Sec.19a-495-6e. General requirements

(a) Core services provided directly by the licensee shall, except as provided in subsection (b) of this section, include the following:

(1) Services of a physician or advanced practice registered nurse;

(2) Nursing services provided by a registered nurse, or licensed practical nurse;

(3) Social services;

(4) Counseling services if required;

(5) Pain assessment and management; and

(6) Availability of drugs and biological products on a twenty-four hour basis.

(b) The licensee may use contracted services to supplement the hospice inpatient facility's staff under extraordinary circumstances when it is necessary to meet the needs of the patients. If contractors are used, the licensee shall maintain responsibility for the services and shall assure that the qualifications of staff and services provided meet the requirements of the Regulations of Connecticut State Agencies and relevant Connecticut General Statutes. When a contractor is providing services during an outpatient admission, the licensee and contractor shall have a "Coordination of Outpatient Services Agreement" in place for the provision of services which includes, but is not limited to:

(1) A criminal history and patient abuse background search pursuant to section 19a-491c of the Connecticut General Statutes including, but not limited to, all hospice inpatient facility employees or contracted employees and volunteers who have direct patient contact or access to patient records;

(2) Mechanisms for the collaboration and coordination of care; and

(3) The exchange of information to meet the ongoing needs of the patient and family;

(c) In addition to the core services, the licensee shall ensure that the following services are provided, as needed, directly by the licensee or by a contractor under written agreement with the licensee:

(1) Home health aide and homemaker services;

(2) Short-term respite care and general inpatient care;

(3) Physical therapy, occupational therapy, and speech and language pathology services;

(4) Medical supplies and appliances;

(5) Nutrition counseling;

(6) Complementary therapies; and

(7) Any other services identified in the patient centered plan of care.

(d) The licensee shall make services available as follows:

(1) Nursing services, physician services, drugs and biological products continuously available on a twenty-four hour basis;

(2) All other services available on a twenty-four hour basis to the extent necessary and reasonable to meet the needs of the patient care for the palliation and management of the patient's terminal illness and related conditions in accordance with the patient centered plan of care;

(3) Assessment capability available on a twenty-four hour basis to respond to acute and urgent patient or family needs; and

(4) Additional health services or related services may be provided as deemed appropriate to meet the patient's and family's needs, and all services shall be rendered in a manner consistent with accepted standards of practice and applicable law.

(e) The licensee shall ensure patient accessibility to the following:

(1) A functioning system that enables inpatients or outpatients and their families to make telephone contact with hospice inpatient facility staff on a twenty-four hour basis. Mechanical answering devices shall not be acceptable;

(2) A system that provides twenty-four hour, pharmacy services for the palliative care and management of the patient; and

(3) A system that ensures that patients are permitted to receive visitors, including small children and pets, at any hour, provided that a therapeutic environment is maintained.

(f) The licensee shall ensure the continuity of patient and family care through adoption and implementation of written policies, procedures and criteria providing for the following:

(1) Coordination of community physicians and nurses with hospice inpatient facility staff prior to and at the time of admission;

(2) Admission criteria for the initial assessment of the patient or family needs and decision for care;

(3) Signed informed consent;

(4) Ongoing assessment of the patient's and family's needs;

(5) Development and review of the patient centered plan of care by the interdisciplinary team;

(6) Transfer of patients to inpatient care facilities for inpatient respite care or general inpatient care;

(7) The provision of appropriate patient and family information at the point of transfer between care settings;

(8) Community or other resources to ensure continuity of care and to meet patient and family needs;

(9) Management of pain and symptom control through palliative care and utilization of therapeutic services; and

(10) Constraints imposed by limitations of services or family conditions and such other criteria as may be deemed appropriate for each patient and family.

(Effective July 31, 2012)