reglab/statecodes huggingface dataset:
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Preamble

Current through Register 1525, July 5, 2024
Pursuant to St. 2002, c. 283, which amended the hospice program
				licensure statute at M.G.L. c. 111, § 57D, the Department is authorized to
				establish regulations for the licensure of not more than six hospice inpatient
				facilities directly owned and operated by licensed hospice programs. Only
				hospice programs licensed for two years prior to October 10, 2003 shall be
				eligible to apply for lice nsure of a hospice inpatient fac ility as an a dded
				compone nt of their license . The licensing, administrative, programmatic,
				clinical and physical plant requirements each hospice inpatient facility must
				meet are described in 105 CMR 141.000. The Depar tment will accept applications
				for hospice inpatient facilities beginning 90 days from the effective date of
				these amendments and until six applications are approved.
The De partment by statute is require d to conduct an inter im
				review of the number of approved hospice inpatient programs after November 12,
				2004 and a final review af ter November 12, 2006 to det ermine whe ther the
				numbe r of pr ograms should be incr eased or decreased.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.002 - Authority

Current through Register 1525, July 5, 2024
105 CMR 141.000 is adopted
				under authority of M.G.L. c. 111, §§ 3 and 57D.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.010 - Scope

Current through Register 1525, July 5, 2024
105 CMR 141.000 applies to
				every hospice subject to licensure under M.G.L. c. 111, §
				57D.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.025 - Special Projects

Current through Register 1525, July 5, 2024
The Department will consider proposals for special projects for
				the innovative delivery of hospice services. No such proposal shall be
				implemented without prior written approval of the Department. Such plans shall
				be implemented only on an experimental basis and subject to renewal of the
				approval by the Department at such periods as the Department shall
				fix.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.099 - Compliance with Requirements

Current through Register 1525, July 5, 2024
(A) Unless
			 otherwise provided, all hospice programs licensed pursuant to this chapter
			 shall meet the requirements set forth in
			 105 CMR 141.000. Programs
			 operated by a hospital licensed pursuant to M.G.L. c. 111, § 51 shall meet
			 the requirements of
			 105 CMR
			 141.100 and
			 141.200 through
			 141.212.
(B) The Department may waive the
			 applicability to a particular hospice program of one or more of the
			 requirements imposed on hospice programs by
			 105 CMR 141.000 if:
(1) the Department finds that:
(a) compliance would cause undue hardship to
			 the hospice program;
(b) the
			 hospice program is in substantial compliance with the requirement;
			 and
(c) the hospice program's
			 non-compliance does not jeopardize the health or safety of its patients and
			 does not limit the hospice program's capacity to give adequate care;
			 and
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.100 - Requirement of License

Current through Register 1525, July 5, 2024
(A) A hospital
			 licensed pursuant to M.G.L. c. 111, § 51 which intends to operate a
			 hospice program shall obtain approval from the Department indicating that it
			 meets the requirements in
			 105 CMR 141.099(A)
			  for operating such a program. Upon a
			 determination that the hospital meets the relevant requirements, the Department
			 shall issue a license to indicate that the licensee is authorized to operate a
			 hospice program as a specific service of the hospital.
(B) All other hospice programs shall obtain a
			 license pursuant to M.G.L. c. 111, §§ 3 and 57D and
			 105 CMR 141.000, said
			 license to be obtained prior to operating such a program except as otherwise
			 provided in
			 105 CMR
			 141.103.
(C) A hospice program shall not operate in
			 the Commonwealth or use the word "hospice" or "hospice program" without a
			 hospice license issued by the Department. A person not licensed to provide
			 hospice services shall not use the word 'hospice' in a title or description of
			 a facility, organization, program, service provider or services or use any
			 words, letters, abbreviations or insignia indicating or implying that the
			 person holds a license to provide hospice services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.101 - Application for a License

Current through Register 1525, July 5, 2024
(A) Application for
			 original or renewal licensure shall be made on forms prescribed by and
			 available from the Department. Every application shall be signed under the
			 pains and penalties of perjury by the applicant or a person authorized to act
			 on behalf of the applicant.
(B) The
			 Department will accept an application for an inpatient hospice facility only if
			 the applicant is a hospice program that has been licensed pursuant to
			 105 CMR 141.000 for more
			 than two years.
(C) The Department
			 shall determine the number of licensed hospice inpatient facilities in
			 accordance with M.G.L. c. 111, § 57D.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.102 - Other Licensing Requirements

