reglab/statecodes huggingface dataset:
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 792 - Certification Of Hospices › Section 792.1 - Certificate of approval

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 commissioner shall not issue a certificate of approval to any hospice unless it
					 complies with the provisions of article 40 of the Public Health Law and the
					 rules and regulations promulgated pursuant thereto, and is qualified to
					 participate as a hospice under title XVIII of the Federal Social Security Act;
					 provided, however, that the commissioner shall issue a certificate of approval
					 to a hospice if he is satisfied that the hospice cannot qualify to participate
					 as a hospice under title XVIII of the Federal Social Security Act solely
					 because it proposes to provide nursing services by arrangement with a certified
					 home health agency.
(b) No person,
					 partnership or organization shall hold itself out as a hospice unless it
					 possesses a valid certificate of approval.
(c) A certificate of approval shall specify
					 the service area of the hospice and shall be posted conspicuously on the
					 premises of the principal office of the hospice located within its approved
					 service area.
(d) A certificate of
					 approval shall remain in force until revised, limited, annulled, revoked,
					 suspended or surrendered, unless an expiration date is specified in the
					 operating certificate as a result of a determination that a subsequent
					 evaluation is necessary to ensure that the facility is operating in compliance
					 with Public Health Law, article 40 and the rules and regulations promulgated
					 thereunder.
(e) A certificate of
					 approval may be revoked, suspened, limited or annulled by the commissioner on
					 proof that the hospice has failed to comply with the provisions of article 40
					 of the Public Health Law, this Article or any other applicable provision of
					 law.
(f) A certificate of approval
					 shall be surrendered promptly to the State Department of Health when revoked,
					 suspended, limited or annulled by the commissioner, or when the organization
					 terminates service.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 793 - Patient/family Care Services › Section 793.2 - Eligibility, election, admission and discharge

Current through Register Vol. 46, No. 28, July 10, 2024
The governing authority shall ensure that:
(a) except as prohibited by article 45 of the
					 Public Health Law or any other law or regulation, a patient referred to a
					 hospice may be accepted from any source;
(b) policies and procedures for admission and
					 discharge are developed and implemented;
(c) any individual admitted to hospice is
					 certified as being terminally ill consistent with State and/or Federal
					 definitions. Written certification of terminal illness is required for each
					 election period defined in paragraph (d)(4) of this section. If the hospice
					 cannot obtain the written certification within two calendar days after the
					 election period begins, it must obtain an oral certification within two
					 calendar days and the written certification before it submits a claim for
					 payment.
(1) Initial certification of
					 terminal illness must be obtained from either the medical director of the
					 hospice or the physician member of the hospice interdisciplinary group provided
					 for in section
					 793.4 of this Part, and also from
					 the individual's attending physician, if the individual has an attending
					 physician. In connection with the initial certification, the medical director
					 or physician designee must consider the following:
(i) diagnosis of the primary terminal
					 condition, along with any supporting current clinically relevant
					 information;
(ii) related
					 diagnoses, if any, along with any supporting current clinically relevant
					 information;
(iii) current
					 subjective and objective medical findings;
(iv) current medication and treatment orders;
					 and
(v) information about the
					 medical management of any of the patient's conditions unrelated to the terminal
					 illness.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 793 - Patient/family Care Services › Section 793.3 - Initial and comprehensive assessment

