Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 16 - Health Facilities › Subpart 1 - Health Facilities Licensure and Certification › Chapter 1 - MINIMUM STANDARDS OF OPERATION FOR HOSPICE › Subchapter 3 - DEFINITIONS › Rule 15-16-1-1.3.1

Current through June 25, 2024
Unless a different meaning is required by the context,
						the following terms as used in these rules and regulations shall have the
						meaning hereinafter respectively ascribed to them:
1.
Administrator
- Means the
					 person, designated by the governing body, who is responsible for the management
					 of the overall operation of the hospice.
2.
Advance Directives
-
					 Directive from the patient/family (see definition of family) such as a durable
					 power of attorney for health care, a directive pursuant to patient
					 self-determination initiatives, a living will, or an oral directive which
					 either states a person's choices for medical treatment or, in the event the
					 person is unable to make treatment choices, designates who shall make those
					 decisions.
3.
Attending/Primary Physician
- A Doctor of Medicine or Osteopathy
					 licensed to practice medicine in the State of Mississippi, who is designated by
					 the patient or responsible party as the physician responsible for his/her
					 medical care.
4.
Bereavement
					 Services
- Organized services provided under the supervision of a
					 qualified counselor (see definition) to help the family cope with death related
					 grief and loss. This shall be available for at least one year after the death
					 of the patient.
5.
Autonomous
- Means a separate and distinct operational entity
					 which functions under its own administration and bylaws, either within or
					 independently of a parent organization.
6.
Bed Capacity
- Means the
					 largest number which can be installed or set up in the freestanding hospice at
					 any given time for use of patients. The bed capacity shall be based upon space
					 designed and/or specifically intended for such use whether or not the beds are
					 actually installed or set up.
7.
Bed Count
- Means the number of beds that are actually installed
					 or set for patients in freestanding hospice at a given time.
8.
Branch Office/Alternate Site
- A location or site from which a hospice agency provides services within a
					 portion of the total geographic area served by the parent agency. The branch is
					 a part of the parent hospice agency and is located within the 50-mile radius of
					 the parent agency and shares administration and supervision. No branch office
					 site shall be opened unless the parent office has had full licensure for the
					 immediately preceding 12 months and has admitted 3 patients within the last
					 twelve (12) months. A branch office does not extend the Geographic Service Area
					 of the Parent Agency.
9.
Bureau
- Mississippi State Department of Health, Bureaus of Health
					 Facilities, Licensure and Certification.
10.
Care Giver
- The person whom
					 the patient designates to provide his/her emotional support and/or physical
					 care.
11.
Chaplain
-
					 Means an individual representative of a specific spiritual belief who is
					 qualified by education received through accredited academic or theological
					 institutions, and/or experience thereof, to provide counseling and who serves
					 as a consultant for and/or core member of the hospice care team.
12.
Change of Ownership
- Means
					 but is not limited to, intervivos, gifts, transfers, leases, cash and/or stock
					 transactions or other comparable arrangements whenever the person or entity
					 acquires a majority interest (fifty percent (50%) or more) of the facility or
					 service. Changes of ownership from partnerships, single proprietorships, or
					 corporations to another form of ownership are specifically included. Provided,
					 however, "Change of Ownership" shall not include any inherited interest
					 acquired as a result of a testamentary instrument or under the laws of descent
					 and distribution of the State of Mississippi. The change of IRS exemption
					 status also constitutes a change of ownership.
13.
Community
- A group of
					 individuals or a defined geographic area served by a hospice.
14.
Continuous Home Care
- Care
					 provided by the hospice during a period of crisis as necessary to maintain the
					 terminally ill individual at home. A minimum of eight hours of care must be
					 furnished on a particular day to be considered continuous home care. Nursing
					 care must be provided for more than one-half of the period of care and must be
					 provided by either a registered nurse or licensed practical nurse. Services may
					 be provided by a homemaker or hospice aide to supplement the nursing care. When
					 determining the necessity for continuous home care, a registered nurse must
					 complete/document a thorough assessment and plan of care that includes
					 participation of all necessary disciplines to meet the patient's identified
					 needs, prior to assigning a licensed practical nurse, homemaker, or a hospice
					 aide to a patient requiring continuous home care. This assignment must comply
					 with accepted professional standards of practice.
15.
Contracted Services
-
					 Services provided to a hospice provider or its patients by a third party under
					 a legally binding agreement that defines the roles and responsibilities of the
					 hospice and service provider.
16.
Core Services
- Nursing services, physician services, medical
					 social services, and counseling services, including bereavement counseling,
					 spiritual counseling, and any other counseling services provided to meet the
					 needs of the individual and family. These services must be provided by
					 employees of the hospice, except that physician services and counseling
					 services may be provided through contract.
17.
Counselor
- Means an
					 individual who has at least a bachelor's degree in psychology, a master's, or
					 bachelor's degree from a school of social work accredited by the Council on
					 Social Work Education, a bachelor's degree in counseling; or the documented
					 equivalent of any of the above in education, training in the spiritual care of
					 the dying and end of life issues, and who is currently licensed in the state of
					 Mississippi, if applicable. Verification of education and training must be
					 maintained in the individual's personnel file.
18.
Department
- Means the
					 Mississippi State Department of Health (MSDH).
19.
Discharge
- The point at
					 which the patient's active involvement with the hospice program is ended and
					 the program no longer has active responsibility for the care of the
					 patient.
20.
Dietitian
- Means a person who is registered by the Commission on Dietetic Registration
					 of the American Dietetic Association or who has the documented equivalent in
					 education, training and/or experience.
