reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter D - Patient Care Services › Section I-8077 - Patient Rights and Responsibilities

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 The CRCC shall ensure that the patient has the right to:
1. be cared for by a team of professionals
					 who provides high quality comprehensive services as needed and appropriate for
					 patient/family;
2. have a clear
					 understanding of the availability of CRCC services;
3. receive appropriate and compassionate care
					 regardless of race, gender, creed, disability, sexual orientation or the
					 ability to pay for services rendered;
4. be fully informed regarding patient status
					 in order to participate in the POC. The professional team shall assist
					 patient/family in identifying which services and treatments will help attain
					 these goals;
5. be fully informed
					 regarding the potential benefits and risks of all medical treatments or
					 services suggested, and to accept or refuse those treatments and/or services as
					 appropriate to patient/family personal wishes;
6. be treated with respect and
					 dignity;
7. have patient/family
					 trained in effective ways of caring for the patient;
8. confidentiality with regard to provision
					 of services and all client records, including information concerning
					 patient/family health status, as well as social, and/or financial
					 circumstances. The patient information and/or records shall be released only
					 with patient/family's written consent, and or as required by law;
9. voice grievances concerning patient care,
					 treatment, and/or respect for person or privacy without being subject to
					 discrimination or reprisal, and have any such complaints investigated by the
					 CRCC; and
10. be informed of any
					 fees or charges in advance of services for which patient/family may be liable.
					 Patient/family has the right to access any insurance or entitlement program for
					 which patient may be eligible.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter D - Patient Care Services › Section I-8079 - Clinical Records

Current through Register Vol. 50, No. 6, June 20, 2024
A. In
					 accordance with accepted principles of practice the CRCC shall establish and
					 maintain a clinical record for every individual receiving care and services.
					 The record shall be complete, promptly and accurately documented, readily
					 accessible and systematically organized to facilitate retrieval. The clinical
					 record shall contain all pertinent past and current medical, nursing, social,
					 and other therapeutic information, including the current POC under which
					 services are being delivered.
B.
					 CRCC records shall be maintained in a distinct location and not mingled with
					 records of other types of health care related agencies.
C. Original clinical records shall be kept in
					 a safe and confidential area which provides convenient access to
					 clinicians.
D. The agency shall
					 have policies addressing who is permitted access to the clinical records. No
					 unauthorized person shall be permitted access to the clinical
					 records.
E. All clinical records
					 shall be safeguarded against loss, destruction and unauthorized use.
F. Records for individuals under the age of
					 majority shall be kept in accordance with current state and federal
					 law.
G. When applicable, the agency
					 shall obtain a signed Release of Information Form from the patient and/or the
					 patient's family. A copy shall be retained in the record.
H. The clinical records shall contain a
					 comprehensive compilation of information including, but not limited to:
1. initial and subsequent plans of care and
					 initial assessment;
2.
					 documentation of a life-limiting diagnosis;
3. written physician's orders for admission
					 and changes to the POC;
4. current
					 clinical notes {at least the past 60 days);
5. plan of care;
6. signed consent and authorization
					 forms;
7. pertinent medical
					 history; and
8. identifying data,
					 including:
a. name;
b. address;
c. date of birth;
d. sex;
e. agency case number; and
f. next of kin.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter D - Patient Care Services › Section I-8081 - Nursing Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. There shall
					 be an organized nursing service that provides 24-hour nursing services. The
					 nursing services shall be under the direction of a director of nursing, who is
					 a registered nurse licensed to practice in Louisiana, employed full time by
					 only one licensed agency. There shall be a similarly qualified registered nurse
					 available to act in the absence of the director of nursing.
B. The CRCC facility shall have staff on the
					 premises on a 24-hour a day, seven-day a week basis. There shall be a
					 registered nurse on duty at all times when patients are in the facility. In
					 addition, the facility shall provide nursing services sufficient to meet the
					 total nursing needs of the patients in the facility. When there are no patients
					 in the CRCC facility, the facility shall have a registered nurse on-call to be
					 immediately available to the CRCC facility. The services provided must be in
					 accordance with the patient's plan of care. Each shift shall include at least
					 two direct patient care staff, one of which must be a registered nurse who
					 provides direct patient care. The nurse to patient ratio shall be at least one
					 nurse to every eight patients. In addition, there shall be sufficient number of
					 direct patient care staff on duty to meet the patient care needs.
C. Written nursing policies and procedures
					 shall define and describe the patient care provided.
D. Nursing services shall be either furnished
					 and/or supervised by a registered nurse and all nursing services shall be
					 evaluated by a registered nurse.
E.
					 A registered nurse shall assign the nursing service staff for each patient in
					 the CRCC facility. The CRCC facility shall provide 24-hour nursing services
					 sufficient to meet the total nursing needs of the patient and which are in
					 accordance with the patient's plan of care. Staffing shall be planned so that
					 each patient receives treatments, medications and diet as prescribed, and is
					 kept clean, well-groomed, and protected from accident, injury, and infection.
					 Nursing services staff shall be assigned clinical and/or management
					 responsibilities in accordance with education, experience and the current
					 Louisiana Nurse Practice Act.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						40:2175.14(B).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter D - Patient Care Services › Section I-8083 - Nutritional Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Nutritional
					 services shall be under the supervision of a qualified registered dietitian,
					 who is employed either full time, part time, on a consulting or volunteer
					 basis. If the registered dietitian is not full time, there shall be a full-time
					 dietary manager who is responsible for the daily management of dietary
					 services.
B. The registered
					 dietician shall be responsible for assuring that quality nutritional care is
					 provided to patients by providing and supervising the nutritional aspects of
					 patient care.
C. The CRCC facility
					 shall have a dietary manager who is responsible for:
1. planning menus that meet the nutritional
					 needs of each patient, following the orders of the patient's physician and, to
					 the extent medically possible, the recommended dietary allowances of the Food
					 and Nutrition Board of the National Academy of Sciences. There shall be a
					 current therapeutic diet manual approved by the dietician and medical staff,
					 and readily available to all medical, nursing, and food service personnel,
					 which shall be the guide used for ordering and serving diets;
2. supervising the meal preparation and
					 service to ensure that the menu plan is followed.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter E - Administration › Section I-8089 - Agency Operations

