Md. Code Regs. 10.07.21.11 - Continuity of Care
A. The hospice
care program shall coordinate care to ensure continuity of care for the patient
and family.
B. Any changes in
service delivery are to be based on an assessment of the patient's and family's
needs and desires for hospice services and a hospice care program's transfer
and discharge criteria.
C. The
hospice care program shall:
(1) Provide case
management for the patient and family;
(2) Maintain an accurate, complete, and
documented record of services and activities provided to the patient and
family;
(3) Collaborate with other
organizations and individuals providing care to the patient and family to
ensure coordination of services;
(4) Provide on-call medical and nursing
services in response to patient and family needs;
(5) Ensure the safety of staff and inform the
patient and family of any personnel, service, or access limitations;
and
(6) Have reporting mechanisms
to keep all staff informed and updated about patient care changes to ensure
continuity and coordination of care among interdisciplinary team
members.
Notes
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