
program.
(3) Training
shall be specifically tailored to ensure that staff is capable of providing
care to meet the individual needs of patients.
(4) The hospice care program shall provide
continuing inservice education for all employees and volunteers providing
direct patient services at least:
(a) Once a
year for volunteers; and
(b) Four
times a year for employees.