Current through Register Vol. 50, No. 6, June 20, 2024
A. Premises
					 (see definition of
CRCC premises
)
1. The CRCC must have a distinct telephone
					 number. If the telephone number is shared with other health care related
					 agencies, the telephone operator(s) shall demonstrate knowledge and ability to
					 distinguish and direct calls to the appropriate persons. If an answering
					 service is used after normal hours, there shall be evidence of distinct CRCC
					 staff and the answering service should be able to direct calls to the
					 appropriate persons for each service. Staff shall be able to distinguish and
					 describe the scope and delineation of all activities being provided by the
					 CRCC.
2. Staff working areas shall
					 be designed so that when planning for services, patient confidentiality is
					 maintained.
3. The CRCC shall not
					 share office space with a non-health care related entity. When office space is
					 shared with another health care related entity, the CRCC shall operate separate
					 and apart.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter E - Administration › Section I-8091 - Contract Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 administrator and the DON shall be direct employees of the CRCC.
B. Whenever services are provided by an
					 outside agency or individual, a legally binding written agreement shall be
					 effected. The legally binding written agreement shall include at least the
					 following items:
1. identification of the
					 services to be provided;
2. a
					 stipulation that services shall be provided only with the express authorization
					 of the CRCC;
3. the manner in which
					 the contracted services are coordinated, supervised, evaluated by the
					 CRCC;
4. the delineation of the
					 role(s) of the CRCC and the contractor in the admission process, patient/family
					 assessment, and the IDT conferences;
5. requirements for documenting that services
					 are furnished in accordance with the agreement;
6. the qualifications of the personnel
					 providing the services;
7.
					 assurance that the personnel contracted complete the clinical record in the
					 same timely manner as required by the staff personnel of the CRCC;
8. payment fees and terms; and
9. statement that the CRCC retains
					 responsibility for appropriate training of the personnel who provide care under
					 the agreement.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter E - Administration › Section I-8093 - Quality Assurance