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 hospice registered nurse, as a member of the interdisciplinary group identified
					 in section
					 793.4 of this Part, must complete
					 an initial assessment within 48 hours after the election of hospice care in
					 accordance with section
					 793.2 of this Part unless the
					 physician, patient, or representative requests that the initial assessment be
					 completed in less than 48 hours. Initial assessment means an evaluation of the
					 patient's physical, psychosocial and emotional status related to the terminal
					 illness and related conditions to determine the patient's immediate care and
					 support needs.
(b) The hospice
					 interdisciplinary group, in consultation with the individual's attending
					 physician (if any), shall conduct and document in writing a patient-specific
					 comprehensive assessment no later than five calendar days after the election of
					 hospice care.
Comprehensive assessment
means a thorough
					 evaluation of the patient's physical, psychosocial, emotional and spiritual
					 status related to the terminal illness and related conditions including the
					 caregiver's and family's willingness and capability to care for the
					 patient.
(c) The comprehensive
					 assessment must take into consideration the following factors:
(1) the nature and condition causing
					 admission (including the presence or lack of objective data and subjective
					 complaints);
(2) complications and
					 risk factors that affect care planning;
(3) functional status, including the
					 patient's ability to understand and participate in his or her own
					 care;
(4) imminence of
					 death;
(5) severity of
					 symptoms;
(6) a review of all of
					 the patient's prescription and over-the-counter drugs, herbal remedies and
					 other alternative treatments that could affect drug therapy. This includes, but
					 is not limited to, identification of the following:
(i) effectiveness of drug therapy;
(ii) drug side effects;
(iii) actual or potential drug
					 interactions;
(iv) duplicate drug
					 therapy; and
(v) drug therapy
					 currently associated with laboratory monitoring;
(7) an initial bereavement assessment of the
					 needs of the patient's family and other individuals focusing on the social,
					 spiritual, and cultural factors that may impact their ability to cope with the
					 patient's death. Information gathered from the initial bereavement assessment
					 must be incorporated into the plan of care and considered in the bereavement
					 plan of care; and
(8) the need for
					 referrals and further evaluation by appropriate health professionals.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 793 - Patient/family Care Services › Section 793.4 - Patient plan of care, interdisciplinary group and coordination of care

Current through Register Vol. 46, No. 28, July 10, 2024
The governing authority must:
(a) designate an interdisciplinary group or
					 groups composed of individuals who work together to meet the physical, medical,
					 psychosocial, emotional, and spiritual needs of the hospice patients and
					 families facing terminal illness and bereavement. The members of the
					 interdisciplinary group are responsible for providing the care and services
					 offered by the hospice, and the group must collectively supervise the care and
					 services;
(1) The interdisciplinary group
					 must include, but is not limited to:
(i) a
					 doctor of medicine or osteopathy (who is an employee or under contract with the
					 hospice);
(ii) a registered
					 nurse;
(iii) a social worker;
					 and
(iv) a pastoral or other
					 counselor.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 793 - Patient/family Care Services › Section 793.5 - Quality assessment and performance improvement

Current through Register Vol. 46, No. 28, July 10, 2024
The governing authority must ensure that the
						hospice:
(a) develops, implements, and
					 maintains an ongoing, effective, hospice-wide data-driven program for quality
					 assessment and performance improvement, which shall be evaluated annually. The
					 program must:
(1) reflect the complexity of
					 the hospice organization and services;
(2) involve all hospice services, including
					 those services furnished under contract or arrangement, and all
					 locations;
(3) include the use of
					 quality indicator data in the design of the program, which focuses on improved
					 palliative and end of life outcomes;
(4) take actions to demonstrate improvement
					 in hospice performance;
(5) address
					 priorities for improved quality of care and patient safety; and
(6) be capable of showing measurable
					 improvement in indicators related to improved palliative outcomes and hospice
					 services.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 793 - Patient/family Care Services › Section 793.6 - Infection control

Current through Register Vol. 46, No. 28, July 10, 2024
The hospice must:
(a) implement and enforce an agency wide
					 program for the surveillance, identification, prevention, control and
					 investigation of infectious and communicable diseases, which could result in
					 staff, volunteers, visitors, or patients and family members becoming exposed to
					 such communicable diseases or infections. Such a program shall include:
(1) policies and procedures for maintaining
					 and documenting an effective infection control program in all settings where
					 patients reside, including but not limited to protocols for addressing patient
					 care issues and prevention of infection related to airborne pathogens, infusion
					 therapy, urinary tract care, respiratory tract care, wound care and multi-drug
					 resistant organisms;
(2) following
					 accepted standards of practice to prevent transmission of infections and
					 communicable disease;
(3)
					 monitoring staff for compliance with hospice policies and procedures related to
					 infection control;
(4) protocols
					 for educating staff, contracted personnel, patients, families and other
					 caregivers in infectious disease transmission, standard precautions and the
					 prevention and control of infection; and
(5) a specific program for protecting
					 patients, staff and families from bi-directional spread of HIV and other blood
					 borne pathogens, as specified in subdivision (b) of this section.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 793 - Patient/family Care Services › Section 793.7 - Staff and services

