SECTION 310:661-3-2. Organization

(a)   Organization and administration of services. The hospice shall organize, manage, and administer its resources to provide the hospice care and services to patients, caregivers and families necessary for the palliation and management of the terminal illness and related conditions.

(b)   Serving the hospice patient and family. The hospice shall provide hospice care that:

(1)   Optimizes comfort and dignity; and

(2)   Is consistent with patient and family needs and goals, with patient needs and goals as priority.

(c)   Continuation of care. A hospice shall not discontinue or reduce care provided because of the inability to pay for that care.

(d)   Professional management responsibility. A hospice that has a written agreement with another agency, individual, or organization to furnish any services under arrangement shall retain administrative and financial management, and oversight of staff and services for all arranged services, to ensure the provision of quality care. Arranged services shall be supported by written agreements that require that all services be:

(1)   Authorized by the hospice;

(2)   Furnished in a safe and effective manner by qualified personnel; and

(3)   Delivered in accordance with the patient's plan of care.

(e)   Narrative program. Each Hospice shall provide a narrative program with its application which describes the functions, staffing, services available to the patient and other basic information relating to the fulfillment of the facility's objectives.

(f)   Governing body. A hospice shall have a governing body that assumes full legal responsibility for determining, implementing and monitoring policies governing the total operations of the hospice. The governing body shall designate an individual who is responsible for the day-to-day management of the hospice program. The governing body shall also ensure that all services provided are consistent with accepted standards of practice.

(g)   Hospice team. A hospice team shall be developed and function according to the Act. The hospice team is responsible for:

(1)   Participation in the establishment of the plan of care.

(2)   Provision or supervision of hospice care and services.

(3)   Periodic review and updating of the plan of care for each individual receiving hospice care.

(4)   Implementation of policies governing the day-to-day provisions of hospice care and services.

(h)   Medical advisor. The medical advisor shall be a medical doctor or osteopathic physician and shall assume overall responsibility for the medical component of the patient care program for the hospice. The physician shall also serve as medical advisor to the hospice and shall possess a license free of sanctions. The medical advisor shall be a doctor of medicine or osteopathy who is an employee, or be under contract with the hospice. When the medical advisor is not available, a physician designated by the hospice assumes the same responsibilities and obligations as the medical advisor.

(1)   Medical advisor contract. When contracting for medical advisor services, the contract shall specify the physician who assumes the medical advisor responsibilities and obligations. A hospice may contract with either of the following:

(A)   A self-employed physician; or

(B)   A physician employed by a professional entity or physicians group.

(2)   Initial certification of terminal illness. The medical advisor or physician designee reviews the clinical information for each hospice patient and provides written certification that it is anticipated that the patient's life expectancy is one (1) year or less if the illness runs its normal course. The physician shall consider the following when making this determination:

(A)   The primary terminal condition;

(B)   Related diagnosis(es), if any;

(C)   Current subjective and objective medical findings;

(D)   Current medication and treatment orders; and

(E)   Information about the medical management of any of the patient's conditions unrelated to the terminal illness.

(3)   Medical advisor responsibility. The medical advisor or physician designee has responsibility for the medical component of the hospice's patient care program.

(i)   Patient care coordinator. A registered nurse shall be appointed and approved by the hospice governing body and employed by the hospice as patient care coordinator to supervise and coordinate the palliative and supportive care for patients and families provided by a hospice team.

(j)   Medical social services. Medical social services shall be provided by a social worker employed by the hospice.

(k)   Support services. Support services shall be available to both the individual and the family. These services include bereavement support provided before the patient's death, spiritual support and any other support or service needed by the patient or family. These services may be provided by members of the interdisciplinary group as well as other qualified professionals as determined by the hospice.

(l)   Training.

(1)   A hospice shall provide orientation about the hospice philosophy to all employees and contracted staff who have patient and family contact.

(2)   A hospice shall provide an initial orientation for each employee that addresses the employee's specific job duties.

(3)   A hospice shall assess the skills and competence of all individuals furnishing care, including volunteers furnishing services, and, as necessary, provide in-service training and education programs where required. The hospice shall have written policies and procedures describing its method(s) of assessment of competency and maintain a written description of the inservice training provided during the previous twelve(12) months.

(m)   Volunteers. Volunteers shall be used in defined roles and under the supervision of a designated hospice employee. The hospice shall provide appropriate orientation and training.

(1)   Training. The hospice shall maintain, document, and provide volunteer orientation and training.

(2)   Role. Volunteers shall be used in day-to-day administrative and/or direct patient care roles.

(3)   Recruiting and retaining. The hospice shall document and demonstrate viable and ongoing efforts to recruit and retain volunteers.

(4)   Utilization. The hospice shall document

(A)   The identification of each position that is occupied by a volunteer.

(B)   The work time spent by volunteers occupying those positions.

(n)   Criminal background checks.

(1)   The hospice shall obtain a criminal background check on all hospice employees who have direct patient contact or access to patient records. Hospice contracts shall require that all contracted entities obtain criminal background checks on contracted employees who have direct patient contact or access to patient records.

(2)   Each such criminal background check shall meet the criteria established for certified nurse aides as provided for in O.S. Title 63 Section 1-1950.1. [The Nursing Home Care Act] shall be obtained in accordance with State requirements.

[Source: 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 26 Ok Reg 2042, eff 6-25-09]