Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 82 - Minimum Standards for Licensure of Hospice Agencies › Subchapter A - General Provisions › Section I-8201 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. The following
					 words and terms, when used in this Chapter, shall have the following meanings,
					 unless the context clearly indicates otherwise:
Activities of Daily Living (ADLs)
- the
						following functions or self-care tasks performed either independently or with
						supervision or assistance:
a.
					 mobility;
b.
					 transferring;
c. walking;
d. grooming;
e. bathing;
f. dressing and undressing;
g. eating; and
h. toileting.
Acute/General Inpatient
						Care
-short-term, intensive hospice services provided in an
						appropriately licensed facility to meet the patient's need for skilled nursing,
						symptom management or complex medical treatment.
Advance Directives
- a witnessed
						document, statement, or expression voluntarily made by the declarant,
						authorizing the withholding or withdrawal of life-sustaining procedures. A
						declaration may be made in writing, such as a durable power of attorney for
						health care, a directive pursuant to patient self-determination initiatives, a
						living will, or by other means of communication such as an oral directive which
						either states a persons choices for medical treatment or, in the event the
						person is unable to make treatment choices, designates who shall make those
						decisions.
Advanced Practice Registered Nurse
(
APRN
)- a nurse who is legally authorized to practice advanced
						practice nursing in the state and designated by the patient as the licensed
						medical practitioner responsible for his/her medical care.
Attending/Primary Physician
- a person
						who is a doctor of medicine or osteopathy licensed to practice medicine in the
						state of Louisiana, who is designated by the patient as the physician
						responsible for his/her medical care.
Bereavement Services
- organized services
						provided under the supervision of a qualified professional to help the family
						cope with death related grief and loss issues. This shall be provided for at
						least one year following the death of the patient.
Branch
- an alternative delivery site
						from which a hospice agency provides services within a portion of the total
						geographic area served by the parent agency. The branch office is part of the
						parent hospice agency and is located within a 50 mile radius of the parent
						agency and shares administration and supervision.
Bureau
- Repealed.
Care Giver
-the person whom the patient
						designates to provide his/her emotional support and/or physical care.
Certified Nurse Aide
(
CNA
)
Registry
- the state registry used to
						determine if a prospective hire who is a CNA has had a finding placed on the
						registry that he/she has abused or neglected a resident or misappropriated a
						residents property or funds.
Cessation of Business
- provider is
						non-operational and/or has stopped offering or providing services to the
						community.
Chaplain
-a member of the clergy.
Community
-a group of individuals or a
						defined geographic area served by a hospice.
Continuous Home Care
- care provided by
						the hospice during a period of crisis as necessary to maintain the terminally
						ill individual at home. A minimum of eight hours of care shall be furnished on
						a particular day to be considered continuous home care. Nursing care shall be
						provided for more than one half of the period of care and shall be provided by
						either a registered nurse or licensed practical nurse. Services may be provided
						by a homemaker or home health aide to supplement the nursing care. A registered
						nurse shall complete an assessment of the patient and determine that the
						patient requires continuous home care prior to assigning a licensed practical
						nurse, homemaker, or a hospice aide to a patient requiring continuous home
						care. This assignment must comply with accepted professional standards of
						practice.
Contracted Services
-services provided
						to a hospice provider or its patients by a third party under a legally binding
						agreement that defines the roles and responsibilities of the hospice and
						service provider.
Core Services
- nursing services,
						licensed medical practitioner services, medical social services, and counseling
						services, including bereavement counseling, dietary counseling, spiritual
						counseling, and any other counseling services provided to meet the needs of the
						individual and family. These services shall be provided by employees of the
						hospice, except that licensed medical practitioner services and dietary
						counseling services may be provided through contract. Core services also
						include support services, such as trained volunteers.
Department
- the Department of Health
						(LDH).