Current through Register 1525, July 5, 2024
(A)
Ownership Interest
. An applicant or licensee must be
			 the owner of the premises on which the hospice program administration and any
			 hospice inpatient facility directly operated by the hospice program is operated
			 or lessee of the premises for at least one year.
(B)
Name
. Each
			 hospice program applying for a license shall be designated by permanent and
			 distinctive name that shall appear on the application for a license. To avoid
			 public confusion or misrepresentation, this name shall not be changed without
			 prior approval by the Department.
(C)
Fees
. The
			 hospice license fee shall accompany every application and shall be as set by
			 the Executive Office of Administration and Finance. Payment of the fee shall be
			 by check or money order payable to the Commonwealth of Massachusetts.
(D)
Clinical Laboratory
			 Improvement Amendments (CLIA) Certificate of Waiver
. If a hospice
			 program intends to perform on its patients any laboratory tests, such as
			 glucose monitoring or fecal occult blood tests, the hospice program must apply
			 for and receive, through the Department's Clinical Laboratory Program, a CLIA
			 Certificate of Waiver prior to performing these tests.
(E) Any hospice that is authorized to provide
			 inpatient care directly in a hospice inpatient facility shall, prior to the
			 operation of such facility, and, as a prerequisite for subsequent licensure
			 renewal, submit to the Department the following:
(1) a certificate of inspection of the
			 egresses, the means of preventing the spread of fire, and the apparatus for
			 extinguishing fire, issued by the Department.
(2) a certificate of inspection, issued by
			 the head of the local fire department, certifying compliance with local
			 ordinances.
(3) evidence that the
			 licensee owns the premises on which the facility is operated or has a valid
			 lease agreement.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.103 - Timing of Application

Current through Register 1525, July 5, 2024
(A) In the case of a
			 transfer of ownership, the application shall be submitted no later than 48
			 hours following the transfer, provided, however, that the Department will not
			 accept an application from any owner who was not found suitable pursuant to
			 105 CMR
			 141.104.
(B) In the case of a renewal license, the
			 application shall be submitted at least three months prior to expiration of the
			 license.
(C) An application filed
			 in accordance with the provisions of 105 CMR 141.103(A) or (B) shall have the
			 effect of a license until the application is acted upon by the
			 Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.104 - Transfer of Ownership

Current through Register 1525, July 5, 2024
(A) The proposed
			 licensee shall submit a Notice of Intent to acquire a hospice program to the
			 Department at least 30 calendar days in advance of any transfer of ownership.
			 The Department shall notify each applicant in writing of the date on which the
			 form is deemed complete. Within 30 days of such date, the Department shall
			 complete its suitability review for licensure. With the consent of the
			 applicant, the Department may extend the 30-day suitability determination
			 period for a maximum of 30 days. In the event that the Department fails to
			 notify the applicant in writing of its decision regarding suitability within
			 the prescribed time period, the applicant shall be deemed responsible and
			 suitable.
(B) Any notice of
			 hearing, order or decision which the Department or the Commissioner issues for
			 a hospice program prior to a transfer of ownership shall be effective against
			 the former owner prior to such transfer and, where appropriate, the new owner,
			 following such transfer unless said notice, order or decision is modified or
			 dismissed by the Department or by the Commissioner.
(C) A transfer of ownership shall not be
			 recognized and the new owner shall not be considered suitable for licensure
			 when the transfer is proposed or made to circumvent the effect and purpose of
			 105 CMR 141.000. The
			 Department shall consider the following factors in determining whether a
			 transfer has been proposed or made to circumvent
			 105 CMR 141.000:
(1) The transferor's record of compliance
			 with Department licensure laws and regulations;
(2) The transferor's current licensure
			 status;
(3) The transferor's
			 familial, business and/or financial relation to the transferee;
(4) The terms of the transfer;
(5) The consequences of the
			 transfer.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.105 - Acceptance of Application

Current through Register 1525, July 5, 2024
(A) The Department
			 shall not accept an application for an original or renewal license unless:
(1) The application includes all information
			 required by the Commissioner;
(2)
			 The application and all required attachments and statements submitted by the
			 applicant meet the requirements of
			 105 CMR 141.000;
(3) The applicant has paid all required
			 fees.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.106 - Updating of Ownership Information