Current through Register Vol. 46, No. 28, July 10, 2024
(a) At a
					 minimum, hospice staff shall be composed of:
(1) a hospice administrator who is appointed
					 by the governing authority and is an employee of the hospice who works a
					 minimum of half-time for the hospice. The administrator is responsible for the
					 day-to-day management of the hospice;
(2) a hospice medical director who is:
(i) a doctor of medicine or osteopathy who is
					 licensed and registered to practice in New York State or maintains a current
					 license and who is an employee or is under contract with the hospice. When the
					 medical director is not available, a physician designated by the hospice shall
					 assume the same responsibilities and obligations as the medical director;
					 and
(ii) responsible for
					 supervision of all physician employees and physicians under contract;
(3) a hospice nurse
					 coordinator;
(4) a hospice social
					 worker;
(5) a pastoral care
					 coordinator; and
(6) a coordinator
					 of volunteer services, whose responsibilities shall include:
(i) ensuring implementation of policies and
					 procedures related to volunteer services;
(ii) providing and documenting volunteer
					 orientation and training;
(iii)
					 ensuring that volunteers are used in defined administrative or direct patient
					 care roles under the supervision of a designated hospice employee;
(iv) ongoing efforts to recruit and retain
					 volunteers; and
(v) demonstrating
					 and documenting cost savings achieved through the use of volunteers including:
(a) identification of each position that is
					 occupied by a volunteer and his or her work time; and
(b) estimates of the dollar costs that the
					 hospice would have incurred if paid employees occupied the positions.
					 Volunteers must provide services in an amount that, at a minimum, equals five
					 percent of the total patient care hours of all paid hospice employees and
					 contract staff.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.1 - Governing authority

Current through Register Vol. 46, No. 28, July 10, 2024
The governing authority, as defined in Part 790 of this
						Title shall:
(a) be responsible for
					 the management and fiscal operations of the hospice, the provision of all
					 hospice services, and continuous quality assessment and performance
					 improvement;
(b) ensure compliance
					 with all applicable Federal, State and local laws, rules and
					 regulations;
(c) provide for
					 coordinated, interdisciplinary inpatient and home care services, 24 hours a
					 day, 7 days a week;
(d) ensure
					 adequate staff and resources to provide continuity of care based on the needs
					 of the persons served;
(e) adopt,
					 amend and implement bylaws regarding the responsibilities, functions and
					 activities of the governing body;
(f) adopt the hospice budgets, control assets
					 and funds, and provide for annual fiscal audits;
(g) prohibit any employee of the hospice to
					 be reimbursed by any party other than the hospice for service provided as part
					 of the hospice program, or the splitting or sharing of fees between a referral
					 agency/facility or individual and the hospice;
(h) ensure the prompt submission of all
					 records and reports required by the department;
(i) ensure compliance with the pertinent
					 provisions regarding the discontinuance of operations of a medical facility, as
					 set forth in section
					 401.3 of this Title, in the event
					 the hospice discontinues operation for any reason;
(j) negotiate agreements with other patient
					 care facilities/agencies for the referral and acceptance of hospice
					 patients;
(k) adopt and amend
					 policies and procedures regarding management and operation of the hospice and
					 the provision of patient care services;
(l) ensure the development and implementation
					 of a patient complaint procedure to include:
(1) documentation of receipt, investigation
					 and resolution of any complaint, including maintenance of a complaint log
					 indicating the dates of receipt and resolution of all complaints received by
					 the program;
(2) review of each
					 complaint with a written response to all written complaints and to oral
					 complaints, if requested by the individual making the oral complaint,
					 explaining the complaint investigation findings and the decisions rendered to
					 date by the program within 15 days of receipt of such complaint; and
(3) an appeals process with review by a
					 member or committee of the governing authority within 30 days of receipt of the
					 appeal.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.2 - Contracts

