New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 370 - OVERSIGHT OF LICENSED HEALTHCARE FACILITIES AND COMMUNITY BASED WAIVER PROGRAMS
Part 14 - ASSISTED LIVING FACILITIES FOR ADULTS
Section 8.370.14.68 - HOSPICE
Universal Citation: 8 NM Admin Code 8.370.14.68
Current through Register Vol. 35, No. 18, September 24, 2024
An assisted living facility that provides or coordinates hospice care and services shall meet the requirements in this section, in addition to the rules applicable to all assisted living facilities, 8.370.14 NMAC.
A. Definitions: in addition to the requirements for all assisted living facilities pursuant to "definitions," 8.370.14.7 NMAC, the following definitions shall also apply.
(1)
"Hospice agency" means an
organization, company, for-profit or non-profit corporation or any other entity
which provides a coordinated program of palliative and supportive services for
physical, psychological, social and the option of spiritual care of terminally
ill people and their families. The services are provided by a medically
directed interdisciplinary team in the person's home and the agency is required
to be licensed pursuant to 8.370.19 NMAC.
(2)
"Hospice care" means a focus
on palliative, rather than curative care. The goal of the plan of care is to
help the patient live as comfortably as possible, with emphasis on eliminating
or decreasing pain and other uncomfortable symptoms.
(3)
"Licensed assisted living
provider" means a facility that provides 24 hour assisted living and is
licensed by the health care authority.
(4)
"Hospice services" means a
program of palliative and supportive services which provides physical,
psychological, social and spiritual care for terminally ill patients and their
family members.
(5)
"Care
coordination requirements" means a written document that outlines the
care and services to be provided by the hospice agency for assisted living
residents that require hospice services.
(6)
"Palliative care" means a
form of medical care or treatment that is intended to reduce the severity of
disease symptoms, rather than to reverse progression of the disease itself or
provide a cure.
(7)
"Terminally ill" means a diagnosis by a physician for a patient
with a prognosis of six months or less to live.
(8)
"Visit notes" means the
documentation of the services provided for hospice residents and includes
ongoing care coordination.
B. Employee training and support: A facility that provides hospice services shall provide the following education and training for employees who assist with providing these services:
(1) provide a minimum of six hours
per year of palliative/hospice care training, which includes one hour specific
to the hospice resident's ISP, in addition to the basic staff education
requirements pursuant to 8.370.14.17 NMAC; and
(2) offer an ongoing employee psychological
support program for end of life care issues.
C. Individual service plan (ISP) requirements:
(1) Each resident who
receives hospice services shall be provided the necessary palliative care to
meet the individual resident's needs as outlined in the ISP and shall include
one hour of training specific to the resident for all direct care
staff.
(2) The assisted living
facility, in coordination with the hospice provider, shall create an ISP that
identifies how the resident's needs are met and includes the following:
(a) the requirements set forth in the
"individual service plan," 8.370.14.26 NMAC, and "Exceptions to admission,
readmission and retention," Subsection C of 8.370.14.20 NMAC;
(b) what services are to be
provided;
(c) who will provide the
services;
(d) how the services will
be provided;
(e) a delineation of
the role(s) of the hospice provider and the assisted living facility in the ISP
process;
(f) documentation (visit
notes) of the care and services that are provided with the signature of the
person who provided the care and services; and
(g) a list of the current medications or
biologicals that the resident receives and who is authorized to administer
them.
(3) Medications
shall be self-administered, self-administered with assistance by an individual
that has completed a state approved program in medication assistance or
administered by the following individuals:
(a)
a physician;
(b) a physician
extender (PA or NP);
(c) a licensed
nurse (RN or LPN);
(d) the resident
if their PCP has approved it;
(e)
family or family designee; and
(f)
any other individual in accordance with applicable state and local laws.
D. Care coordination.
(1) The assisted living
facility shall be knowledgeable with regard to the hospice requirements
pursuant to 8.370.19 NMAC and ensure that the hospice agency is well informed
with regard to the assisted living provisions pursuant to Subsection C of
8.370.14.20 NMAC.
(2) The assisted
living facility shall hold a team meeting prior to accepting or retaining a
hospice resident in accordance with "exceptions to admission, readmission and
retention," Subsection C of 8.370.14.20 NMAC.
(3) Upon admission of a resident into hospice
care, the assisted living facility shall designate a section of the resident's
record for hospice documentation.
(a) The
facility shall provide individual records for each resident.
(b) The hospice agency shall leave
documentation at the facility in the designated section of the resident's
record.
(4) The assisted
living facility shall provide the resident and family or surrogate decision
maker with information on palliative care and shall support the resident's
freedom of choice with regard to decisions.
(5) Hospice services shall be available 24
hours a day, seven days a week for hospice residents, families and facility
staff and may include continuous nursing care for hospice residents as needed.
These services shall be delivered in accordance with the resident's individual
service plan (ISP) and pursuant to 8.370.14 26 NMAC.
(6) The assisted living facility shall ensure
the coordination of services with the hospice agency.
(a) The resident's individual service plan
(ISP) shall be updated with significant changes in the resident's condition and
care needs.
(b) The assisted living
facility shall receive information and communication from the hospice staff at
each visit.
(i) The information shall include
the resident status and any changes in the ISP (i.e., medication changes,
etc.).
(ii) The information shall
be in the form of a verbal report to the assisted living facility staff and
also in the form of written documentation.
(c) The assisted living facility or the
family/resident shall reserve the right to schedule care conferences as the
needs of the resident and family dictate. The care conferences shall include
all care team members.
(d) Concerns
that arise with regard to the delivery of services from either the assisted
living facility or the hospice agency shall first be addressed with the
facility administrator and the hospice agency administrator.
(i) The process may be informal or formal
depending on the nature of the issue.
(ii) If an issue cannot be resolved or if
there is an immediate danger to the resident the appropriate authority shall be
notified.
E. Additional provisions: An assisted living facility that provides or coordinates hospice care and services shall make additional provisions for the following requirements:
(1)
individual services and
care: each resident receiving hospice services shall be provided the
necessary palliative procedures to meet individual needs as defined in the
ISP;
(2)
private visiting
space:
(a) physical space for private
family visits;
(b) accommodations
for family members to remain with the patient throughout the night;
and
(c) accommodations for family
privacy after a resident's death.
F. Medicare and Medicaid restrictions: Assisted living facilities shall not accept a resident considered "hospice general inpatient" which would be billable to medicare or medicaid because the facility will not qualify for payment by medicare or medicaid.
Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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