Current through Register 1525, July 5, 2024
Each licensee shall notify the Department of any changes to the
				ownership and control information submitted under the requirements of
				105 CMR 141.000 or
				otherwise required by the Department. Any document that amends, supplements,
				updates or otherwise alters any ownership and control document required to be
				filed with the Department shall be submitted to the Department within 30 days
				of the change.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.107 - Evaluation of Application

Current through Register 1525, July 5, 2024
The Department shall not approve an application for original or
				renewal license unless:
(1) The
			 Commissioner has conducted an inspection or other investigation of the hospice
			 program or facility and has determined that the applicant complies with
			 105 CMR 141.000;
(2) The Commissioner has conducted an
			 investigation of the applicant(s) and determined the applicant(s) are
			 responsible and suitable to establish or maintain a hospice program.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.108 - Evidence of Responsibility and Suitability

Current through Register 1525, July 5, 2024
(A) In determining whether an applicant is
			 responsible and suitable to be granted a hospice license, the Department shall
			 consider all relevant information including, but not limited to, the following:
(1) the proposed licensee's history of prior
			 compliance with Massachusetts state laws and regulations governing health
			 facility or services operation. Assessment of this factor shall include the
			 ability and willingness of the applicant to take corrective action when
			 notified by the Department of any regulatory violations;
(2) the proposed licensee's financial
			 capacity to provide services in compliance with state law and
			 105 CMR 141.000 as
			 evidenced by sufficiency of present resources and assessment of past history,
			 including financial involvement with health care facilities that have filed
			 petitions for bankruptcy;
(3) the
			 history of criminal conduct of the applicant, and of the hospice administrator,
			 officers and directors as evidenced by criminal proceedings against those
			 individuals that resulted in convictions, or guilty pleas, or pleas of nolo
			 contendere, or admission of sufficient facts; and
(4) the proposed licensee's history of
			 statutory and regulatory compliance for health care facilities in other
			 jurisdictions, including proceedings in which the applicant was involved which
			 proposed or led to a limitation upon or a suspension, revocation, or refusal to
			 grant or renew a health care facility license or service's license or
			 certification for Medicaid or Medicare to the proposed licensee.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.109 - Right to Visit and Inspect

Current through Register 1525, July 5, 2024
The Department or its agents may visit and inspect a program
				subject to licensure under M.G.L. c. 111, § 57D at any time without prior
				notice in order to determine the program's compliance with state law and
				105 CMR 141.000. All parts
				of the program, all staff and activities, and all records are subject to such
				visit and inspection.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.110 - Frequency of Inspection

Current through Register 1525, July 5, 2024
The Commissioner will inspect a program prior to the issuance
				of a license. Additional inspections may be made, consistent with the
				availability of staff, whenever the Commissioner deems it necessary for the
				enforcement of
				105 CMR
				141.000.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.111 - Deficiency Statements

Current through Register 1525, July 5, 2024
After every inspection in which any violation of
				105 CMR 141.000 is
				observed, the Commissioner shall prepare a deficiency statement citing every
				violation observed, a copy of which shall be sent to the
				program.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.112 - Plan of Correction

Current through Register 1525, July 5, 2024
(A) A hospice shall
			 submit to the Commissioner a written plan of correction of violations cited in
			 a deficiency statement prepared pursuant to
			 105 CMR
			 141.111 within ten days after the deficiency
			 statement is sent.
(B) Every plan
			 of correction shall set forth, with respect to each deficiency, the specific
			 corrective step(s) to be taken, a timetable for such steps, and the date by
			 which compliance with
			 105 CMR 141.000 will be
			 achieved. The timetable and the compliance dates shall be consistent with
			 achievement of compliance in the most expeditious manner possible.
(C) The Commissioner shall review the plan of
			 correction for compliance with the requirements of
			 105 CMR 141.000 and will
			 notify the hospice of either the acceptance or rejection of the plan. An
			 unacceptable plan must be amended and resubmitted within five days of the date
			 of notice.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.120 - Issuance of License

Current through Register 1525, July 5, 2024
Upon the approval of the application for a license the
				Department shall issue a license to the applicant. The license shall not be
				transferable. The licensee shall be responsible to ensure compliance with all
				applicable rules and regulations.
The license shall contain the name and address of the hospice,
				and, in the case of a hospice authorized to directly own and operate a hospice
				inpatient facility pursuant to the provisions of
				105 CMR
				141.102 and
				141.204(H),
				the name and address of any such facility.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.121 - Period of License

