Current through Reg. 49, No. 38; September 20, 2024
(a) A hospice must make inpatient care
available when needed for pain control, symptom management, and respite
purposes.
(b) A hospice must
ensure that inpatient care for pain control and symptom management is provided
in either:
(1) a hospice inpatient unit that
meets the additional standards in Division 7 of this subchapter (relating to
Hospice Inpatient Units) and the Medicare Conditions of Participation for
providing inpatient care directly as specified in
42
CFR §
418.110; or
(2) a Medicare-certified hospital or skilled
nursing facility that also meets:
(A) the
licensing standards specified in § 558.870(b)(1) and (2) of this
subchapter (relating to Staffing in a Hospice Inpatient Unit) regarding 24-hour
nursing services, and in § 558.871(d)(1)-(4) of this subchapter (relating
to Physical Environment in a Hospice Inpatient Unit); and
(B) the federal Medicare standards specified
in
42
CFR §
418.110(b) and
(e) regarding 24-hour nursing services and
patient areas.
(c) A hospice must ensure that inpatient care
for respite purposes is provided either by:
(1) a facility specified in subsection (b)(1)
or (2) of this section; or
(2) a
Medicare-certified or Medicaid-certified nursing facility that also meets the
licensing standards specified in § 558.871(d)(1)-(4) of this subchapter
regarding client areas and the federal Medicare standards specified in
42
CFR §
418.110(e)
regarding patient areas.
(d) A facility providing respite care must
provide 24-hour nursing services that meet the nursing needs of all clients and
are furnished in accordance with each client's plan of care. Each client must
receive all nursing services as prescribed and must be kept comfortable, clean,
well-groomed, and protected from accident, injury, and infection.
(e) In addition to the requirements in §
558.289(b) of this chapter (relating to Independent Contractors and Arranged
Services), if a hospice has an agreement with a facility to provide for
inpatient care, there must be a written contract coordinated by the hospice
that specifies that:
(1) the hospice supplies
the facility with a copy of the client's plan of care and specifies the
inpatient services to be furnished;
(2) the facility has established client care
policies consistent with those of the hospice and agrees to abide by the plan
of care established by the hospice for each client and to follow the hospice
agency's protocols for supporting optimal quality of life for its clients;
(3) the facility's clinical record
for a hospice client includes documentation of all inpatient services furnished
and events regarding care that occurred at the facility;
(4) a copy of the discharge summary be
provided to the hospice at the time of discharge;
(5) a copy of the inpatient clinical record
is available to the hospice at the time of discharge;
(6) the facility has identified a person
within the facility who is responsible for the implementation of the provisions
of the agreement;
(7) the hospice
retains responsibility for ensuring that the training of personnel who will be
providing the client's care in the facility has been provided and that a
description of the training and the names of those giving the training are
documented; and
(8) a method for
verifying that the requirements in paragraphs (1) - (7) of this subsection are
met.