Current through Register Vol. 50, No. 6, June 20, 2024
A. The CRCC
					 shall have an on-going comprehensive, integrated, self-assessment quality
					 improvement process which provides assurance that patient care is provided at
					 all times in compliance with accepted standards of professional
					 practice.
B. The CRCC shall have
					 written plans, policies and procedures addressing quality assurance.
C. The CRCC shall monitor and evaluate its
					 resource allocation regularly to identify and resolve problems with the
					 utilization of its services, facilities and personnel.
D. The CRCC shall follow a written plan for
					 continually assessing and improving all aspects of operations which include:
1. goals and objectives;
2. the identity of the person responsible for
					 the program;
3. a system to ensure
					 systematic, objective regular reports are prepared and distributed to the
					 governing body and any other committees as directed by the governing
					 body;
4. the method for evaluating
					 the quality and the appropriateness of care;
5. a method for resolving identified
					 problems; and
6. a method for
					 implementing practices to improve the quality of patient care.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 80 - Children's Respite Care Centers › Subchapter E - Administration › Section I-8095 - Cessation of Business

Current through Register Vol. 50, No. 6, June 20, 2024
A. If at any
					 time the agency is no longer operational, the license shall be deemed to be
					 invalid and shall be returned to DHH within five working days.
B. The agency owner shall be responsible for
					 notifying DHH of the location of all records and a contact person.
C. In order to be operational, an agency
					 shall:
1. have had at least 10 new patients
					 admitted since the last annual survey;
2. be able to accept referrals at any
					 time;
3. have adequate staff to
					 meet the needs of their current patients;
4. have required designated staff on the
					 premises at all times during operation;
5. be immediately available by
					 telecommunications 24 hours per day. A registered nurse shall answer calls from
					 patients and other medical personnel after hours; and
6. be open for the business of providing CRCC
					 services to those who need assistance.
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-8203 - Licensing

Current through Register Vol. 50, No. 6, June 20, 2024
A. Except to the
					 extent required by §8205. A 1, it shall be unlawful to operate or maintain
					 a hospice without first obtaining a license from the department. The Department
					 of Health is the only licensing authority for hospice in the state of
					 Louisiana.
B. A separately
					 licensed hospice may not use a name which is substantially the same as the name
					 of another hospice licensed by the department unless the agency is part of a
					 corporation or is chain affiliated.
C. Issuance of a License. The licensing
					 agency shall have authority to issue two licenses as described below.
1. Full license is issued only to those
					 agencies that are in substantial compliance with applicable federal, state, and
					 local laws. The license shall be valid until the expiration date shown on the
					 license.
2. Provisional license is
					 issued to those existing licensed agencies which do not meet criteria for Full
					 licensure. The license shall be valid for six months or until termination date.
a. At the sole discretion of the department,
					 the provisional license may be extended for a period of time, not to exceed 90
					 days, in order for the facility to correct the noncompliance or
					 deficiencies.
b. An agency with a
					 provisional license may be issued a full license, if at the follow-up survey
					 the agency has corrected the violations. A full license will be issued for the
					 remainder of the year until the hospice agency's license anniversary
					 date.
c. LDH may re-issue a
					 provisional license or allow a provisional license to expire when the hospice
					 fails to correct violations within 60 days of being cited, or at the time of
					 the follow-up survey, whichever occurs first.
d. A provisional license may be issued by LDH
					 for the following non-exclusive reasons:
i.
					 agency has more than five violations of hospice regulations during one
					 survey;
ii. agency has more than
					 three valid complaints in a one year period;
iii. there is a documented incident that
					 places a patient at risk;
iv.
					 agency fails to correct violations within 60 days of being cited, or at the
					 time of a follow-up survey, whichever occurs first;
v. agency has an inadequate referral base,
					 other than at the time of the initial survey for licensure, has less than 20
					 new patients admitted since the last annual survey.
e. Agency fails to submit assessed fees after
					 notification by LDH.
f. Documented
					 evidence that agency has bribed, or harassed any person to use the services of
					 any particular hospice agency.
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-8205 - Survey