Current through Register 1525, July 5, 2024
(A) The term of the
			 license shall be, unless otherwise provided in 105 CMR 141.121, for two years
			 from the date of issuance, and any renewals thereof shall also be for two
			 years.
(B) The Department may issue
			 a provisional license for a period of no more than one year to a hospice
			 program that is not in full compliance with applicable requirements but that
			 the Department finds is in substantial compliance with such requirements and
			 demonstrates potential for achieving full compliance within the provisional
			 licensure period. Consecutive provisional licenses shall not be issued to a
			 hospice.
(C) Provided a licensed
			 hospice submits a timely application for a renewal license, its previous
			 license shall be valid until the Department acts on its renewal
			 application.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.122 - Posting of License

Current through Register 1525, July 5, 2024
The hospice shall post the current license from the Department
				in a conspicuous place on the program office premises and, in the case of a
				hospice that directly owns and operates a hospice inpatient facility, a copy of
				the license in a conspicuous place on the hospice inpatient facility
				premises.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.123 - Renewal of License

Current through Register 1525, July 5, 2024
(A) The Department
			 shall send each licensee notification of the need to renew its license and the
			 necessary application forms no later than 90 days prior to the expiration of an
			 existing license.
(B) The licensee
			 shall complete and return the application form within 30 days of its receipt of
			 notification from the Department, together with such other information and
			 materials as the Department shall deem appropriate.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.130 - Suspension of a License

Current through Register 1525, July 5, 2024
(A) The Commissioner
			 may, upon finding that continued operation of a hospice poses an imminent risk
			 to the health or safety of the patients, suspend the license of the hospice
			 without a prior hearing.
(B) Upon
			 suspension, the Commissioner shall give to the program a written notice setting
			 forth the reasons for the suspension. The suspension shall take effect
			 immediately upon issuance of the notice.
(C) Within 14 days after receipt of notice
			 that a license has been suspended, the licensee may appeal such suspension by
			 filing a Notice of Claim for an Adjudicatory Proceeding pursuant to
			 801 CMR 1.00:
Standard
			 Adjudicatory Rules of Practice and Procedure
. After receipt of a
			 Notice of Claim for Adjudicatory Proceeding, the Commissioner shall schedule an
			 adjudicatory hearing for a date as early as is practicable.
(D) In cases of suspension of a license, the
			 hearing officer shall determine whether the Commissioner has proved by a
			 preponderance of the evidence that there existed, immediately prior to or at
			 the time of the suspension, an imminent risk to the health or safety of the
			 hospice's patients.
(E) The
			 decision of a hearing officer in any adjudicatory proceeding conducted under
			 105 CMR 141.130 shall be reviewed by the Commissioner and the Commissioner's
			 decision upon this review shall constitute final agency action.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.131 - Denial, Revocation, and Refusal to Renew Licenses

Current through Register 1525, July 5, 2024
(A) A license may be denied, revoked, or
			 refused renewal for cause. Cause shall include but not be limited to the
			 following (each of which shall constitute cause in and of itself):
(1) Lack of legal capacity to provide the
			 service(s) to be covered by a license as determined pursuant to
			 105 CMR
			 141.101 and
			 141.102;
(2) Lack of responsibility and suitability to
			 operate a hospice, as determined pursuant to
			 105 CMR
			 141.108.
(3) Failure to submit the required license
			 fee.
(4) Violation of any state
			 statute pertaining to hospice licensure.
(5) Failure to give proper patient care to
			 hospice patients.
(6) Violation of
			 any applicable provision of
			 105 CMR 141.000 and:
(a) Failure to submit an acceptable plan of
			 correction pursuant to
			 105 CMR
			 141.112 or;
(b) Failure to remedy or correct a cited
			 violation by the date specified in the plan of correction as accepted or
			 modified by the Department.
(7) Denial of entry to agents of the
			 Department.
(8) Refusal to permit
			 inspection or photocopying by the Department of any records or other
			 information as necessary to determine compliance with
			 105 CMR 141.000.
(9) There is a reasonable basis for the
			 Department to conclude that there is a discrepancy between representations by a
			 program as to the services to be afforded clients and the services actually
			 rendered or to be rendered.
(10)
			 False or fraudulent statements from the Department.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.140 - Closing of a Program

