Texas Administrative Code › Title 26 - HEALTH AND HUMAN SERVICES › Part 1 - HEALTH AND HUMAN SERVICES COMMISSION › Chapter 558 - LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES › Subchapter H - STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES › Division 8 - HOSPICES THAT PROVIDE HOSPICE CARE TO RESIDENTS OF A SKILLED NURSING FACILITY, NURSING FACILITY, OR INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH AN INTELLECTUAL DISABILITY OR RELATED CONDITIONS › Section 558.880 - Providing Hospice Care to a Resident of a Skilled Nursing Facility, Nursing Facility, or Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions

Current through Reg. 49, No. 28; July 12, 2024
(a)
					 Professional management. A hospice must assume responsibility for professional
					 management of the hospice services it provides to a resident of a skilled
					 nursing facility (SNF), nursing facility (NF), or an intermediate care facility
					 for individuals with an intellectual disability or related conditions
					 (ICF/IID), in accordance with the hospice plan of care. The hospice must make
					 arrangements, as necessary for hospice-related inpatient care in a
					 participating Medicare or Medicaid facility, in accordance with § 558.850
					 of this subchapter (relating to Organization and Administration of Hospice
					 Services) and § 558.863 of this subchapter (relating to Hospice Short-term
					 Inpatient Care).
(b) Written
					 contract. A hospice and SNF, NF, or ICF/IID must have a written contract that
					 allows the hospice to provide services in the facility. The contract must be
					 signed by an authorized representative of the hospice and the SNF, NF, or
					 ICF/IID before hospice services are provided. In addition to the requirements
					 in § 558.289 of this chapter (relating to Independent Contractors and
					 Arranged Services), the written contract must include:
(1) the way the SNF, NF, or ICF/IID and the
					 hospice are to communicate with each other and document such communications to
					 ensure that the needs of a client are addressed and met 24 hours a
					 day;
(2) a provision that the SNF,
					 NF, or ICF/IID immediately notifies the hospice of:
(A) a significant change in the client's
					 physical, mental, social, or emotional status;
(B) clinical complications that suggest a
					 need to alter the plan of care;
(C)
					 the need to transfer the client from the SNF, NF, or ICF/IID; or
(D) the death of a client;
(3) a provision stating that if
					 the SNF, NF, or ICF/IID transfers the client from the facility that the hospice
					 arranges for, and remains responsible for, any necessary continuous care or
					 inpatient care related to the terminal illness and related
					 conditions;
(4) a provision stating
					 that the hospice assumes responsibility for determining the appropriate course
					 of hospice care, including the determination to change the level of services
					 provided;
(5) an agreement that the
					 SNF, NF, or ICF/IID is responsible for furnishing 24-hour room and board care,
					 meeting the personal care and nursing needs that would have been provided by
					 the primary caregiver at home at the same level of care provided before the
					 client elected hospice care;
(6) an
					 agreement that the hospice is responsible for providing services at the same
					 level and to the same extent as those services would be provided if the SNF,
					 NF, or ICF/IID resident were in his or her own home;
(7) a delineation of the hospice's
					 responsibilities, which include providing medical direction and management of
					 the client; nursing; counseling, including spiritual, dietary and bereavement
					 counseling; social work; medical supplies, durable medical equipment, and drugs
					 necessary for the palliation of pain and symptoms associated with the terminal
					 illness and related conditions; and all other hospice services that are
					 necessary for the care of the resident's terminal illness and related
					 conditions;
(8) a provision that
					 the hospice may use the SNF, NF, or ICF/IID nursing personnel where permitted
					 by State law and as specified by the SNF, NF, or ICF/IID to assist in the
					 administration of prescribed therapies included in the plan of care, only to
					 the extent that the hospice would routinely use the services of a hospice
					 client's family in implementing the plan of care;
(9) a provision stating that the hospice must
					 report an alleged violation involving mistreatment, neglect, or verbal, mental,
					 sexual, and physical abuse, including injuries of unknown source, and
					 misappropriation of client property by non-hospice personnel to the SNF, NF, or
					 ICF/IID administrator within 24 hours after the hospice becomes aware of the
					 alleged violation;
(10) a
					 delineation of the responsibilities of the hospice and the SNF, NF, or ICF/IID
					 to provide bereavement services to SNF, NF, or ICF/IID staff; and
(11) a provision regarding management and
					 disposal, in compliance with applicable law, of drugs, including controlled
					 substance prescription drugs and biologicals.