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 governing authority may enter into contracts with appropriate qualified
					 individuals, organizations, agencies and/or facilities, when necessary, to
					 provide for those services required by patients/families when the hospice
					 itself does not have sufficient staff or necessary equipment available to
					 render such services directly.
(1) Such
					 contracts shall meet all applicable State and Federal requirements and shall
					 specify:
(i) each party's responsibilities,
					 functions, objectives, financial arrangements and charges, including
					 responsibility for supervision;
(ii) that personnel meet the personnel
					 requirements as set forth in section
					 794.3 of this Part, which can be
					 verified by written documented evidence accessible to the hospice or department
					 on request;
(iii) that services
					 provided by contract to the patient shall be authorized by the hospice in
					 accordance with the plan of care developed by the hospice and that the contract
					 provider agrees to abide by the patient care policies established by the
					 hospice for its patients;
(iv) that
					 the contracting provider agrees to participate in patient/family care planning
					 conferences as requested by the hospice;
(v) that contracting providers who are
					 licensed professionals agree to participate in:
(a) the coordination of all aspects of the
					 patient's hospice care, including ongoing interdisciplinary comprehensive
					 assessments, developing and evaluating the plan of care, and contributing to
					 patient and family counseling and education;
(b) the hospice's quality assessment and
					 performance improvement program; and
(c) hospice sponsored in-service
					 training.
(vi) any
					 provisions made for indemnification between the hospice and contracting
					 providers; and
(vii) the following
					 terms and conditions: "Notwithstanding any other provision in this contract,
					 the hospice remains responsible for (a) ensuring that any service provided
					 pursuant to this contract complies with all pertinent provisions of Federal,
					 State and local statutes, rules and regulations; (b) planning, coordinating and
					 ensuring the quality of all services provided; and (c) ensuring adherence to
					 the plan of care established for patients."
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.3 - Personnel

Current through Register Vol. 46, No. 28, July 10, 2024
The governing authority shall ensure for all personnel,
						which includes direct employees, contract staff and volunteers:
(a) the development and implementation of
					 written personnel policies and procedures, which are reviewed annually and
					 revised as necessary;
(b) that
					 personnel are qualified as specified in section
					 700.2 of this Title;
(c) that the health status of all new
					 personnel is assessed prior to the beginning of patient/family contact. The
					 assessment shall be of sufficient scope to ensure that no person shall assume
					 his/her duties unless he/she is free from a health impairment that is of
					 potential risk to the patient/family or to employees or that may interfere with
					 the performance of his/her duties including the habituation or addiction to
					 depressants, stimulants, alcohol, or other drugs or substances which may alter
					 the individual's behavior;
(d) that
					 a record of the following tests and examinations is maintained for all
					 employees, and those volunteers who have direct patient/family contact:
(1) a
certificate of immunization
					 against rubella
which means:
(i) a
					 document prepared by a physician, physician assistant, specialist assistant,
					 nurse practitioner or a laboratory possessing a laboratory permit issued
					 pursuant to Part 58 of this Title, demonstrating a serologic evidence of
					 rubella antibodies, or
(ii) a
					 document indicating one dose of live virus rubella vaccine was administered on
					 or after the age of 12 months, showing the product administered and the date of
					 administration, and prepared by the health practitioner who administered the
					 immunization, or
(iii) a copy of a
					 document described in subparagraph (i) or (ii) of this paragraph which comes
					 from a previous employer or the school which the employee attended as a
					 student;
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.4 - Clinical record

Current through Register Vol. 46, No. 28, July 10, 2024
The governing authority shall ensure that:
(a) there is a standardized clinical record
					 system which is maintained in conformance with generally accepted medical
					 record practices;
(b) a clinical
					 record containing past and current findings is maintained for each hospice
					 patient. The clinical record must contain correct clinical information that is
					 available to the patient's attending physician and hospice staff including:
(1) initial assessment, comprehensive
					 assessments and updated comprehensive assessments;
(2) initial plan of care and updated plans of
					 care;
(3) clinical notes. A
clinical note
means a notation of a contact with the patient
					 and/or the family that is written and dated by any person providing services
					 and that describes signs and symptoms, treatments and medications administered,
					 including the patient's reaction and/or response, any changes in physical,
					 emotional, psychosocial or spiritual condition during a given period of
					 time;
(4) signed copies of the
					 notice of patient rights pursuant to section
					 793.1 of this Title and election
					 statement pursuant to section
					 793.2 of this Title;
(5) responses to medications, symptom
					 management, treatments and services;
(6) outcome measure data elements;
(7) physician certification and
					 recertification of terminal illness;
(8) any advance directive;
(9) physician orders;
(10) documentation regarding instructions and
					 written information provided to patients and families on the use, management
					 and disposal of controlled substances and durable medical equipment and
					 supplies; and
(11) a discharge
					 summary if the patient is discharged from hospice, completed by appropriate
					 personnel, including but not limited to:
(i)
					 reason for discharge and date;
(ii)
					 a summary of the hospice care given including treatments, symptoms and pain
					 management; and
(iii) patient
					 status upon discharge including a description of any remaining needs.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.5 - Short-term inpatient service