Current through Register 1525, July 5, 2024
(A)
Approval
. If a program intends to cease operation for
			 a period greater than seven consecutive days, written approval for a specified
			 period shall be obtained from the Commissioner. The holder of a license shall
			 submit to the Department a Notice of Intent to close the program at least 60
			 days in advance of the proposed closure. Such notice shall be subject to the
			 Commissioner's approval and shall include a plan for appropriate notice to, and
			 relocation of, the facility's patients. If circumstances are such that it is
			 not possible to obtain approval from the Commissioner prior to closing, such
			 approval shall be obtained within 72 hours of closing. Failure to obtain
			 approval and closure of the program for more than seven days shall constitute
			 abandonment of license.
(B)
Patient Transfer
. When a hospice ceases to operate
			 through license denial, refusal to renew, suspension, revocation or closure
			 pursuant to 105 CMR 141.140(A), the licensee will be responsible for the
			 transfer of patients to a suitable program.
(1) At least 21 days prior to ceasing
			 operation, staff at the hospice program will orally or in writing notify each
			 patient/family that the program will cease operation. Staff will also notify
			 each patient/family of the referral plan to another appropriate program for
			 continuation of services.
(2) Staff
			 at the hospice to be closed will be responsible for developing a written
			 referral plan to be placed in the patient record for each ongoing case. Staff
			 will also refer the patient to a program that will be responsible for
			 continuing service.
(3) Clinical
			 records shall be transferred to the receiving agency provided that a signed
			 authorization to release such records shall be obtained from each
			 patient/family prior to the transfer.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.141 - Temporary Interruption of Service

Current through Register 1525, July 5, 2024
If a hospice finds that any of the services required under
				105 CMR 141.000 cannot be
				provided to patients for a temporary period of time, the hospice shall report
				such a temporary interruption of service to the Department as soon as the
				interruption of service is known to the hospice.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.200 - Governing Body

Current through Register 1525, July 5, 2024
(A) The hospice
			 shall have a governing body that assures full legal authority and
			 responsibility for determining, implementing and monitoring policies governing
			 the hospice's total operation.
(B)
			 The governing body shall designate an administrator who shall be responsible on
			 a day-today basis for the management and operation of the hospice
			 program.
(C) The governing body
			 shall be responsible for:
(1) managing the
			 fiscal affairs and operation of the hospice program;
(2) ensuring quality care and
			 services;
(3) ensuring compliance
			 of the hospice with all applicable federal, state and local laws, rules and
			 regulations;
(4) providing for
			 coordinated, interdisciplinary hospice services available 24 hours a day, seven
			 days a week;
(5) ensuring adequate
			 staff and resources to provide continuity of care based on the needs of the
			 persons served;
(6) adopting,
			 amending and implementing by-laws;
(7) adopting the hospice budgets and
			 controlling assets and funds; and
(8) establishing committees as
			 appropriate.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.201 - Administration

Current through Register 1525, July 5, 2024
(A)
Administrator
.
(1) Each hospice shall designate a hospice
			 administrator who is responsible to the governing body, either directly or
			 through the governing body's chief executive officer, for the administration
			 and management of the hospice.
(2)
			 The hospice administrator shall be a person who has a minimum of two years of
			 relevant experience in the health care, human services or related fields, which
			 shall include at least one year of supervisory/administrative
			 experience.
(3) The duties of the
			 administrator shall include but not be limited to:
(a) Directing the hospice and ensuring
			 implementation of policies and procedures regarding all activities and services
			 provided in the hospice, whether provided through staff employed directly by
			 the hospice, by volunteers or through contract arrangement;
(b) Designating, in writing, an alternate to
			 act in his or her absence;
(c)
			 Implementing administrative and personnel policies;
(d) Implementing an effective budgetary and
			 accounting system;
(e) Implementing
			 a quality assurance mechanism to assess the overall hospice program;
(f) Keeping the governing body informed of
			 the hospice's operations;
(g)
			 Appointing qualified hospice staff members when and where appropriate and
			 ensuring adequate staff education and evaluations;
(h) Developing and proposing an annual budget
			 for adoption by the governing body and managing the financial aspects of the
			 hospice;
(i) Ensuring that action
			 is taken to correct problems identified either through patient/ family record
			 reviews, fiscal audits, or as a result of patient/family
			 recommendations;
(j) Ensuring a
			 public education program through contact with community organization to inform
			 consumers about hospice care;
(k)
			 Ensuring that patient care services are appropriately coordinated;
			 and
(l) Ensuring incident reports
			 are submitted to the Department as required under 105 CMR 141.201(F).
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.202 - Plan of Care/Assessments