Current through Register Vol. 50, No. 6, June 20, 2024
A. Initial Survey.
					 An initial on-site survey will be conducted to assure compliance with all
					 hospice minimum standards.
1. Within 90 days
					 after submitting its application and fee, the hospice shall complete the
					 application process, shall become operational to the extent of providing care
					 to only two outpatients, shall be in substantial compliance with applicable
					 federal, state, and local laws, and shall be prepared for the initial survey.
					 If the applicant fails to meet this deadline, the application shall be
					 considered closed and the agency shall be required to submit a new application
					 packet including the license application fee.
2. The hospice agency that applies for an
					 inpatient facility license shall not provide care to patients in the agencys
					 inpatient hospice facility setting prior to the initial survey and achieving
					 inpatient facility licensure.
3.
					 The initial survey will be scheduled after the agency notifies the department
					 that the agency had become operational and is ready for the survey as provided
					 in §8205. A 1
4. If, at the
					 initial licensing survey, the agency is in substantial compliance with all
					 regulations, a full license will be issued.
5. If, at the initial licensure survey, an
					 agency has more than five violations of any minimum standards or if any of the
					 violations are determined to be of such a serious nature that they may cause or
					 have the potential to cause actual harm, LDH shall deny licensing.
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-8207 - Revocation or Denial of Initial License or Renewal of License

Current through Register Vol. 50, No. 6, June 20, 2024
A. The secretary of
					 LDH may deny an application for a license, or refuse to renew a license or
					 revoke a license in accordance with R.S. 40:2187-2188. An agency's license may
					 not be renewed and/or may be revoked for any of the following:
1. failure to be in substantial compliance
					 with the hospice minimum standards;
2. failure to provide services essential to
					 the palliative care of terminally ill individuals;
3. failure to uphold patient rights whereby
					 violations may result in harm or injury;
4. failure of agency to protect
					 patients/persons in the community from harmful actions of the agency employees;
					 including, but not limited to, health and safety, coercion, threat,
					 intimidation, and harassment;
5.
					 failure to notify proper authorities of all suspected cases of neglect,
					 criminal activity, or mental or physical abuse which could potentially cause
					 harm to the patient;
6. failure to
					 maintain staff adequate to provide necessary services to current active
					 patients;
7. failure to employ
					 qualified personnel;
8. failure to
					 submit fees including, but not limited to, annual fee, renewal fee, provisional
					 follow-up fee, or change of agency address or name, or any fines assessed by
					 LDH;
9. failure to allow surveyors
					 entry to hospice agency or access to any requested records during any
					 survey;
10. failure to protect
					 patient from unsafe skilled and/or unskilled care by any person employed or
					 contracted by the agency;
11.
					 agency staff or owner has knowingly, or with reason to know, made a false
					 statement of a material fact in:
a.
					 application for licensure;
b. data
					 forms;
c. clinical
					 record;
d. matter under
					 investigation by the department;
e.
					 information submitted for reimbursement from any payment source;
f. the use of false, fraudulent or misleading
					 advertising;
g. that the agency
					 staff misrepresented or was fraudulent in conducting hospice business;
					 or
h. convictions of a felony by an
					 owner, administrator, director of nursing or medical director as shown by a
					 certified copy of the record of the court of conviction of the above
					 individual; or if the applicant is a firm or corporation, of any of its members
					 or officers, or of the person designated to manage or supervise the hospice
					 agency;
12. failure to
					 maintain proper insurance; or
13.
					 failure to comply with all reporting requirements in a timely manner.
13.a. - 15. Repealed.
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-8209 - License Renewal Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. License
					 shall be renewed annually.
B.
					 Renewal packet includes forms required for renewal of license.
C. An agency seeking a renewal of its hospice
					 license shall:
1. request a renewal packet
					 from HSS if one is not received at least 45 days prior to license
					 expiration;
2. complete all forms
					 and return to HSS at least 30 days prior to license expiration;
3. submit the current annual licensure fees
					 with packet. An application is not considered to have been submitted unless the
					 required licensure fees are received.
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-8211 - Notice and Appeal Procedure for Revocation of Licensure and Denial of Initial License or License Renewal

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Notice shall be given in accordance with the current State Statutes.
B. Administrative Reconsideration
1. The hospice agency may request an
					 administrative reconsideration of the violation(s) which support the
					 departments actions.
a. The request for
					 reconsideration shall be made, and received by the department, within 15
					 calendar days of receipt of notice.
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-8213 - Fees

