Current through Register No. 40, October 3, 2024
(a) The licensee
shall provide the following core hospice care services:
(1) Nursing services sufficient to meet the
nursing needs of the patient, which are:
a.
Determined by the patient's care plan;
b. Available, as needed, 24 hours a day;
and
c. Supervised by a registered
nurse.
(2) Home health
aide and personal care services that are provided either directly or by
contract as the needs of the patient dictate and as determined by the patient's
care plan;
(3) Assisting patients
to acquire pharmaceutical services such as equipment, appliances, medical
supplies, and other pharmaceutical services as the needs of the patient dictate
and as determined by the patient's care plan;
(4) Hospice care social services such as
assessment of the social environment and financial issues supervised by a
social worker;
(5) Hospice
volunteer services;
(6) Nutritional
counseling, physical or occupational therapy, and speech therapy that are
provided or arranged for as needed in accordance with patient's care
plan;
(7) Spiritual services which
are offered in accordance with the patient's and family's beliefs and values;
and
(8) Bereavement services that
are available to the family for up to one year following the death of the
patient.
(b) If, on a
temporary basis, not to exceed 90 days, the HHCP cannot provide any of the core
care and services in (a) above, the HHCP shall have a written agreement with
another agency to provide the required services.
(c) Any contractual agreement to provide care
and services shall:
(1) Identify the care and
services to be provided;
(2)
Specify the qualifications of the personnel that will be providing the care and
services;
(3) Require that the HHCP
must authorize the services; and
(4) Stipulate the HHCP retains professional
responsibility for all care and services provided.
(d) The HHCP shall provide or arrange for the
provision of short-term in-patient stays in a hospital, nursing home, or
hospice house during those times when the patient's pain or symptoms are unable
to be managed in the home.
(e) The
HHCP shall retain professional management responsibility for all services that
are provided including contracted services when a hospice patient is in another
licensed facility. These responsibilities shall be defined in a written
contractual agreement.
(f) The
licensee shall provide staff for the following positions:
(1) An administrator to oversee the HHCP,
except as allowed by 823.15(g) (1) below;
(2) A full time director of patient
services;
(3) A medical
director;
(4) A volunteer
coordinator;
(5) A social services
coordinator; and
(6) Spiritual and
or bereavement coordinator.
(g) Any administrator shall have at least a
bachelor's degree in business or a health-related field with a minimum of one
year's experience in hospice care or be a registered nurse and:
(1) Designate, in writing, an alternate
administrator who shall assume the responsibilities of the administrator in his
or her absence; and
(2) Be
permitted to hold more than one position at the HHCP if:
a. The individual meets the qualifications of
all positions; and
b. The duties
and responsibilities of the positions can be accomplished by one individual;
and
(3) Be responsible
for maintaining the HHCP in full compliance with all federal, state, and local
laws, rules, codes, and ordinances at all times.
(h) Any director of patient services shall:
(1) Be a New Hampshire-licensed or
compact-registered nurse;
(2) Be a
New Hampshire-licensed advanced practice registered nurse; or
(3) Have a bachelor's degree in a health
field related to hospice care.
(i) The director of patient services shall:
(1) Be responsible for the overall delivery
of patient care and services;
(2)
Provide sufficient nursing personnel to meet the need of the
patients;
(3) Supervise the overall
delivery of patient care and services; and
(4) Coordinate the supervision of licensed
nurse aides (LNA) at least every 2 weeks by a registered nurse at the patient's
home to determine if the LNA is providing care and services in accordance with
the patient's care plan. The LNA shall not have to be present during this
visit.
(j) The medical
director shall be a licensed provider and shall be responsible for:
(1) The overall medical component of the
hospice plan of care;
(2)
Participating on the interdisciplinary patient care team;
(3) Determining, in consultation with the
interdisciplinary team, that an individual is appropriate for hospice care
services; and
(4) Consultative
physician visits for hospice and palliative care patients as requested by
physicians.
(k)
Volunteer services shall be provided under the direction of a coordinator of
volunteer services who:
(1) Implements a
direct service volunteer program;
(2) Coordinates the orientation, education,
support, and supervision of direct service volunteers; and
(3) Coordinates the utilization of direct
service volunteers with other hospice staff.
(l) All volunteers shall be oriented and
educated relative to their prescribed function according to the hospice care
provider's policies and procedures.
(m) The licensee shall develop and maintain
policies and procedures for its volunteer services that address the following
areas:
(1) Recruitment and
retention;
(2) Screening;
(3) Orientation;
(4) Scope of function;
(5) Supervision;
(6) Ongoing training and support;
(7) Records of volunteer activities;
and
(8) Criminal record
checks.
(n) The social
services coordinator shall have:
(1) At least
a master's degree from a graduate school of social work; or
(2) A bachelor's degree in a related health
or human services field, have at least 2 years experience as a social worker
and have established a consultative relationship with a person who qualifies in
(1) above.
(o) The
social services coordinator shall:
(1)
Participate in the development of the care plan; and
(2) Work in conjunction with the director of
patient services to coordinate all social services required by the care plan
and ensure their delivery.
(p) The spiritual and or bereavement
coordinator shall be a person who has at least a bachelor's degree in an
applicable field such as theology of education, psychology, or counseling and
who has completed at least 8 additional hours in death and dying, grief, and
bereavement.
(q) Persons providing
bereavement services shall have education in death and dying, grief, and
bereavement.
(r) The spiritual and
or bereavement coordinator shall be responsible for providing an organized
program of bereavement services for up to 12 months after the death of the
patient including:
(1) Counseling to families
after the patient's death;
(2)
Developing a care plan that reflects the needs of the patient's family;
and
(3) Others services necessary
to aid in the bereavement process.
(s) If the licensee collects human specimens
for laboratory testing, it shall follow the manufacturer's instructions and/or
the reference laboratory's instructions for collection and storage of human
specimens.
(t) If the licensee test
human specimens, it shall be licensed as a laboratory in accordance with He-P
808, except the licensee may perform the following CLIA-waiverd point of care
test without obtaining a laboratory license in accordance with He-P 808:
(1) Glucose;
(2) PT/INR;
(3) Dipstick urinalysis; and
(4) Occult blood.
(u) The licensee shall hold the appropriate
CLIA certificate to perform any laboratory tests.
(v) Licensee collecting human specimens for
laboratory testing shall require a collecting station license in accordance
with He-P 817 except when collected by a trained registered nurse or licensed
nursing assistant.
(w) Training
shall consist of collection, storage, and transport of the specimens.
(x) Training shall be done by a registered
nurse trained in the collection, storage and transport of human
specimens.
#9292, eff
10-9-08