Current through Register 1525, July 5, 2024
(A) The hospice
			 shall develop a comprehensive written plan of care by an interdisciplinary
			 hospice care team and if applicable, the patient's attending physician or
			 primary care provider, prior to provision of services. The initial plan of care
			 shall be developed within three days of admission by at least three members of
			 the interdisciplinary team as defined by
			 105
			 CMR 141.203, including a registered nurse and
			 the medical director. The initial plan of care shall be reviewed and ratified
			 by the full interdisciplinary team at their next scheduled meeting.
(B) The patient/family shall be permitted and
			 encouraged to actively participate in the care planning process and the
			 provision of care. Such participation shall be documented in the patient/
			 family record.
(C) The plan of care
			 shall include, but not be limited to:
(1)
			 pertinent diagnosis and prognosis;
(2) identification of the physical,
			 psychological, social, economic and spiritual status of the
			 patient/family;
(3) need for
			 inpatient care (respite or general), nutritional needs, medication needs, need
			 for management of discomfort and symptom control, and need for management of
			 grief;
(4) plan to address
			 identified needs including scope of services required;
(5) identification of anticipated frequency
			 of services needed;
(6) designation
			 of the primary care giver or alternate plan to provide 24-hour care and support
			 in the patient's home;
(7)
			 identification of the person responsible for coordinating care;
(8) plans instructing the patient/family or
			 designated caregiver in patient care;
(9) plans for support and care at the time of
			 death; and
(10) plans for providing
			 bereavement care to family.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.203 - Interdisciplinary Team

Current through Register 1525, July 5, 2024
(A) The hospice
			 shall establish an interdisciplinary care team(s) that includes, but is not
			 limited to:
(1) medical director
(2) registered nurse
(3) coordinator of volunteers
(4) social worker
(5) spiritual or other counselor
(6) bereavement coordinator A team member may
			 serve more than one role on the team.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.204 - Required Patient Care Services

Current through Register 1525, July 5, 2024
(A) A
			 hospice shall provide directly or arrange, pursuant to a written agreement, for
			 the provision of each of the following services at home, in the community and
			 in inpatient facilities: physician services, nursing services, social services,
			 direct service volunteer services, counseling services, and inpatient care for
			 palliative reasons.
(B) As needed,
			 the hospice shall provide or arrange for the following services:
(1) personal care homemaker;
(2) home health aide;
(3) therapeutic (dietary, occupational
			 therapy, physical therapy, speech, hearing, respiratory therapy);
(4) medical supplies and
			 appliances;
(5) pharmaceutical;
			 and
(6) respite services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.205 - Patient Rights and Responsibilities

Current through Register 1525, July 5, 2024
(A) Each
			 hospice shall have written policies and procedures that protect the rights of
			 all patients/families. Rights shall include but need not be limited to:
(1) the right to be informed of the hospice
			 philosophy and concept, admission criteria, services to be provided, any third
			 party coverage and personal charges, and any sliding fee scale associated with
			 services provided;
(2) the right to
			 confidentiality of all records and communications;
(3) the right to informed consent;
(4) the right to participate in developing
			 the patient care plan; and
(5) the
			 right to refuse service or withdraw from the program at anytime.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.206 - Policies and Procedures

Current through Register 1525, July 5, 2024
(A) The hospice
			 shall develop and implement written policies and procedures to coordinate an
			 interdisciplinary program of hospice care services.
(B) These policies and procedures shall be
			 reviewed and approved by the governing body at least annually.
(C) The policies and procedures shall include
			 but need not be limited to:
(1) philosophy,
			 objectives and goals of the hospice;
(2) the services to be provided and record
			 keeping requirements for clinical records;
(3) criteria for the selection, admission,
			 discharge and transfer of terminally ill patients/ families;
(4) affiliation or and referral arrangements
			 with community and other health care facilities or agencies to assure
			 continuity of patient/family care;
(5) the hospice's professional management
			 responsibilities for overseeing services provided under contractual
			 arrangements;
(6) patient/family
			 consent and involvement in the development of a care plan;
(7) patient/family education;
(8) plans and arrangements for the patient's
			 death whether at home or in an institution;
(9) community education;
(10) patient and family rights;
(11) review of the quality and utilization of
			 hospice services;
(12)
			 resuscitation practices; and
(13)
			 infection control.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.207 - Pharmaceutical Services and Medications