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any remittance
					 submitted in payment of a required fee shall be in the form of a company or
					 certified check or money order made payable to the "Louisiana Department of
					 Health".
B. Fee amounts are
					 determined by LDH. (Check with LDH to determine the current required
					 fees.)
C. Fees paid to LDH are not
					 refundable.
D. A licensing fee is
					 required for:
1. an initial
					 application;
2. a
					 renewal;
3. a change of controlling
					 ownership; and
4. a change of
					 location.
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-8215 - Changes

Current through Register Vol. 50, No. 6, June 20, 2024
A. LDH shall be
					 notified, in writing, of any of the following within five working days
					 following the occurrence:
1. address/location
					 (an inpatient hospice facility shall notify and receive approval by LDH prior
					 to a change of address/location)-fee required;
2. agency name - fee required;
3. phone number;
4. hours of operation/24 hour contact
					 procedure;
5. ownership
					 (Controlling) - fee required;
6.
					 change in address of any branch office-fee required;
7. administrator (completed key personnel
					 change form, obtained from LDH required);
8. director of nursing (completed key
					 personnel change form required); or
9. cessation of business in accordance with
					 the requirements of §8243
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-8216 - Emergency Preparedness

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 hospice shall annually conduct and document an all hazard vulnerability or risk
					 assessment for the agencys patients, both outpatient and inpatient.
B. The hospice shall develop an emergency
					 responsiveness plan based on the risk assessment, inclusive of the following
					 but not limited to:
1. preparation for
					 evacuation;
2. training of
					 employees;
3. patient and caregiver
					 education and individual preparedness;
4. tracking of staff and patients;
5. communication and chain of
					 command;
6. sheltering in place;
					 and
7. coordination with local and
					 state emergency operation offices.
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 C - Patient Care Services › Section I-8219 - Patient Care Standard

Current through Register Vol. 50, No. 6, June 20, 2024
A. Patient
					 Certification. To be eligible for hospice care, an individual, or his/her
					 representative, shall sign an election statement with a licensed hospice; the
					 individual shall have a certification of terminal illness and shall have a plan
					 of care (POC) which is established before services are provided.
B. Admission Criteria. The hospice shall have
					 written policies to be followed in making decisions regarding acceptance of
					 patients for care. Decisions are based upon medical, physical and psychosocial
					 information provided by the patient's attending licensed medical practitioner,
					 the patient/family and the interdisciplinary team. The admission criteria shall
					 include:
1. the ability of the agency to
					 provide core services on a 24-hour basis and provide for or arrange for
					 non-core services on a 24-hour basis to the extent necessary to meet the needs
					 of individuals for care that is reasonable and necessary for the palliation and
					 management of terminal illness and related conditions;
2. certification of terminal illness (CTI)
					 signed by the attending licensed medical practitioner and the medical director
					 of the agency;
NOTE: The CTI shall not be signed by an APRN
3. assessment of the
					 patient/family needs and desires for hospice services;
4. informed consent signed by patient or
					 representative who is authorized in accordance with state law to elect the
					 hospice care, which will include the purpose and scope of hospice services;
					 and
5. patient meets all other
					 criteria required by any applicable payor sources.
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 C - Patient Care Services › Section I-8221 - Plan of Care (POC)

