Current through Register Vol. 24-18, September 15, 2024
Except as provided in subsection (5) of this section, the
licensee must:
(1) Develop and
implement a written hospice plan of care for each patient with input from the
authorizing practitioner, appropriate interdisciplinary team members, and the
patient, designated family member, or legal representative;
(2) Ensure each plan of care is developed by
appropriately trained or credentialed agency personnel and is based on a
patient and family assessment;
(3)
Ensure the hospice plan of care includes:
(a)
Current diagnoses and information on health status;
(b) Goals and outcome measures which are
individualized for the patient;
(c)
Symptom and pain management;
(d)
Types and frequency of services to be provided;
(e) Palliative care, if applicable;
(f) Use of telehealth or telemedicine, if
applicable;
(g) Home medical
equipment and supplies used by the patient;
(h) Orders for treatments and their frequency
to be provided and monitored by the licensee;
(i) Special nutritional needs and food
allergies;
(j) Orders for
medications to be administered and monitored by the licensee including name,
dose, route, and frequency;
(k)
Medication allergies;
(l) The
patient's physical, cognitive and functional limitations;
(m) Patient and family education needs
pertinent to the care being provided by the licensee;
(n) Indication that the patient has a signed
advanced directive or POLST, if applicable. Include resuscitation status
according to advance directives or POLST, if applicable; and
(o) The level of medication assistance to be
provided.
(4) Develop
and implement a system to:
(a) Ensure and
document that the plan of care is reviewed by the appropriate interdisciplinary
team members within the first week of admission and every two weeks
thereafter;
(b) Ensure the plan of
care is signed or authenticated and dated by appropriate agency personnel and
the authorizing practitioner;
(c)
Ensure the signed or authenticated plan of care is returned to the agency
within sixty days from the initial date of service;
(d) Inform the authorizing practitioner
regarding changes in the patient's condition that indicates a need to update
the plan of care;
(e) Obtain
approval from the authorizing practitioner for additions and modifications;
and
(f) Ensure all verbal orders
for modification to the plan of care are immediately documented in writing and
signed or authenticated and dated by an agency individual authorized within the
scope of practice to receive the order and signed or authenticated by the
authorizing practitioner and returned to the agency within sixty days from the
date the verbal orders were received.
(5) Hospice agencies providing a one-time
visit for a patient may provide the following written documentation in lieu of
the hospice plan of care requirements in subsection (3) of this section:
(a) Patient's name, age, current address, and
phone number;
(b) Confirmation that
the patient was provided a written bill of rights under WAC
246-335-635;
(c) Patient consent for services to be
provided;
(d) Authorizing
practitioner orders; and
(e)
Documentation of services provided.