Current through Register 1525, July 5, 2024
(A)
			 All hospices shall maintain current written policies and procedures regarding
			 the administration and recording of drugs and biologicals.
(B) Hospices shall comply with all federal
			 and state laws and regulations (including
			 105 CMR 700.000:
Implementation of M.G.L. c. 94C
) relating to the procurement,
			 storage, dispensing, administration, recording and disposal of drugs.
(C) No drug or medication that has been
			 removed from the market by the Food and Drug Administration shall be stocked or
			 administered by a hospice.
(D) The
			 hospice shall make arrangements for 24-hour availability of medications. If the
			 hospice program admits pediatric patients, it shall provide age and size
			 appropriate drug administration and dosing.
(E) There shall be a current written order by
			 a physician, nurse practitioner or physician assistant in the patient's
			 clinical record for all medications or drugs administered by hospice staff to
			 the patient. All drugs and medications the patient receives shall be recorded
			 on a profile sheet which shall be kept as part of the patient's clinical
			 record.
(1) Verbal or telephone orders shall
			 be given only to a licensed nurse and shall be immediately recorded in writing
			 in the patient's clinical record and signed by the same nurse. All verbal or
			 telephone orders shall be countersigned by a physician, physician assistant or
			 nurse practitioner within 21 days.
(2) If medications for a patient are ordered
			 by a physician assistant or nurse practitioner, there shall be a general review
			 of medications by the physician assistant or nurse practitioner and the
			 supervising physician as specified in
			 105 CMR 700.000:
Implementation of M.G.L. c. 94C
.
(3) Orders for medication and treatments
			 shall be in effect for the specific number of days indicated by the physician,
			 physician assistant or nurse practitioner.
(4) Hospice staff administering drugs shall
			 be appropriately licensed to carry out this function.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.208 - Admissions

Current through Register 1525, July 5, 2024
(A) The hospice shall establish written
			 admission criteria and policies which shall include an assessment of the
			 patient's/family's desire and need for hospice service, and any eligibility
			 limitations of a patient who does not have a designated primary care
			 giver.
(B) Admission to a hospice
			 shall be limited to patients
(1) who are
			 terminally ill with a limited life expectancy,
(2) who are no longer receiving treatment for
			 cure,
(3) who along with the
			 physician and family agree that palliative care is appropriate, and
(4) who have elected to receive hospice
			 care.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.209 - Clinical Records

Current through Register 1525, July 5, 2024
(A) The hospice
			 shall maintain in a centralized location at the hospice administrative office
			 an accurate clinical record for every individual receiving care and services.
When a hospice patient is admitted to a hospice inpatient
				facility, a copy of the patient's plan of care and sufficient relevant
				supporting documentation to ensure coordination of care shall be transmitted to
				the inpatient facility. When the patient is discharged from the hospice
				inpatient facility, a medical record and discharge summary shall be transmitted
				to the hospice administrative office to be included in the patient's clinical
				record.
(B) The record shall
			 be complete, promptly and accurately documented, readily accessible and
			 systematically organized to facilitate retrieval. The refusal of services shall
			 also be documented.
(C) Record
			 entries shall be made and signed by the person providing the service for all
			 services provided.
(D) The record
			 shall include documentation of all services whether furnished directly or under
			 arrangements made by the hospice.
(E) Each individual's record shall include:
(1) the initial and subsequent
			 assessments;
(2) the plan of
			 care;
(3) identification
			 data;
(4) consent forms;
(5) pertinent medical history;
(6) complete documentation of all services
			 and events (including evaluations, treatments, progress notes
etc
.);
(7) primary
			 care providers' orders;
(8)
			 medication records;
(9)
			 discharge/transfer records;
(10)
			 all pertinent diagnoses;
(11) the
			 patient's prognosis;
(12)
			 designation of the attending physician or medical team;
(13) a bereavement assessment and plan for
			 intervention, if any; and
(14)
			 instructions to the family concerning care if patient is discharged.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.210 - Quality Assurance