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Part
					 702 of this Title, section
					 717.3 of this Title and Part 14 of
					 the Sanitary Code shall apply to hospice inpatient settings as
					 applicable.
(b) The hospice may
					 provide short-term inpatient services for respite and for pain control and
					 management of symptoms related to the terminal illness in a free-standing
					 hospice facility, a skilled nursing facility or a general hospital.
(c) The provision of inpatient services shall
					 be consistent with applicable Federal requirements and with the definition of
					 hospice as defined in section
					 700.2 of this Title, and shall
					 include, but not be limited to:
(1) 24-hour
					 nursing services that meet the needs of all patients and are furnished in
					 accordance with the patient's plan of care, including the services of a
					 registered professional nurse if a hospice patient has been admitted to
					 inpatient services for other than respite care. Each patient must receive all
					 nursing services as prescribed and must be comfortable, clean, well groomed,
					 and protected from accident, injury and infection;
(2) accommodations to enable families to
					 store and prepare food brought in by the family;
(3) accommodations to enable families to
					 remain with the patient throughout the night;
(4) flexible visitation policies which
					 include 24-hour a day visiting privileges regardless of age of
					 visitor;
(5) provision of adequate
					 and wholesome food and supplemental nourishments under the direction of a
					 dietician;
(6) flexibility in meal
					 times and in selection of food based on individual needs of patients;
(7) accommodations for recreational and
					 religious activities;
(8) adequate
					 space for private small group interactions;
(9) retention and use of personal possessions
					 as space and safety permits;
(10) a
					 telephone accessible to the patient; and
(11) oxygen available to each patient, as
					 necessary.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.6 - Hospice residence service

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Part
					 702 of this Title, section
					 717.4 of this Title and Part 14 of
					 the Sanitary Code shall apply to all hospice residence settings, as
					 applicable.
(b)
Hospice
					 residence
as defined in Part 702 of this Title shall mean a hospice
					 operated home which is residential in character and physical structure, and
					 operated for the purpose of providing more than two hospice patients, but not
					 more than 16 hospice patients, with hospice care.
(c) Hospice residence service shall include,
					 but not be limited to:
(1) the provision of
					 services as specified in section
					 794.5(c)(2), (3), (4), (6), (7), (8), (9), (10) and
					 (11) of this Part.
(2) the provision of either home health aide,
					 licensed practical nurse or registered nurse services, as appropriate, to
					 address the medical needs and ensure the safety and well-being of residents on
					 a 24-hour a day basis;
(3) the
					 provision of adequate and wholesome food and supplemental nutrition under the
					 direction of a dietician. The hospice residence must:
(i) store, prepare, distribute and serve food
					 under sanitary conditions in accordance with the sanitary requirements of Part
					 14 of this Title;
(ii) offer each
					 resident at least three meals, or their equivalent, each day at regular times,
					 with not more than 14 hours between a substantial evening meal and breakfast;
					 and
(iii) prepare and serve
					 therapeutic diets, prescribed by a physician, and planned and supervised by a
					 professionally qualified dietitian; and
(4) routine and emergency drugs and
					 biologicals, provided either directly to residents, or obtained under contract
					 as described in section
					 794.2 of this Part, in accordance
					 with article 33 of the Public Health Law and Part 80 of this Title.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.7 - Leases