Direct Service Worker
(
DSW
)- an unlicensed person who provides personal care or
						other services and support to persons with disabilities or to the elderly to
						enhance their well-being, and who is involved in face-to-face direct contact
						with the person. Functions performed may include, but are not limited to,
						assistance in activities of daily living and personal care services. An example
						of a DSW may be a hospice or home health aide or homemaker.
Discharge
-the point at which the
						patient's active involvement with the hospice program is ended and the program
						no longer has active responsibility for the care of the patient.
Do Not Resuscitate Orders
-orders
						written by the patient's physician which stipulate that in the event the
						patient has a cardiac or respiratory arrest, no cardiopulmonary resuscitation
						will be initiated or carried out.
Emotional Support
-counseling provided
						to assist the person in coping with stress, grief, and loss.
Employee
- an individual who may be
						contracted, hired for a staff position or a volunteer under the jurisdiction of
						the hospice.
Facility-Based Care
- hospice services
						delivered in a place other than the patients home, such as an inpatient hospice
						facility, nursing facility or hospital inpatient unit.
Family
-a group of two or more
						individuals related by ties of blood, legal status, or affection who consider
						themselves a family.
Geographic Area-
area around location of
						licensed agency that includes any parish within 50 mile radius of the hospice
						premises. Each hospice shall designate the geographic area in which the agency
						will provide services.
Governing Body
- the person or group of
						persons that assumes full legal responsibility for determining, implementing
						and monitoring policies governing the hospice's total operation. The governing
						body shall designate an individual who is responsible for the day-to-day
						management of the hospice program, and shall also ensure that all services
						provided are consistent with accepted standards of practice. Written minutes
						and attendance of governing body meetings are to be maintained.
Health Standards Section
(
HSS
)- the agency within the Department of Health responsible
						for regulation of licensed health care providers, agencies or
						facilities.
Home
-a person's place of
						residence.
Homemaker
-an individual who provides
						light housekeeping services to patients in their homes.
Hospice
-an autonomous, centrally
						administered, medically directed program providing a continuum of home,
						outpatient, and homelike inpatient care for the terminally ill patient and his
						family. It employs an interdisciplinary team to assist in providing palliative
						and supportive care to meet the special needs arising out of the physical,
						emotional, spiritual, social, and economic stresses which are experienced
						during the final stages of illness and during dying and bereavement.
Hospice Inpatient Facility
- a facility
						where specific levels of hospice care ranging from residential to acute,
						including respite, are provided in order to meet the needs of the
						patient/family.
Hospice Inpatient Services
- care and
						services available for pain control, symptom management and/or respite purposes
						that are provided for a patient either directly by the hospice agency or in a
						participating facility.
Hospice Physician
- a person who is a
						doctor of medicine or osteopathy, and is currently and legally authorized to
						practice medicine in the State of Louisiana, designated by the hospice to
						provide medical care to hospice patients in lieu of their primary licensed
						medical practitioner.
Hospice Premises
- the physical site
						where the hospice maintains staff to perform administrative functions, and
						maintains its personnel records, or maintains its patient service records, or
						holds itself out to the public as being a location for receipt of patient
						referrals.
Hospice Services
- a coordinated program
						of palliative and supportive care, in a variety of appropriate settings, from
						the time of admission through bereavement, with the focus on keeping terminally
						ill patients in their place of residence as long as possible.
Informed Consent
-a documented process
						in which information regarding the potential and actual benefit and risks of a
						given procedure or program of care is exchanged between provider and
						patient.
Inpatient Services
- Repealed.
Interdisciplinary Team
(
IDT
)- an interdisciplinary team or teams designated by the
						hospice, composed of representatives from all the core services. The IDT shall
						include at least a doctor of medicine or osteopathy, a registered nurse, a
						social worker, a pastoral or other counselor, and a representative of the
						volunteer services. The interdisciplinary team is responsible for participation
						in the establishment of the plan of care; provision or supervision of hospice
						care and services; periodic review and updating of the plan of care for each
						individual receiving hospice care, and establishment of policies governing the
						day-to-day provision of hospice care and services. If a hospice has more than
						one interdisciplinary team, it shall designate in advance the team it chooses
						to execute the establishment of policies governing the day-to-day provision of
						hospice care and services.
