Current through Bulletin 2024-06, March 15, 2024
(1) A hospice unit
of care includes the patient and the patient's family. The licensee shall
ensure that the patient, family, or other primary care person participates in
the development and implementation of the interdisciplinary care plan according
to their ability.
(2) Hospice care
includes responding to the scheduled and unscheduled needs of the patient and
family 24 hours per day. The licensee shall ensure that written policies and
procedures include:
(a) a procedure for
accepting referrals;
(b) a
procedure for completing an initial assessment and developing the
interdisciplinary care plan;
(c) a
procedure for providing for and documenting that the interdisciplinary team
meets regularly to evaluate care and includes inpatient and in-home care
staff;
(d) a requirement that the
care plan to be available to team members for in-home and inpatient
services;
(e) a process for the
appropriate transfer of care from hospice in-home care to hospice inpatient
care and vice-versa where available;
(f) a clearly defined and integrated
administrative structure between in-home care and inpatient services;
and
(g) coordination of the care
plan between in-home hospice and inpatient hospice care.
(3) Hospice care shall be provided by the
interdisciplinary team.
(a) The
interdisciplinary team may include ancillary staff when appropriate.
(b) The interdisciplinary team shall meet at
least twice a month to develop and maintain an appropriate plan of
care.
(4) A care plan for
each patient shall be signed by the attending physician and include the
following:
(a) the name of patient;
(b) any pertinent diagnoses;
(c) objectives, interventions, and goals of
treatment, based upon needs identified in a comprehensive patient
assessment;
(d) services to be
provided, at what intervals and by whom; and
(e) the date the plan was initiated and dates
of subsequent reviews.
(5) A hospice nurse may not give any
medication or treatment requiring an order except on order of a person lawfully
authorized to give such an order.
(a) Initial
orders and subsequent changes in orders for the administration of medications
shall be signed by the person lawfully authorized to give such orders and
incorporated in the patient's record maintained by the licensee.
(b) Telephone orders shall only be received
by licensed personnel, who shall record them immediately in the patient's
medical record. Telephone orders shall be countersigned by the initiator within
15 days of the date of issue.
(c)
Orders for therapy services shall include the specific procedures to be used
and the frequency and duration of the services.
(d) The attending physician shall review,
sign, and date orders at least every 90 days.
(e) Only those hospice employees licensed to
do so may administer medications to patients.
(f) Medications and treatments that are
administered by hospice employees, shall be administered as prescribed and
recorded in the patients record.
