Oklahoma Administrative Code › Title 310 - Oklahoma State Department of Health › Chapter 661 - Hospice › Subchapter 1 - General Provisions › Section 310:661-1-2 - Definitions

Current through Vol. 41, No. 20, July 1, 2024
The following words and terms, when used in this Chapter,
				  shall have the following meaning, unless the context clearly indicates
				  otherwise.
"Act"
means the Oklahoma Hospice Licensing Act,
				  63 O.S. 1991, §§ 1-860.1 et seq.
"Alternate Administrative Office"
means an
				  approved location from which the hospice provides the same full range of
				  hospice care and services that is required of the hospice issued, stores
				  supplies, and/or is used for documentation and meets the requirements of
				  310:661-2-1(f)(2).
				  Each location shall meet all of the applicable requirements of Chapter 661.
				  Hospice.
"Attending physician"
means a doctor of medicine
				  or osteopathy, identified by the patient or representative at the time the
				  patient or representative elects to receive hospice care, as having the most
				  significant role in the determination and delivery of the patient's medical
				  care.
"Bereavement counseling"
means emotional,
				  psychosocial, and spiritual support and services provided before and after the
				  death of the patient to assist with issues related to grief, loss, and
				  adjustment.
"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, and
				  any changes in physical, emotional, psychosocial or spiritual condition during
				  a given period of time.
"Comprehensive assessment"
means an evaluation
				  of the patient's physical, psychosocial, emotional and spiritual status related
				  to the terminal illness and related conditions. This includes an evaluation of
				  the caregiver's and family's willingness and capability to care for the
				  patient.
"Continuous care"
means nursing care that is
				  provided by a skilled nurse or a qualified hospice aide for as much as 24-hours
				  a day during periods of medical crisis as necessary to maintain a hospice
				  patient at their place of residence.
"Department"
means the Oklahoma State Department
				  of Health.
"Dietary counseling"
means education and
				  interventions provided to the patient and family regarding nutritional intake
				  as the patient's condition changes. Dietary counseling is provided by qualified
				  individuals, which may include a registered nurse or dietitian, when identified
				  in the patient's plan of care.
"Employed"
means contracting with a person for
				  services, regardless of compensation. This term also includes
				  volunteers.
"Employee"
means a person who:
(1) Works for the hospice and for whom the
				hospice is required to issue a W-2 form on his or her behalf;
(2) if the hospice is a subdivision of an
				agency or organization, an employee of the agency or organization who is
				assigned to the hospice; or
(3) is a
				volunteer under the jurisdiction of the hospice.
"Fast-track"
The process where advance approval
				  may be secured for construction starts while design details are
				  completed.
"First-year license"
means a license issued for
				  the initial twelve (12) month license period.
"Follow-up inspection"
means the inspection by
				  representatives of the Department that shall occur after a hospice has provided
				  hospice services for at least six (6) months.
"Governing body"
means a person, persons, or
				  legal entity that is legally responsible for the conduct of the facility as an
				  institution and carries out the functions, ownership, and governance in
				  accordance with these regulations and the laws of this state.
"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.
"License"
means a first-year or permanent
				  hospice license issued pursuant to the Act and these rules.
"Licensed independent practitioner"
means any
				  individual permitted by law and by the licensed hospice to provide care and
				  services, without direct supervision, within the scope of the individual's
				  license and consistent with clinical privileges individually granted by the
				  licensed hospice. Licensed independent practitioners may include advanced
				  practice nurses with prescriptive authority, physician assistants, dentists,
				  podiatrists, optometrists, chiropractors, and psychologists.
"Medical Crisis"
means an event or situation in
				  which a registered nurse, through direct assessment of the hospice patient,
				  determines that the patient has entered into a period of crisis which requires
				  a physician's intervention and continuous nursing care to achieve palliation or
				  management of acute medical symptoms. Peaceful symptom controlled death is an
				  expected patient outcome and is not considered a medical crisis. A medical
				  crisis would include, but not be limited to the following: uncontrolled
				  terminal agitation as demonstrated by hallucinations, confusion, and
				  combativeness; uncontrolled pain; uncontrolled respiratory distress;
				  uncontrolled nausea and vomiting; hemorrhaging; uncontrolled seizures; family
				  distress as a result of ongoing symptom management for the patient requiring
				  administration of medications to maintain the patient's comfort; and, any
				  uncontrolled symptom that requires the administration of medications with
				  ongoing assessment of the effectiveness and adjustment of the medication
				  regimen to achieve control of symptoms.
"Palliative care"
means patient and
				  family-centered care that optimizes quality of life by anticipating,
				  preventing, and treating suffering. Palliative care throughout the continuum of
				  illness involves addressing physical, intellectual, emotional, social, and
				  spiritual needs and to facilitate patient autonomy, access to information, and
				  choice.
"Permanent license"
means a license first issued
				  to a hospice program after the first-year license period has been completed and
				  the required follow-up inspection has been conducted.
"Physician designee"
means a doctor of medicine
				  or osteopathy designated by the hospice who assumes the same responsibilities
				  and obligations as the medical advisor when the medical advisor is not
				  available.
"Registered nurse"
means a person who is
				  currently licensed to practice registered nursing in the State of
				  Oklahoma.
"Representative"
or
"Court appointed
				  guardian"
means a person who is authorized in accordance with State law
				  to execute or revoke an election for hospice care or terminate medical care on
				  behalf of the terminally ill individual.
"Skilled nurse"
means a person who is currently
				  licensed to practice registered nursing or practical nursing in the State of
				  Oklahoma.
"Social worker"
means a person who has a degree
				  from a school accredited or approved by the Council on Social Work Education
				  and conforms to the requirements of the State Licensure Laws of Oklahoma for
				  Social Workers.
Added at 9 Ok Reg 1985,
				  eff 6-11-92; Amended at 14 Ok Reg 2106, eff 4-7-97 (emergency); Amended at 14
				  Ok Reg 2269, eff 6-12-97; Amended at 19 Ok Reg 2094, eff 6-27-02; Amended at 21
				  Ok Reg 1303, eff 5-27-04; Amended at 23 Ok Reg 2412, eff 6-25-06; Amended at 26
				  Ok Reg 2042, eff 6-25-09