Interdisciplinary Team Conferences
-
						regularly scheduled periodic meetings of specific members of the
						interdisciplinary team to review the most current patient/family assessment,
						evaluate care needs, and update the plan of care.
Louisiana At-Risk Registry
- the
						reporting mechanism for hospice patients that require community assistance in
						emergency situations.
Louisiana Physician Order for Scope of
						Treatment
(
LaPOST
)- a physicians order that documents
						the wishes of a qualified patient for life-sustaining interventions, as well as
						the patient's preferred treatment for each intervention, on a form that is
						recognized, adopted, and honored across treatment settings in accordance with
						state laws.
Major Alteration
- any repair or
						replacement of building materials and equipment which does not meet the
						definition of minor alteration.
Medical Social Services
- include a
						comprehensive psychosocial assessment; ongoing support for the patient and
						family; and assistance with coping skills, anticipatory grief, and grief
						reactions.
Minor Alteration
- repair or replacement
						of building materials and equipment with materials and equipment of a similar
						type that does not diminish the level of construction below that which existed
						prior to the alteration. This does not include any alteration to the function
						or original design of the construction.
Non-Core Services
- services provided
						directly by hospice employees or under arrangement. These services include, but
						are not limited to:
a. hospice aide
					 and homemaker;
b. physical therapy
					 services;
c. occupational therapy
					 services;
d. speech-language
					 pathology services;.
e. inpatient
					 care for pain control and symptom management and respite purposes;
					 and
f. medical supplies and
					 appliances including drugs and biologicals.
Non-Operational
- the hospice agency
						location is not open for business operation on designated days and hours as
						stated on the licensing application and business location signage.
Palliative Care
- the reduction or
						abatement of pain or other troubling symptoms by appropriate coordination of
						all services of the hospice care team required to achieve needed relief of
						distress.
Period of Crisis
-a period in which a
						patient requires predominately nursing care to achieve palliation or management
						of acute medical problems.
Plan of Care
(
POC
)- a
						written document established and maintained for each individual admitted to a
						hospice program. Care provided to an individual shall be in accordance with the
						plan. The plan includes an assessment of the individual's needs and
						identification of the services including the management of discomfort and
						symptom relief.
Public Health Emergency (PHE)
-a
						declaration made pursuant to the Louisiana Health Emergency Powers Act,
						R.S.
						29:760 et seq.
Representative
-an individual who has
						been authorized under State law to terminate medical care or to elect or revoke
						the election of hospice care on behalf of a terminally ill individual who is
						mentally or physically incapacitated.
Residential Care
- hospice care provided
						in a nursing facility, adult residential facility or any residence or facility
						other than the patients private residence.
Respite Care
-short-term care generally
						provided in a nursing facility or hospice facility to provide relief for the
						family from daily care of the patient.
Spiritual Services
-providing the
						availability of clergy as needed to address the patient's/family's spiritual
						needs and concerns.
State Certified Hospice Attendant
-a
						former inmate of a Louisiana state prison with a hospice provider license
						issued by the Department of Health who shall be eligible to be employed as a
						non-licensed person by a provider licensed to provide hospice services pursuant
						to the requirements of
						R.S.
						40:2192 if the following provisions are
						satisfied:
a. the former inmate shall
					 not have been convicted of a sex offense as defined by R.S. 2715:541;
b. while incarcerated, the former inmate
					 shall have been a caregiver in the licensed hospice program, with documentation
					 of such, and successfully completed the training pursuant to subsection B of
					 R.S.40:2192;
c. the former inmate shall hold a
					 certification issued by the Department of Public Safety and
					 Corrections;
d. the former inmate
					 shall submit notice of his/her certification to the department in a manner
					 prescribed by the Department of Health; and
e. there are no federal restrictions or
					 prohibitions against the former inmate providing hospice
					 services.