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
					 Whenever a hospice leases premises in which the inpatient component of a
					 hospice or a hospice residence is to be provided, the hospice shall ensure that
					 the lease contains the following language:
"The landlord acknowledges that its rights of reentry
						into the premises set forth in this lease do not confer on it the authority to
						operate a hospital or hospice as defined in Articles 28 and 40, respectively,
						of the Public Health Law on the premises and agrees to provide the New York
						State Department of Health with notification by certified mail of intent to
						reenter the premises or to initiate dispossess proceedings or that the lease is
						due to expire, at least 30 days prior to the date on which the landlord intends
						to exercise a right of reentry or to initiate such proceedings or at least 60
						days before expiration of the lease."
(b) Upon receipt of notice from the landlord
					 of its intent to exercise its right of reentry or upon the service of process
					 in dispossess proceedings and 60 days prior to the expiration of the lease, the
					 hospice shall immediately notify by certified mail the New York State
					 Department of Health of receipt of such notice or service of such process or
					 that the lease is about to expire.
(c) No lease covering the administrative
					 office site or the premises in which the inpatient component of a hospice or a
					 hospice residence as defined in article 40 of the Public Health Law is to be
					 conducted and no lease covering any equipment used in the operation of a
					 hospice may contain any provision whereby rent, or any increase therein, is
					 based upon the Consumer Price Index or any other cost of living index. In the
					 event the lease covering such hospice premises or equipment contains provisions
					 whereby it is the lessor's responsibility to pay necessary expenses associated
					 with such premises or equipment, such as real estate taxes, utilities, heat,
					 insurance, maintenance and operating supplies, such lease may contain
					 provisions which allow adjustments to the rent only to the extent necessary to
					 compensate the lessor for changes in such expenses.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 9 - Hospice Operation › Part 794 - Organization and Administration › Section 794.9 - Records and reports

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 governing authority shall ensure that:
(1)
					 the following records are retained on file at the principal office of the
					 hospice within its approved geographic service area and available to the
					 department upon request:
(i) the certificate
					 of incorporation, if applicable;
(ii) the certificate of approval;
(iii) all current contracts, leases and other
					 agreements entered into by the hospice;
(iv) current operating policies and
					 procedures; and
(v) a current
					 patient/family roster;
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.1 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
As used in this Part:
(a) A
midwifery birth center
means a facility licensed pursuant to article 28 of the Public Health Law that
					 is engaged principally in providing prenatal and obstetric care, and where such
					 services are provided principally by midwives. The facility shall be organized
					 to provide prenatal, child birth and postpartum care and primary preventive
					 reproductive health care to patients at low risk. Services are provided by a
					 midwife, licensed pursuant to article 140 of the Education Law, to patients at
					 low risk, during pregnancy, labor, delivery, and who require only a stay of
					 less than 24 hours after birth. Such services shall include newborn evaluation,
					 resuscitation and referral. Midwifery birth center services are based on a
					 philosophy that promotes a home-like setting and family-centered approach to
					 care and views pregnancy and delivery as a normal physiological process
					 requiring limited technological and pharmacological support. The center
					 services are designed to meet the specific needs of the population being served
					 and promote optimum pregnancy outcomes. The licensed midwife provides care for
					 the low-risk patient during pregnancy and remains available to the patient
					 during labor from the time of admission to the midwifery birth center through
					 the immediate postpartum period, providing continuous physical and emotional
					 support, evaluating progress, facilitating family interaction and assisting the
					 patient in labor and delivery. Other health care providers can provide prenatal
					 and postpartum care to midwifery birth center patients. They may also provide
					 supportive care during labor and delivery, but the attending provider for birth
					 must be a licensed midwife.
(b) A
patient at low risk
means a patient who has: a normal medical,
					 surgical, and obstetrical history; a normal, uncomplicated pregnancy as
					 determined by adequate prenatal care; and prospects for a normal, uncomplicated
					 gestation and birth. Risk shall be determined using standardized criteria based
					 on generally accepted standards of professional practice.
(c) The
department
means the
					 New York State Department of Health.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.2 - Administrative requirements

