Connecticut Administrative Code › Title 19a - Public Health and Well-being › 495 - Licensure of Private Freestanding Mental Health Day Treatment Facilities, Intermediate Treatment Facilities and Psychiatric Outpatient Clinics for Adults › Short-term Hospitals, Special, Hospice and Hospice Inpatient Facilities › Section 19a-495-6f - Hospice inpatient facility services

Current through July 10, 2024
(a) The licensee
				shall provide staff in sufficient numbers and services of sufficient duration
				to meet the physical, psychosocial and spiritual needs of patients and their
				families. The licensee is responsible for ensuring that staffing for all
				services reflect its volume of patients, their acuity, and the level of
				intensity of services needed to ensure that the plan of care outcomes are
				achieved and negative outcomes are avoided.
(b) The licensee shall provide quality care
				through the provision of the following services:
(1) Physical, occupational, and speech and
				language therapy shall be available and when provided, such services shall be
				rendered by a licensed person in accordance with the patient centered plan of
				care and in a manner consistent with accepted standards of practice and
				applicable law.
(2) Attending
				practitioner services shall be provided by a licensed physician or advanced
				practice registered nurse to meet the medical needs of patients for the
				management of the terminal illness and related conditions, through palliative
				and supportive care. Attending practitioner services shall be provided in
				accordance with hospice inpatient facility policies in a manner consistent with
				accepted standards of practice and applicable law. In addition to palliation
				and management of terminal illness and related conditions, physicians and
				advanced practice registered nurses that are part of the staff of the hospice
				inpatient facility or members of the interdisciplinary team, shall meet the
				medical needs of the patients to the extent that these needs are not met by the
				attending practitioner.
(3)
				Bereavement counseling services shall be provided to meet the needs of the
				family both before and after the death of the patient.
(4) Dietary counseling services for the
				patient and family shall be available as may be required, while the patient is
				in hospice care.
(5) Dietary
				services shall be provided to patients under the supervision of a certified
				food protection manager as defined in section 19a-36g of the Connecticut
				General Statutes. The certified food protection manager shall:
(A) Ensure the dietary services operation
				complies with all applicable state regulations and statutes;
(B) Employ an adequate number of individuals
				to perform the duties and responsibilities of the food service operation;
				and
(C) Consult with a registered
				dietician on a regular basis, and an advanced practice registered nurse, or
				physician concerning patients' diets, as necessary.
(6) Medical supply services including, but
				not limited to, appliances, drugs and biological products as may be needed,
				shall be provided for the palliation and management of the patients' terminal
				illness.
(7) Nursing assistants
				shall provide personal care and other related support services under the
				delegation and supervision of a registered nurse. Duties of nursing assistants
				shall include, but not be limited to:
(A)
				Personal care;
(B) Ambulation and
				exercise;
(C) Assisting a patient
				with eating;
(D) Reporting changes
				in a patient's condition and needs;
(E) Completing a patient's medical records as
				directed; and
(F) Assisting with
				the patient's self-administration of drugs and biological products by:
(i) Reminding a patient to self-administer
				the drugs or biological products;
(ii) Verifying that a patient has
				self-administered their drugs or biological products;
(iii) Opening bottles, bubble packs or other
				forms of packaging if the patient is not capable of performing this
				function.
(8)
				Nursing services shall be provided under the direction of a licensed registered
				nurse to meet the nursing care needs of the patient and family, as identified
				in the patient centered plan of care. Nursing services shall be provided in
				accordance with accepted standards of practice, applicable law and hospice
				inpatient facility policies. There shall be a registered nurse on the premises
				on a twenty-four hour basis and there shall be a sufficient number of nursing
				personnel on a twenty-four hour basis to:
(A)
				Assess patients' needs;
(B) Assist
				in the development and implementation of patient centered plans of
				care;
(C) Provide direct patient
				care services; and
(D) Coordinate
				or perform other related activities to maintain the health and safety of the
				patients.
(9) Pharmacy
				services shall be provided under the direction of a licensed pharmacist who is
				an employee of or has a written agreement with the hospice inpatient facility.
				Duties of the pharmacist shall include, but not be limited to the following:
(A) Identification of potential adverse drug
				reactions, and recommended appropriate corrective action;
(B) Compounding, packaging, labeling,
				dispensing, and distributing all drugs to be administered to
				patients;
(C) Monitoring patient
				drug therapy for potential drug interactions and incompatibilities at least
				monthly with documentation of same;
(D) Inspecting all areas within the facility
				where drugs (including emergency supplies) are stored at least monthly to
				assure that all drugs are properly labeled, stored and controlled;
				and
(E) Serving as a consultant to
				the interdisciplinary team for pain control and symptom management.
(10) Spiritual counseling services
				shall be provided in accordance with the wishes of the patient as noted in the
				patient centered plan of care. Services may include, but not be limited to:
(A) Communication and support from a
				spiritual counselor;
(B)
				Consultation and education for the patient, family and interdisciplinary team
				members.
(11) Social work
				services shall be provided as identified in the patient centered plan of care
				and in accordance with accepted standards of practice, applicable law and
				hospice inpatient facility policies. The social worker's functions shall
				include, but not be limited to:
(A)
				Comprehensive evaluation of the psychosocial status of the patient and family
				as it relates to the patient's illness and environment;
(B) Counseling of the patient, family and
				primary caregivers;
(C)
				Participation in development of the patient centered plan of care;
				and
(D) Participation in ongoing
				case management with the hospice inpatient facility inter-disciplinary
				team.
(12) Volunteer
				Services shall be provided under the supervision of designated hospice
				inpatient facility employees.
(A) Volunteers
				may provide administrative services or non-direct patient care services under
				the supervision of designated hospice inpatient facility employees;
(B) Direct patient care services may be
				provided by licensed or registered volunteers who meet the requirements for the
				provision of such services, under the supervision of appropriate, licensed
				hospice inpatient facility employees;
(C) The licensee shall provide and document a
				volunteer orientation and training program for each volunteer;
(D) Volunteer services involving any direct
				patient care services shall be provided in accordance with the patient centered
				plan of care.