Current through Register Vol. 50, No. 6, June 20, 2024
A. Prior to
					 providing care, a written plan of care is developed for each patient/family by
					 the attending physician, the medical director, physician designee or the APRN
					 and the IDT. The care provided to an individual shall be in accordance with the
					 POC.
1. The initial plan of care (IOPC) will
					 be established on the same day as the assessment if the day of assessment is to
					 be a covered day of hospice.
2. The
					 IDT member who assesses the patient's needs shall meet or call at least one
					 other IDT member before writing the IPOC. At least one of the persons involved
					 in developing the IPOC shall be a registered nurse or physician. Within two
					 days of the assessment, the other members of the IDT shall review the IPOC and
					 provide their input. This input may be by telephone. The IPOC shall be signed
					 by the attending licensed medical practitioner and an appropriate member of the
					 IDT.
3. At a minimum the POC shall
					 include the following:
a. an assessment of
					 the individual's needs and identification of services, including the management
					 of discomfort and symptom relief;
b. in detail, the scope and frequency of
					 services needed to meet the patient's and family's needs;
c. identification of problems with realistic
					 and achievable goals and objectives;
d. medical supplies and appliances including
					 drugs and biologicals needed for the palliation and management of the terminal
					 illness and related conditions;
e.
					 patient/family understanding, agreement and involvement with the POC;
					 and
f. recognition of the
					 patient/family's physiological, social, religious and cultural variables and
					 values.
4. The POC is
					 incorporated into the individual clinical record.
5. The hospice shall designate a registered
					 nurse to coordinate the implementation of the POC for each patient.
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 C - Patient Care Services › Section I-8223 - Pharmaceutical Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Hospice
					 provides for the pharmaceutical needs of the patient, consistent with the Board
					 of Pharmacy regulations.
1. Agency shall
					 institute procedures which protect the patient from medication
					 errors.
2. Agency shall provide
					 verbal and written instruction to patient and family as indicated.
3. Drugs and treatments are administered by
					 agency staff only as ordered by the licensed medical practitioner.
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 C - Patient Care Services › Section I-8225 - Pathology and Laboratory Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Hospice provides or has access to pathology and laboratory services which
					 comply with CLIA guidelines and meet patient's needs.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2181-2191.
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 C - Patient Care Services › Section I-8227 - Radiology Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Radiology
					 services provided by hospice either directly; or under arrangements that shall
					 comply with applicable federal and state laws, rules and regulations.
AUTHORITY NOTE:
						Promulgated in accordance with R.S.
						40:2181-2191.
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 C - Patient Care Services › Section I-8229 - Discharge/Revocation/Transfer

Current through Register Vol. 50, No. 6, June 20, 2024
A. Hospice provides
					 adequate and appropriate patient/family information at discharge, revocation,
					 or transfer.
B. Discharge. Patient
					 shall be discharged only in the following circumstance:
1. change in terminal status;
2. patient relocates from the hospice's
					 defined geographical service area;
3. if the safety of the patient or of the
					 hospice staff is compromised. The hospice shall make every effort to resolve
					 these problems satisfactorily before discharge. All efforts by the hospice to
					 resolve the problem shall be documented in detail in the patient's clinical
					 record; and
4. if the patient
					 enters a non-contracted nursing facility or hospital and all options have been
					 exhausted (a contract is not attainable or the patient chooses not to transfer
					 to a facility with which the hospice has a contract, the hospice shall then
					 discharge the patient. The hospice shall notify the payor source to document
					 that all options have been pursued and that the hospice is not "dumping" the
					 patient;
5. the hospice shall
					 clearly document why the hospice found it necessary to discharge the
					 patient.
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 C - Patient Care Services › Section I-8231 - Patient Rights and Responsibilities

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 The hospice shall insure that the patient has the right to:
1. be cared for by a team of professionals
					 who provide high quality comprehensive hospice services as needed and
					 appropriate for patient/family;
2.
					 have a clear understanding of the availability of hospice services and the
					 hospice team 24 hours a day, seven days a week;
3. receive appropriate and compassionate
					 care, regardless of diagnosis, race, age, gender, creed, disability, sexual
					 orientation, place of residence, or the ability to pay for the services
					 rendered;
4. be fully informed
					 regarding patient status in order to participate in the POC. The hospice
					 professional team will assist patient/family in identifying which services and
					 treatments will help attain these goals;
5. be fully informed regarding the potential
					 benefits and risks of all medical treatments or services suggested, and to
					 accept or refuse those treatments and/or services as appropriate to
					 patient/family personal wishes;
6.
					 be treated with respect and dignity;
7. have patient/family trained in effective
					 ways of caring for patient;
8.
					 confidentiality with regard to provision of services and all patient records,
					 including information concerning patient/family health status, as well as
					 social, and/or financial circumstances. The patient information and/or records
					 may be released only with patient/family's written consent, and/or as required
					 by law;
9. voice grievances
					 concerning patient care, treatment, and/or respect for person or privacy
					 without being subject to discrimination or reprisal, and have any such
					 complaints investigated by the hospice; and
10. be informed of any fees or charges in
					 advance of services for which patient/family may be liable. Patient/family has
					 the right to access any insurance or entitlement program for which patient may
					 be eligible.
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 C - Patient Care Services › Section I-8233 - Clinical Records