Current through Register Vol. 46, No. 28, July 10, 2024
The operator shall ensure that:
(a) only patients at low risk are admitted
					 and cared for at the midwifery birth center;
(b) written policies, procedures and standard
					 risk assessment criteria for determining low-risk pregnancies based upon
					 generally accepted standards of practice are developed and
					 implemented;
(c) written policies,
					 procedures and protocols for the management of care are implemented pursuant to
					 generally accepted standards of practice and in accordance with midwifery birth
					 center philosophy;
(d) a record is
					 made of all informed consent, including shared decision making, that indicates
					 concurrence from both caregiver and patient parties;
(e) there is a transfer agreement with one or
					 more perinatal centers for medical care of patients when complications arise
					 antepartum, intrapartum, or postpartum and that meets the following
					 requirements:
(1) compliance with section
					 400.9 of this Title;
(2) the surface travel time to reach a
					 receiving perinatal hospital is less than two hours under usual weather and
					 road conditions; and
(3) the
					 receiving hospital is accessible and convenient to the patient's place of
					 residence whenever possible;
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.3 - Service restrictions

Current through Register Vol. 46, No. 28, July 10, 2024
The operator shall ensure that:
(a) only patients at low risk are admitted
					 and cared for at the midwifery birth center;
(b) surgical procedures are limited to those
					 which may be performed during and after an uncomplicated childbirth, such as
					 episiotomy and repair. Other surgical procedures, including forceps and vacuum
					 extraction are not permitted;
(c)
					 general and regional anesthesia are not administered at the center;
					 and
(d) labor is not induced,
					 inhibited, stimulated or augmented with pharmacological agents acting directly
					 on the uterus during the first or second stages of labor.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.4 - Midwifery birth center transfer procedures

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 midwifery birth center shall maintain the capability to evaluate, stabilize and
					 transfer patients other than patients at low risk, including newborns. The
					 midwifery birth center shall refer or transfer patients for any health care
					 services that fall outside the scope of midwifery birth center resources and
					 risk criteria at any point during the course of care. The midwifery birth
					 center shall initiate transfer when risks are identified, including when there
					 is prolonged labor, fetal distress, or a need for spinal or epidural
					 anesthesia, or when there may be an operative or cesarean birth.
(b) Midwifery birth centers shall have
					 written plans and procedures for the transfer of patients to the obstetrical or
					 pediatric services of the receiving hospital(s) when complications arise. Such
					 plans and procedures shall include arrangements for an ambulance service and,
					 when necessary, accompanying the patient in the ambulance with a clinical staff
					 member of the midwifery birth center.
(c) The operator, in consultation with the
					 receiving hospital(s), shall develop a list of indicators necessitating
					 transfer and a written procedure for automatic acceptance of such transfers by
					 the receiving hospital, which shall include transfer of patients when neonatal
					 abstinence syndrome or fetal alcohol syndrome is evident or
					 suspected.
(d) The operator shall
					 implement a system to ensure that a copy of the medical record accompanies the
					 patient upon transfer to the hospital.
(e) The operator shall establish a mechanism
					 for jointly reviewing all transfer cases by the receiving hospital(s) and the
					 midwifery birth center as part of the quality assurance program specified in
					 section 795.9 of this Part.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.5 - Midwifery birth center director and medical consultants

Current through Register Vol. 46, No. 28, July 10, 2024
The operator shall appoint a midwifery birth center
						director who:
(a) is a licensed midwife
					 or physician;
(b) maintains
					 documentation of collaborative relationships required under section
					 6951 of the
					 Education Law;
(c) approves all
					 policies, procedures and protocols for the management of care;
(d) approves standardized criteria for
					 admission screening and monitoring risk status during pregnancy, labor, birth
					 and postpartum;
(e) is available
					 for consultation and referral or has made arrangements with a qualified
					 physician for these services;
(f)
					 may appoint a consultant physician who:
(1)
					 is a qualified specialist, as defined in section
					 700.2 of this Title, in pediatrics
					 or family practice and who has pediatric privileges that include admission and
					 care of newborns at the receiving hospital(s). In the absence of pediatric
					 privileges, there must be formal arrangements included in the transfer
					 agreement for the provision of pediatric care at the receiving hospital(s);
					 and
(2) is available for
					 consultation and referral;
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.6 - Clinical staff

Current through Register Vol. 46, No. 28, July 10, 2024
The operator shall ensure that:
(a) a licensed midwife attends each patient
					 from the time of admission, during labor, during the birth and through the
					 immediate postpartum period, and that such practitioner maintains current
					 certification by the American Academy of Pediatrics as a Neonatal Resuscitation
					 Program (NRP) provider;
(b) a
					 second trained staff person is also present at each birth who:
(1) is under the supervision of the licensed
					 midwife;
(2) has specialized
					 training in labor and delivery techniques and care of the midwifery birth
					 center patient;
(3) receives
					 planned and ongoing training as needed to perform assigned duties effectively;
					 and
(4) maintains current status as
					 a NRP provider;
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.7 - Services for the care of patients