Current through Register 1525, July 5, 2024
(A) The hospice
			 shall develop and implement, through an interdisciplinary committee, an ongoing
			 quality assurance program. One member of the committee shall be designated to
			 be responsible for coordinating quality assurance.
(B) The quality assurance program shall
			 include an evaluation of all services, including any services provided to
			 patients under contractual arrangements. The hospice shall offer contracted
			 hospice providers the opportunity to participate in the quality assurance
			 program.
(C) Each hospice shall
			 establish a written quality assurance plan for review of services delivered.
			 The plan shall include:
(1) A procedure for
			 evaluating care provided on individual cases. At least quarterly, members of
			 professional disciplines representing at least the scope of the hospice program
			 shall review a 10% sample of both active and inactive clinical records of care
			 delivered to hospice patients and families. A written summary shall be prepared
			 for each individual review commenting on the amount and kind of care delivered
			 and including statements addressing any unmet needs.
(2) A process for program evaluation and the
			 identification of problems. At least quarterly, all summaries of individual
			 reviews shall be reviewed by the person responsible for coordinating quality
			 assurance. A written report will be prepared addressing any identified problems
			 with care, treatment, services, availability of services, and methods of care
			 delivery.
(3) A system to report to
			 the governing body the findings and recommendations for improving the quality
			 of care delivered. The quality assurance reports shall be submitted to the
			 hospice administrator and governing body. There shall be evidence in the
			 governing body's meeting minutes that the reports have been reviewed by the
			 governing body at least annually.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.211 - Data Collection

Current through Register 1525, July 5, 2024
(A) Each hospice
			 shall establish and maintain records and data in such a manner as to make
			 uniform a system of periodic reporting. The manner in which the requirements of
			 105 CMR 141.000 shall be
			 met as may be prescribed from time to time in directives developed by the
			 Department.
(B) Each hospice shall
			 maintain statistical data pertaining to its operation and services including
			 demographic and service utilization data. Such reports and data shall be made
			 available to the Department upon request.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.212 - Contractual Services

Current through Register 1525, July 5, 2024
(A) A hospice may
			 contract with other health care providers for the provision of all required
			 services.
(B) All contracted
			 services shall meet the applicable provisions of
			 105 CMR 141.000.
(C) The hospice program shall assure
			 continuity of patient/family care in home, outpatient and inpatient
			 settings.
(D) The hospice program
			 shall retain professional management responsibility for contracted services and
			 ensure they are furnished in a safe and effective manner by qualified personnel
			 in accordance with the patient's plan of care.
(E) When services are not provided directly
			 by a hospice a written agreement shall define the scope of contracted services
			 and the manner of maintaining continuity of care between contracted services
			 and those services provided directly by the hospice. The agreement shall at a
			 minimum specify the following:
(1) the
			 services to be provided;
(2) the
			 duties and responsibilities of each of the contracting parties for the
			 coordination and supervision of care, including delineation of the role(s) of
			 the hospice and contractor in the admission process, patient/family assessment
			 and the interdisciplinary group care conferences;
(3) the stipulation that the hospice is
			 responsible for all hospice services whether or not the services are furnished
			 under contract and may only be provided with the express authorization of the
			 hospice;
(4) the financial and
			 reimbursement arrangements, including any arrangements for donated
			 services;
(5) the manner in which
			 contract services shall be coordinated, supervised, and evaluated by the
			 hospice program;
(6) requirements
			 for documenting that services are furnished in accordance with the agreement;
			 and
(7) qualifications of the
			 personnel providing the services.
Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 141.000 - Licensure of Hospice Programs › Section 141.220 - Construction Standards for Inpatient Hospice Facilities

Current through Register 1525, July 5, 2024
In the case of new construction of a hospice inpatient
				facility, or in the case of alterations or additions to an existing hospice
				inpatient facility, the hospice must submit preliminary architectural plans and
				final architectural plans and specifications to the Department for written
				approval prior to beginning new construction or alterations or additions. The
				Department shall establish standards for review and approval of plans as
				administrative guidelines, based on guidelines for design and construction of
				health care facilities of the Facility Guidelines Institute.