Q:
What are the necessary components of a hospice services agreement?
A:
The following provisions are required:
- Ensuring that the hospice services meet professional standards and principles that apply to individuals providing services in the facility, and to the timeliness of the services
- Having a written agreement with the hospice that is signed by an authorized representative of the hospice and an authorized representative of the facility before hospice care is furnished to any resident with at least the following:
- The services the hospice will provide
- The services the facility will continue to provide based on each resident’s plan of care
- A communication process, including how communication will be documented between the facility and the hospice provider, to ensure that the needs of the resident are addressed and met 24 hours per day
- Notification to hospice immediately about the following:
- A significant change in the resident’s physical, mental, social, or emotional status
- Clinical complications that suggest a need to alter the plan of care
- A need to transfer the resident from the facility for any condition
- The resident’s death
- 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
- An agreement that it is the LTC facility’s responsibility to furnish 24-hour room and board care, meet the resident’s personal care and nursing needs in coordination with the hospice representative, and ensure that the level of care provided is appropriately based on the individual resident’s needs.
- A delineation of the hospice’s responsibilities, including but not limited to, providing medical direction and management of the patient; nursing; counseling (including spiritual, dietary, and bereavement); social work; providing 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
- A provision that when the LTC facility personnel are responsible for the administration of prescribed therapies, including those therapies determined appropriate by the hospice and delineated in the hospice plan of care, the LTC facility personnel may administer the therapies where permitted by State law and as specified by the LTC facility
- A provision stating that the LTC facility must report all alleged violations involving mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property by hospice personnel, to the hospice administrator immediately when the LTC facility becomes aware of the alleged violation.
- A delineation of the responsibilities of the hospice and the LTC facility to provide bereavement services to LTC facility staff
Written By:
Liz Wheeler, BSN, RN CHPN, IPCO, QCP, CDP
Clinical Consultant
Proactive LTC Consulting
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