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; and
b. Available, as needed, 24 hours a
day;
(2) LNA 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) Providing patients with 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)
Medical social services shall be based on the patient's psychosocial assessment
and the patient's and family's needs and acceptance of these services. Medical
social services shall be provided by a qualified 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;
(8) Bereavement services that are available
to the family for up to one year following the death of the patient;
(9) Health and safety services to minimize
the likelihood of accident or injury, with care and oversight provided 24 hours
a day regarding:
a. The patients'
functioning, safety, and whereabouts; and
b. The patients' health status, including the
provision of intervention as necessary or required; and
(10) Medication services in accordance with
He-P
824.17.
(b) In addition to the services in (a) above
the licensee shall provide the following services:
(1) Food services in accordance with
He-P
824.21;
(2) Housekeeping, laundry, and maintenance
services; and
(3) Basic supplies
necessary for patients to maintain personnel hygiene and
grooming.
(c) If, on a
temporary basis, not to exceed 90 days, the hospice care provider cannot
provide any of the core care and services in (a) above, the HH shall have a
written agreement with another agency to provide the required
services.
(d) 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 HH
must authorize the services; and
(4) Stipulate the HH retains professional
responsibility for all care and services provided.
(e) The HH shall provide or arrange for the
provision of short-term in-patient stays in a hospital or nursing home during
those times when the patient's pain or symptoms are unable to be managed in the
HH.
(f) The HH 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.
(g) The licensee shall
ensure that the following positions are staffed at the HH location:
(1) An administrator;
(2) A director of patient services, but the
administrator may also be the director of patient services if the administrator
meets the qualifications of the position;
(3) A volunteer coordinator;
(4) A social services coordinator;
and
(5) A spiritual and or
bereavement coordinator.
(h) Any administrator shall:
(1) Have at least a bachelor's degree in
business or a health-related field with a minimum of 3 years' experience in
hospice or palliative care or;
(2)
Be a registered nurse; and
(3)
Designate, in writing, an alternate administrator who shall assume the
responsibilities of the administrator in his or her absence.
(i) The administrator shall be
responsible for maintaining the HH in full compliance with all federal, state
and local laws, rules, codes and ordinances at all times.
(j) The director of patient services shall:
(1) Be a New Hampshire-licensed registered
nurse or an advanced practice registered nurse; or
(2) Have a bachelor's degree in a health
field related to hospice care.
(k) 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
practical nurses (LPN), licensed nurse aides (LNA) and or personal care
attendants (PCA) by a registered nurse and determine if the LNA or PCA is
providing care and services in accordance with the patient's care
plan.
(l) The medical
director, who shall be a physician licensed in the state of New Hampshire,
shall be responsible for:
(1) The oversight of
the medical component of the HH's patient care program;
(2) Participating on the interdisciplinary
patient care team if the patient's own licensed practitioner cannot
participate; and
(3) Determining,
in consultation with the interdisciplinary team, that an individual is
appropriate for hospice and or palliative care services.
(m) 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.
(n) All volunteers shall be oriented and
educated relative to their prescribed function according to the hospice care
provider's policies and procedures.
(o) The licensee shall develop and maintain
policies and procedures for its volunteer services that address the following
areas:
(1) Recruitment and
retention;
(2) Health screening and
2-step TB testing;
(3)
Orientation;
(4) Scope of
function;
(5)
Supervision;
(6) Ongoing training
and support;
(7) Records of
volunteer activities; and
(8)
Criminal record checks.
(p) 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.
(q) 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.
(r) The coordinator of bereavement and
spiritual care services 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 education in death and dying, grief, and bereavement.
(s) Persons providing bereavement services
shall have education in death and dying, grief and bereavement.
(t) The coordinator of bereavement and
spiritual care services shall be responsible for providing an organized program
of bereavement services for up to 12 months after the death of the patient that
includes but is not limited to:
(1) Counseling
to families after the patient's death; and
(2) Developing a care plan that reflects the
needs of the patient's family.
(u) The licensee may only perform POCT, that
are waived complexity as designated by the federal drug administration (FDA)
and known as CLIA-waived laboratory tests, unless the facility is also licensed
by the State of New Hampshire as a laboratory under He-P 808.
(v) If CLIA-waived laboratory testing is
performed by personnel, the licensee shall:
(1) Obtain the appropriate CLIA certificate
as per 42 CFR Part 493.15 ; and
(2)
Develop and implement a point of care testing policy, which educates and
provides procedures for the proper handling and use of POCT devices, including
the documentation of training and demonstrated competency of all testing
personnel.
(w) The
licensee shall have current copies of manufacturer's instructions and package
inserts and shall follow all manufacturer's instructions and recommendations
for the use of POCT meters and devices to include, but not limited to:
(1) Storage requirements for POCT meters and
devices, test strips, test cartridges, and test kits;
(2) Performance of test specimen
requirements, testing environment, test procedure, troubleshooting error codes
and messages, reporting results; and
(3) All recommended and required quality
control procedures for POCT meters and devices.
(x) Licensee's performing CLIA-waived
laboratory testing or specimen collection shall be in compliance with He-P 808,
He-P 817, and 42 CFR 493.
#9317, eff
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