Wis. Admin. Code Department of Health Services DHS 131.25 - Core services
(1) GENERAL REQUIREMENTS. A hospice is
responsible for providing care and services to a patient and, as necessary, the
patient's family, based on the plan of care developed by the core team.
Volunteers shall participate in the delivery of program services.
(2) CORE TEAM.
(a) Each member of the core team shall be an
employee, including a volunteer of the hospice or be under a contract with the
hospice as specified in par. (c).
(b) With respect to services provided to a
patient, each core team member shall do all of the following:
1. Assess patient and family needs.
2. Promptly notify the registered nurse of
any change in patient status that suggests a need to update the plan of
care.
3. Provide services
consistent with the patient plan of care.
4. Provide education and counseling to the
patient and, as necessary, to the patient's family, consistent with the plan of
care.
5. Participate in developing
and revising written patient care policies and procedures.
(c) The hospice may contract for physician
services as specified in par. (a). A hospice may use contracted staff, if
necessary, to supplement hospice employees in order to meet the needs of
patients under extraordinary or other non-routine circumstances. A hospice may
also enter into a written arrangement with another Medicare certified hospice
program for the provision of core services to supplement hospice staff to meet
the needs of patients. Circumstances under which a hospice may enter into a
written arrangement for the provision of core services include unanticipated
periods of high patient loads, staffing shortages due to illness or other
short-term temporary situations that interrupt patient care and temporary
travel of a patient outside of the hospice's service area.
(3) PHYSICIAN SERVICES. The hospice medical
director, physician employees, and contracted physicians of the hospice, in
conjunction with the patient's attending physician, are responsible for the
palliation and management of the terminal illness and conditions related to the
terminal illness.
(a) All physician employees
and those under contract must function under the supervision of the hospice
medical director.
(b) All physician
employees and those under contract shall meet this requirement by either
providing the services directly or through coordinating patient care with the
attending physician. If the attending physician is unavailable, the medical
director, contracted physician, and or hospice physician employee is
responsible for meeting the medical needs of the patient.
(4) NURSING SERVICES.
(a) Nursing services shall be provided by or
under the supervision of a registered nurse and shall consist of all of the
following:
1. Regularly assessing the
patient's nursing needs, implementing the plan of care provisions to meet those
needs and reevaluating the patient's nursing needs.
2. Supervising and teaching other nursing
personnel, including licensed practical nurses, nurse aides.
3. Evaluating the effectiveness of delegated
acts performed under the registered nurse's supervision.
(b) Highly specialized nursing services that
are provided so infrequently that the provision of such services by direct
hospice employees would be impracticable and prohibitively expensive, may be
provided under contract.
(c)
Licensed practical nursing services. If licensed practical
nursing services are provided, the licensed practical nurse shall function
under the supervision of a registered nurse with duties specified in writing
and updated by a registered nurse.
(5) SOCIAL SERVICES.
(a) Social services shall be provided by a
qualified social worker and shall consist of all of the following:
1. Regularly assessing the patient's social
service needs, implementing the plan of care to meet those needs and
reevaluating the patient's needs and providing ongoing psychosocial assessment
of the family's coping capacity relative to the patient's terminal
condition.
2. Linking patient and
family with needed community resources to meet ongoing social, emotional and
economic needs.
(6) COUNSELING SERVICES. Counseling services
shall be available to the patient and family to assist the patient and family
in minimizing the stress and problems that arise from the terminal illness,
related conditions, and the dying process.
(a)
Bereavement services. Bereavement services shall be provided
to families of hospice patients. Each hospice shall have its own bereavement
program. Bereavement services shall be:
1.
Coordinated by an individual who possesses the capacity by training and
experience to provide for the bereavement needs of families, including the
ability to organize a program of directed care services provided to family
members. DHS 131.25(6).
2.
Compatible with the core team's direction within the plan of care for the
patient.
3. Available for one year
following the patient's death as part of an organized program and provide all
of the following:
a. Orientation and training
to individuals providing bereavement services to ensure that there is
continuity of care.
b. Service
intervention either directly or through trained bereavement
counselors.
c. Assignment,
supervision and evaluation of individuals performing bereavement
services.
d. Referrals of family
members to non-hospice community programs where appropriate.
(b)
Dietary
counseling. Dietary counseling services shall be provided only as
authorized by the hospice and in conjunction with the plan of care. The
services shall be provided by a registered dietitian or an individual who has
documented equivalency in education or training. Dietary services shall be
supervised and evaluated by a registered dietitian or other individual
qualified under this paragraph who may delegate acts to other employees.
Dietary counseling services shall consist of all of the following:
1. Assessment of nutritional needs and food
patterns;
2. Planning diets
appropriate for meeting patient needs and preferences; and
3. Providing nutrition education and
counseling to meet patient needs, as well as necessary consultation to hospice
employees.
(c)
Spiritual counseling. The hospice shall do all of the
following:
1. Provide an assessment of the
patient's and family's spiritual needs.
2. Provide spiritual counseling to meet these
needs in accordance with the patient's and family's acceptance of this service,
and in a manner consistent with patient and family beliefs and
desires.
3. Make all reasonable
efforts to facilitate visits by local clergy, pastoral counselors, or other
individuals who can support the patient's spiritual needs to the best of its
ability.
4. Advise the patient and
family of this service.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.