Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES › Chapter 36 - HOSPICE SERVICES › Section 471-36-003 - PROVIDER REQUIREMENTS

Current through June 17, 2024
003.01
GENERAL PROVIDER REQUIREMENTS.
Providers must comply
  with all applicable provider participation requirements codified in 471
  Nebraska Administrative Code (NAC) 2 and 3. In the event that participation
  requirements in 471 NAC 2 or 3 conflict with requirements outlined in this
  chapter, the participation requirements in this chapter will govern.
003.02
SERVICE SPECIFIC PROVIDER
  REQUIREMENTS.
Hospice providers must participate in Medicare, and
  meet the licensure and certification requirements of the Nebraska Department of
  Health and Human Services Division of Public Health.
003.02(A)
STANDARDS OF
  CARE.
The hospice provider must deliver services in accordance
  with the following standards:
(i) A hospice
  provider must be primarily engaged in providing the scope of services outlined
  in this chapter, and must do so in a manner that is consistent with accepted
  standards of practice;
(ii) The
  hospice provider must designate a physician to serve as medical director. The
  medical director must be a doctor of medicine or osteopathy who is an employee,
  or is under contract with the hospice. When the medical director is not
  available, a physician designated by the hospice provider assumes the same
  responsibilities and obligations as the medical director;
(iii) The hospice provider must maintain
  clinical records containing past and current findings for each hospice client
  for the longer of six years, or the time period identified in 175 NAC 16. The
  clinical record must contain correct clinical information that is available to
  the client's attending physician and hospice staff. The clinical record may be
  maintained electronically;
(iv)
  Medical supplies and appliances, durable medical equipment, and drugs and
  biologicals related to the palliation and management of the terminal illness
  and related conditions, as identified in the hospice plan of care, must be
  provided by the hospice provider while the client is under hospice
  care;
(v) The needs, preferences,
  cultural diversity, values, and expectations of client and caregiver are
  reflected in all aspects of service delivery;
(vi) All service provision is done in a
  manner that is empowering to the client and caregiver;
(vii) The client and caregiver feels safe and
  confident that their right to privacy is protected;
(viii) The client and caregiver is treated
  with dignity and respect at all times;
(ix) The hospice provider must assume full
  responsibility for the professional management of the client's hospice
  care;
(x) The hospice provider must
  conduct and document, in writing or electronically, a client-specific
  comprehensive assessment that identifies the client's need for hospice care and
  services, and the client's need for physical, psychosocial, emotional, and
  spiritual care. This assessment includes all areas of hospice care related to
  the palliation and management of the terminal illness and related conditions as
  outlined in this chapter;
(xi) The
  hospice provider must maintain a certification that the client is terminally
  ill based on the clinical judgment of the hospice medical director or the
  physician member of the hospice interdisciplinary group (IDG), or the client's
  attending physician if the client has an attending physician;
(xii) Maintain the signed election statement
  in its files;
(xiii) The hospice
  provider must designate a hospice interdisciplinary group (IDG) or groups as
  defined in this chapter which, in consultation with the client's attending
  physician, must prepare a written plan of care for each client. The plan of
  care must specify the hospice care and services necessary to meet the client
  and family-specific needs identified in the comprehensive assessment as such
  needs relate to the terminal illness and related conditions;
(xiv) Provide on-call services 24 hours a
  day, seven days a week;
(xv) Allow
  the Department staff to review agency policies regarding hiring and reporting
  to ensure that appropriate procedures regarding abuse, neglect, and law
  violations are in place;
(xvi)
  Agree and assure that any suspected abuse or neglect must be reported to law
  enforcement and appropriate Department staff;
(xvii) A hospice provider must routinely
  provide all core services directly by hospice provider employees. Any hospice
  employee or volunteer who is or will be ordering, referring, or prescribing
  items or services to clients, must be enrolled as a Medicaid provider in
  accordance with the provisions of 471 NAC 2;
(xviii) All professionals who furnish
  services directly, under an individual contract, or under arrangements with a
  hospice provider, must be legally authorized, licensed, certified, or
  registered, in accordance with applicable federal, state, and local laws, and
  must act only within the scope of his or her state license, or state
  certification, or registration. All personnel qualifications must be kept
  current at all times;
(xix) The
  hospice provider must organize, manage, and administer its resources to provide
  the hospice care and services which are reasonable and necessary for the
  palliation and management of the terminal illness and related
  conditions;
(xx) The hospice
  provider must have a signed, written, non-resident-specific contract with each
  certified nursing facility (NF), intermediate care facility for individuals
  with developmental disabilities (ICF/DD), institution for mental diseases
  (IMD), assisted living facility (ALF), or center for the developmental
  disabilities (CDD); and
(xxi) The
  hospice provider must maintain and document an effective infection control
  program that protects clients, families, visitors, and hospice personnel by
  preventing and controlling infections and communicable diseases.