Current through Register Vol. 50, No. 6, June 20, 2024
A. In
					 accordance with accepted principles of practice the hospice shall establish and
					 maintain a clinical record (either hard copy or electronic) for every
					 individual receiving care and services. The record shall be complete, promptly
					 and accurately documented, legible, readily accessible and systematically
					 organized to facilitate retrieval. The clinical record shall contain all
					 pertinent past and current medical, nursing, social, and other therapeutic
					 information, including the current POC under which services are being
					 delivered.
B. Hospice records shall
					 be maintained in a distinct location and not mingled with records of other
					 types of health care related agencies.
C. Original clinical records shall be kept in
					 a safe and confidential area which provides convenient access to
					 clinicians.
D. The agency shall
					 have policies addressing who is permitted access to the clinical records. No
					 unauthorized person shall be permitted access to the clinical
					 records.
E. All clinical records
					 shall be safeguarded against loss, destruction and unauthorized use.
F. Records shall be maintained for six years
					 from the date of discharge, unless there is an audit or litigation affecting
					 the records. Records for individuals under the age of majority shall be kept in
					 accordance with current state and federal law.
G. When applicable, the agency will obtain a
					 signed "release of information" from the patient and/or the patient's family; a
					 copy will be retained in the record.
H. The clinical record shall contain a
					 comprehensive compilation of information including, but not limited to, the
					 following:
1. initial and subsequent Plans of
					 Care and initial assessment;
2.
					 certifications of terminal illness;
3. written orders for admission and changes
					 to the POC;
4. current clinical
					 notes (at least the past 60 days);
5. Plan of Care;
6. signed consent, authorization and election
					 forms;
7. pertinent medical
					 history; and
8. identifying data,
					 including name, address, date of birth, sex, agency case number; and next of
					 kin.
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 D - Administration › Section I-8235 - Agency Operations

Current through Register Vol. 50, No. 6, June 20, 2024
A. Premises
					 (see definition of Hospice Premises).
1.
					 Staff shall be able to distinguish and describe the scope and delineation of
					 all activities being provided by the hospice.
2. Staff working areas are to be designed so
					 that when planning for services, patient confidentiality is
					 maintained.
3. The hospice shall
					 have a distinct telephone number. If the telephone number is shared with other
					 health care related agencies, the telephone operator(s) shall demonstrate
					 knowledge and ability to distinguish and direct calls to the appropriate
					 persons. If an answering service is used after normal hours, there shall be
					 evidence of distinct hospice staff and the answering service should be able to
					 direct calls to the appropriate persons for each service.
4. The hospice shall not share office space
					 with a non-health care related entity. When office space is shared with another
					 health care related entity the hospice agency shall operate separate and
					 apart.
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 D - Administration › Section I-8237 - Contract Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. When the
					 hospice provides services on a contractual basis to a patient the hospice is
					 responsible for all actions of the contract personnel.
B. The hospice shall not at any time use
					 contract employees as administrator/alternate or for the provision of core
					 services, except that physician or physician designee services may be provided
					 through contract.
C. Whenever
					 services are provided by an organization/individual other than the hospice, a
					 written agreement will delineate services available and procedures for
					 accessing those services.
D.
					 Whenever services are provided by an outside agency or individual, a legally
					 binding written agreement shall be effected. The legally binding written
					 agreement shall include at least the following items:
1. identification of the services to be
					 provided;
2. a stipulation that
					 services may be provided only with the express authorization of the
					 hospice;
3. the manner in which the
					 contracted services are coordinated, supervised, and evaluated by the
					 hospice;
4. the delineation of the
					 role(s) of the hospice and the contractor in the admission process,
					 patient/family assessment, and the IDT conferences;
5. requirements for documenting that services
					 are furnished in accordance with the agreement;
6. the qualifications of the personnel
					 providing the services;
7.
					 assurance that the personnel contracted complete the clinical record in the
					 same timely manner as required by the staff personnel of the hospice;
8. payment fees and terms; and
9. statement that the hospice retains
					 responsibility for appropriate hospice care training of the personnel who
					 provide care under the agreement.
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 D - Administration › Section I-8239 - Quality Assurance/Performance Improvement