21.
Do Not Resuscitate Orders
					 (DNR)
- Orders written by the patient's physician which stipulate that
					 in the event the patient has a cardiac or respiratory arrest, cardiopulmonary
					 resuscitation will not be initiated or performed.
22.
Emotional Support
- Support
					 provided to assist the person in coping with stress, grief, and loss.
23.
Family Unit
- Means the
					 terminally ill person and his or her family, which may include spouse,
					 children, sibling, parents, and other with significant personal ties to the
					 patient.
24.
Freestanding
					 Hospice
- Freestanding Hospice means a hospice that is not a part of any
					 other type of health care provider.
25.
Geographic Service Area
-
					 Area around the Parent Office, which is within 50-miles radius of the Parent
					 Office premises. Each hospice must designate the geographic service area in
					 which the agency will provide services. Should any portion of a county fall
					 within a 50-mile radius of the Parent, then the entire county may fall within
					 the geographic service area of the Parent. Nothing herein is intended to
					 automatically expand the service area of any existing Parent. A hospice shall
					 seek approval of the Department for any expansion of their service area. The
					 full range of hospice services, as specified, must be provided to the entire
					 designated geographic services area.
26.
Governing Body
- A hospice
					 program shall have a clearly defined organized governing body that has
					 autonomous authority for the conduct of the hospice program. (Section:
					 41-85-19) This governing body is not required to meet more often than
					 quarterly. Written minutes and attendance of governing body minutes shall be
					 maintained.
27.
Hospice
					 Aide
- An individual who is currently qualified in the State of
					 Mississippi to provide personal care services to hospice patients under the
					 direction of a registered nurse of the hospice.
28.
Hospice Inpatient Facility
-
					 Organized facilities where specific levels of care ranging from residential to
					 acute, including respite, are provided on a 24-hour basis within the confines
					 of a licensed hospital, nursing home, or freestanding hospice in order to meet
					 the needs of the patient/family. A hospice inpatient facility shall meet the
					 Condition of Participation for providing inpatient care directly as specified
					 in Title 42, Section 418.100 of the Code of Federal Regulations.
29.
Hospice
- Means an
					 autonomous, centrally administered, nonprofit or for profit medically directed,
					 nurse-coordinated program providing a continuum of home, outpatient, and
					 homelike inpatient care for not less than four (4) terminally ill patients and
					 their families. It employs a hospice care team (see definition of hospice care
					 team) to assist in providing palliative and supportive care to meet the special
					 needs arising out of the physical, emotional, spiritual, social, and economic
					 stresses which are experienced during the final stages of illness and during
					 dying and bereavement. This care is available twenty-four (24) hours a day,
					 seven (7) days a week, and is provided on the basis of need regardless of
					 inability to pay. (Section
					 41-85-3)
30.
Hospice Care Team
- Means an
					 interdisciplinary team which is a working unit composed by the integration of
					 the various helping professions and lay persons providing hospice care. Such
					 team shall, as a minimum, consist of a licensed physician, a registered nurse,
					 a social worker, a member of the clergy, or a counselor and
					 volunteers.
31.
Hospice
					 Services
- Means items and services furnished to an individual by a
					 hospice, or by others under arrangements with such a hospice program.
32.
Hospice Physician
- A Doctor
					 of Medicine or Osteopathy who is currently and legally authorized to practice
					 medicine in the State of Mississippi and is designated by the hospice to
					 provide medical care to hospice patients, in coordination with the patient's
					 primary physician.
33.
Hospice Premises
- The physical site where the hospice maintains
					 staff to perform administrative functions, maintains its personnel records,
					 maintains its client service records, and holds itself out to the public as
					 being a location for receipt of client referrals. A hospice must be physically
					 located within the State of Mississippi. A license for a hospice program shall
					 not be issued if the hospice is to be located in an area in violation of any
					 local zoning ordinance or regulation.
34.
Informed Consent
- A
					 documented process in which information regarding the potential and actual
					 benefits and risks of a given procedure or program of care is exchanged between
					 provider and patient.
35.
Inpatient Services
- Care available for General Inpatient Care or
					 Respite Care that is provided in an Inpatient Hospice Facility, hospital, or
					 SNF that meets the Condition of Participation for providing inpatient care
					 directly as specified in Title 42, Section 418.100 of the Code of Federal
					 Regulations.
36.
Interdisciplinary Group (IDG)
- An interdisciplinary group(s)
					 designated by the hospice, composed of representatives from all the core
					 services. The Interdisciplinary Group
must
include at least a
					 Doctor of Medicine or Osteopathy, a registered nurse, a social worker, and a
					 pastoral or other counselor. The interdisciplinary group is responsible for
					 participation in the establishment of the plan of care; provision or
					 supervision of hospice care and services; periodic review and updating of the
					 plan of care for each individual receiving hospice care, and establishment of
					 policies governing the day-to-day provision of hospice care and services. If a
					 hospice has more than one interdisciplinary team; it must designate, in
					 advance, the group it chooses to execute the establishment of policies
					 governing the day-to-day provision of hospice care and services.
37.
Interdisciplinary Team
					 Conferences
- Regularly scheduled periodic meetings of specific members
					 of the interdisciplinary team (see Rule 1.3.36 ) to review the most current
					 patient/family assessment, evaluate care needs, and update the plan of
					 care.
38.
Level of
					 Care
- Hospice care is divided into four categories of care rendered to
					 the hospice patient.
A. Routine home
					 care
B. Continuous home
					 care
C. Inpatient respite
					 care
D. General inpatient
					 care