Current through Register Vol. 46, No. 28, July 10, 2024
All patients shall be assessed to determine availability
						of sufficient resources prior to and following delivery. The operator shall
						ensure that the midwifery birth center provides at least the following:
(a) admission screenings to ensure that only
					 patients at low risk are admitted to the midwifery birth center;
(b) active participation by patients and
					 families in their own plan of health care, which shall include but not be
					 limited to:
(1) orientation to the midwifery
					 birth center services and its philosophy and goals preceding registration;
					 and
(2) access to prenatal
					 education classes approved by the clinical staff which address, at a minimum,
					 labor and delivery, infant care and feeding, parenting, nutrition, the effects
					 of smoking, alcohol and other drugs on fetal development and on the newborn
					 patient, signs of postpartum depression, what to expect if transferred, and the
					 newborn screening program, including hearing screening, with the provision and
					 distribution of newborn screening educational literature;
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.8 - Medical records

Current through Register Vol. 46, No. 28, July 10, 2024
The operator shall ensure that, in addition to meeting
						the requirements in section
						751.7 of this Title:
(a) The medical record for each patient shall
					 contain the following information:
(1)
					 results of physical and risk assessments;
(2) patient history, to include medical,
					 surgical, gynecological and psychosocial history;
(3) record of informed consent, including
					 shared decision making, for midwifery birth center services;
(4) ongoing assessments of fetal growth and
					 development;
(5) periodic
					 evaluations of patient health;
(6)
					 results of laboratory tests;
(7)
					 labor and birth information;
(8)
					 newborn patient physical assessment, including APGAR scores, maternal-newborn
					 interaction, ability to feed, eye prophylaxis, vital signs and accommodation to
					 extrauterine life;
(9) postpartum
					 assessment;
(10) discharge and
					 follow-up plans;
(11) home visit
					 reports;
(12) midwifery birth
					 center follow-up visit report; and
(13) documentation of family planning
					 counseling and the arrangements made for family planning services, if
					 any.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.9 - Quality assurance

Current through Register Vol. 46, No. 28, July 10, 2024
In addition to meeting the requirements set forth in
						section 795.8 of this Part, the operator
						shall ensure that there is a review of all pregnant and postpartum patients
						and/or newborn hospital transfers, with reasons for such transfers documented.
						Findings from these reviews shall be used by the operator and midwifery birth
						center director in the development and revision of policies and in the
						consideration of renewing or granting staff privileges.
New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 10 - Midwifery Birth Centers › Part 795 - Midwifery Birth Centers › Section 795.10 - Emergency care

Current through Register Vol. 46, No. 28, July 10, 2024
The midwifery birth center shall have the capability and
						equipment to provide care to patients at low risk and a readiness at all times
						to meet any unexpected needs of patients within the center, and to facilitate
						transport to an acute care setting when necessary. The midwifery birth center
						shall stabilize and transfer patients to an appropriate general hospital for
						continued care when medically indicated. Staff with required current course
						completion status in NRP, BLS, and ACLS shall be available and shall have
						immediate access to all necessary equipment in accordance with these
						certifications to initiate resuscitation of patients. The midwifery birth
						center must have availability of adequate numbers of qualified professionals
						with competence and ability to stabilize and transfer high-risk patients. The
						operator shall ensure that at a minimum:
(a) emergency equipment and supplies approved
					 by the midwifery birth center director are available for use for resuscitation
					 of both adult and neonate patients and include at least the following:
(1) intravenous therapy equipment;
(2) infant warmer;
(3) infant transport equipment;
(4) oxygen and oxygen administration
					 equipment for patient and infant;
(5) airways and manual breathing bags for
					 patient and infant;
(6) suction
					 machine and equipment for patient and infant;
(7) adult and infant laryngoscope and
					 endotracheal tubes; and
(8)
					 medications and intravenous fluids with supplies and equipment for
					 administration;