Current through Register Vol. 50, No. 6, June 20, 2024
A. Agency shall have an on-going,
					 comprehensive, integrated, self-assessment quality improvement process which
					 provides assurance that patient care, including inpatient care, home care, and
					 care provided by arrangement, is provided at all times in compliance with
					 accepted standards of professional practice.
B. The hospice shall have written plans,
					 policies and procedures addressing quality assurance and performance
					 improvement.
C. Hospice shall
					 monitor and evaluate its resource allocation regularly to identify and resolve
					 problems with the utilization of its services, facilities and
					 personnel.
D. Hospice shall follow
					 a written plan for continually assessing and improving all aspects of
					 operations which include:
1. goals and
					 objectives;
2. the identity of the
					 person responsible for the program;
3. a system to ensure systematic, objective
					 regular reports are prepared and distributed to appropriate areas;
4. the method for evaluating the quality and
					 the appropriateness of care;
5. a
					 method for resolving identified problems; and
6. application to improving the quality of
					 patient care.
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 D - Administration › Section I-8241 - Branch Offices

Current through Register Vol. 50, No. 6, June 20, 2024
A. No branch
					 office may be opened without written approval from LDH.
B. No branch office may be opened unless the
					 parent office has had full licensure for at least the immediately preceding 12
					 months and has a current census of at least 10 active patients.
C. Each branch shall serve the same or part
					 of the geographic area approved for the parent.
D. Each branch office shall have a registered
					 nurse immediately available to be on site, or on site in the branch office at
					 all times during stated operating hours.
E. All services provided by the parent agency
					 shall be available in the branch.
F. The branch site shall retain all Clinical
					 Records for its patients. Duplicate records need not be maintained at the
					 parent agency, but shall be made available to federal/state surveyors during
					 any review upon request.
G.
					 Original personnel files are to be kept at the parent agency, but shall be made
					 available to federal/state surveyors during any review upon request.
H. A statement of personnel policies is
					 maintained in each branch for staff usage.
I. Approval for branch offices will be
					 issued, in writing, by LDH for one year and will be renewed at time of annual
					 renewal if the branch office:
1. is
					 operational and providing hospice services;
2. serves only patients who are
					 geographically nearer to the branch than to the parent office;
3. offers exact same services as the parent
					 agency; and
4. if the parent office
					 meets requirements for full licensure.
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 D - Administration › Section I-8243 - Cessation of Business

Current through Register Vol. 50, No. 6, June 20, 2024
A. Except as
					 provided in
					 §8245 and §8246 of these licensing
					 regulations, a license shall be immediately null and void if a hospice ceases
					 to operate.
1. - 2. Repealed.
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 D - Administration › Section I-8245 - Inactivation of Licensure due to a Declared Disaster or Emergency

Current through Register Vol. 50, No. 6, June 20, 2024
A. A hospice agency
					 licensed in a parish which is the subject of an executive order or proclamation
					 of emergency or disaster issued in accordance with
					 R.S.
					 29:724 or
					 R.S.
					 29:766 may seek to inactivate its license for
					 a period not to exceed one year, provided that the following conditions are
					 met:
1. the licensed agency shall submit
					 written notification to the Health Standards Section within 60 days of the date
					 of the executive order or proclamation of emergency or disaster that:
a. the hospice agency has experienced an
					 interruption in the provisions of services as a result of events that are the
					 subject of such executive order or proclamation of emergency or disaster issued
					 in accordance with
					 R.S.
					 29:724 or
					 R.S.
					 29:766;
b. the hospice agency intends to resume
					 operation as a hospice in the same service area;
c. includes an attestation that the emergency
					 or disaster is the sole causal factor in the interruption of the provision of
					 services;
d. includes an
					 attestation that all patients have been properly discharged or transferred to
					 another agency or facility; and
e.
					 provides a list of patients and where that patient is discharged or transferred
					 to;