Current through Vol. 42, No. 1, September 16, 2024
(a)
General. Medical supplies
and appliances; durable medical equipment; and drugs and biologicals related to
the palliation and management of the terminal illness and related conditions,
as identified in the hospice plan of care, must be provided by the hospice
while the patient is under hospice care.
(b)
Managing drugs and
biologicals.
(1) The hospice must
ensure that the interdisciplinary group confers with an individual with
education and training in drug management as defined in hospice policies and
procedures and State law, who is an employee of or under contract with the
hospice to ensure that drugs and biologicals meet each patient's
needs.
(2) A hospice that provides
inpatient care directly in its own facility must provide pharmacy services
under the direction of a qualified licensed pharmacist who is an employee of or
under contract with the hospice. The provided pharmacist services must include
evaluation of a patient's response to medication therapy, identification of
potential adverse drug reactions, and recommended appropriate corrective
action.
(c)
Ordering of drugs.
(1) Only a
licensed independent practitioner with prescriptive authority, in accordance
with the plan of care and State law, may order drugs for the patient.
(2) If the drug order is verbal or given by
or through electronic transmission:
(A) It
must be given only to a licensed health care practitioners within their scope
of practice under state law and authorized by hospice policy to receive verbal
orders; and
(B) The individual
receiving the order must record and sign it immediately and have the
prescribing person sign it in accordance with State and Federal
regulations.
(d)
Dispensing of drugs and
biologicals. The hospice must obtain drugs and biologicals from
community or institutional pharmacists or stock drugs and biologicals
itself.
(e)
Administration of
drugs and biologicals. The interdisciplinary group, as part of the
review of the plan of care, must determine the ability of the patient and/or
family to safely self-administer drugs and biologicals to the patient in his or
her home.
(f)
Labeling,
disposing, and storing of drugs and biologicals.
(1)
Labeling. Drugs and
biologicals must be labeled in accordance with currently accepted professional
practice and include appropriate usage and cautionary instructions, as well as
an expiration date (if applicable).
(2)
Disposing. The hospice must
have written policies and procedures for the management and disposal of
controlled drugs in the patient's home. At the time when controlled drugs are
first ordered the hospice must:
(A) Provide a
copy of the hospice written policies and procedures on the management and
disposal of controlled drugs to the patient or patient representative and
family;
(B) Discuss the hospice
policies and procedures for managing the safe use and disposal of controlled
drugs with the patient or representative and the family in a language and
manner that they understand to ensure that these parties are educated regarding
the safe use and disposal of controlled drugs; and
(C) Document in the patient's clinical record
that the written policies and procedures for managing controlled drugs was
provided and discussed.
(g)
Use and maintenance of equipment
and supplies.
(1) The hospice must
ensure that manufacturer recommendations for performing routine and preventive
maintenance on durable medical equipment are followed. The equipment must be
safe and work as intended for use in the patient's environment. Where a
manufacturer recommendation for a piece of equipment does not exist, the
hospice must ensure that repair and routine maintenance policies are developed.
The hospice may use persons under contract to ensure the maintenance and repair
of durable medical equipment.
(2)
The hospice must ensure that the patient, where appropriate, as well as the
family and/or other caregiver(s), receive instruction in the safe use of
durable medical equipment and supplies. The hospice may use persons under
contract to ensure patient and family instruction. The patient, family, and/or
caregiver must be able to demonstrate the appropriate use of durable medical
equipment to the satisfaction of the hospice staff.
Added at 26 Ok Reg 2042,
eff 6-25-09
