Section He-P 823.15 - Required Services(a) The licensee shall provide the following core hospice care services: (1) Nursing services sufficient to meet the nursing needs of the patient, which are: a. Determined by the patient's care plan;b. Available, as needed, 24 hours a day; andc. Supervised by a registered nurse.(2) Home health aide and personal care services that are provided either directly or by contract as the needs of the patient dictate and as determined by the patient's care plan;(3) Assisting patients to acquire pharmaceutical services such as equipment, appliances, medical supplies, and other pharmaceutical services as the needs of the patient dictate and as determined by the patient's care plan;(4) Hospice care social services such as assessment of the social environment and financial issues supervised by a social worker;(5) Hospice volunteer services;(6) Nutritional counseling, physical or occupational therapy, and speech therapy that are provided or arranged for as needed in accordance with patient's care plan;(7) Spiritual services which are offered in accordance with the patient's and family's beliefs and values; and(8) Bereavement services that are available to the family for up to one year following the death of the patient.(b) If, on a temporary basis, not to exceed 90 days, the HHCP cannot provide any of the core care and services in (a) above, the HHCP shall have a written agreement with another agency to provide the required services.(c) Any contractual agreement to provide care and services shall: (1) Identify the care and services to be provided;(2) Specify the qualifications of the personnel that will be providing the care and services;(3) Require that the HHCP must authorize the services; and(4) Stipulate the HHCP retains professional responsibility for all care and services provided.(d) The HHCP shall provide or arrange for the provision of short-term in-patient stays in a hospital, nursing home, or hospice house during those times when the patient's pain or symptoms are unable to be managed in the home.(e) The HHCP shall retain professional management responsibility for all services that are provided including contracted services when a hospice patient is in another licensed facility. These responsibilities shall be defined in a written contractual agreement.(f) The licensee shall provide staff for the following positions: (1) An administrator to oversee the HHCP, except as allowed by 823.15(g) (1) below;(2) A full time director of patient services;(4) A volunteer coordinator;(5) A social services coordinator; and(6) Spiritual and or bereavement coordinator.(g) Any administrator shall have at least a bachelor's degree in business or a health-related field with a minimum of one year's experience in hospice care or be a registered nurse and: (1) Designate, in writing, an alternate administrator who shall assume the responsibilities of the administrator in his or her absence; and(2) Be permitted to hold more than one position at the HHCP if: a. The individual meets the qualifications of all positions; andb. The duties and responsibilities of the positions can be accomplished by one individual; and(3) Be responsible for maintaining the HHCP in full compliance with all federal, state, and local laws, rules, codes, and ordinances at all times.(h) Any director of patient services shall: (1) Be a New Hampshire-licensed or compact-registered nurse;(2) Be a New Hampshire-licensed advanced practice registered nurse; or(3) Have a bachelor's degree in a health field related to hospice care.(i) The director of patient services shall: (1) Be responsible for the overall delivery of patient care and services;(2) Provide sufficient nursing personnel to meet the need of the patients;(3) Supervise the overall delivery of patient care and services; and(4) Coordinate the supervision of licensed nurse aides (LNA) at least every 2 weeks by a registered nurse at the patient's home to determine if the LNA is providing care and services in accordance with the patient's care plan. The LNA shall not have to be present during this visit.(j) The medical director shall be a licensed provider and shall be responsible for: (1) The overall medical component of the hospice plan of care;(2) Participating on the interdisciplinary patient care team;(3) Determining, in consultation with the interdisciplinary team, that an individual is appropriate for hospice care services; and(4) Consultative physician visits for hospice and palliative care patients as requested by physicians.(k) Volunteer services shall be provided under the direction of a coordinator of volunteer services who: (1) Implements a direct service volunteer program;(2) Coordinates the orientation, education, support, and supervision of direct service volunteers; and(3) Coordinates the utilization of direct service volunteers with other hospice staff.(l) All volunteers shall be oriented and educated relative to their prescribed function according to the hospice care provider's policies and procedures.(m) The licensee shall develop and maintain policies and procedures for its volunteer services that address the following areas: (1) Recruitment and retention;(6) Ongoing training and support;(7) Records of volunteer activities; and(8) Criminal record checks.(n) The social services coordinator shall have: (1) At least a master's degree from a graduate school of social work; or(2) A bachelor's degree in a related health or human services field, have at least 2 years experience as a social worker and have established a consultative relationship with a person who qualifies in (1) above.(o) The social services coordinator shall:(1) Participate in the development of the care plan; and(2) Work in conjunction with the director of patient services to coordinate all social services required by the care plan and ensure their delivery.(p) The spiritual and or bereavement coordinator shall be a person who has at least a bachelor's degree in an applicable field such as theology of education, psychology, or counseling and who has completed at least 8 additional hours in death and dying, grief, and bereavement.(q) Persons providing bereavement services shall have education in death and dying, grief, and bereavement.(r) The spiritual and or bereavement coordinator shall be responsible for providing an organized program of bereavement services for up to 12 months after the death of the patient including: (1) Counseling to families after the patient's death;(2) Developing a care plan that reflects the needs of the patient's family; and(3) Others services necessary to aid in the bereavement process.(s) If the licensee collects human specimens for laboratory testing, it shall follow the manufacturer's instructions and/or the reference laboratory's instructions for collection and storage of human specimens.(t) If the licensee test human specimens, it shall be licensed as a laboratory in accordance with He-P 808, except the licensee may perform the following CLIA-waiverd point of care test without obtaining a laboratory license in accordance with He-P 808: (3) Dipstick urinalysis; and(u) The licensee shall hold the appropriate CLIA certificate to perform any laboratory tests.(v) Licensee collecting human specimens for laboratory testing shall require a collecting station license in accordance with He-P 817 except when collected by a trained registered nurse or licensed nursing assistant.(w) Training shall consist of collection, storage, and transport of the specimens.(x) Training shall be done by a registered nurse trained in the collection, storage and transport of human specimens.N.H. Admin. Code § He-P 823.15
Amended by Volume XXXVII Number 19, Filed May 11, 2017, Proposed by #12168, Effective 4/29/2017, Expires 10/26/2017.Amended by Volume XXXVIII Number 45, Filed November 8, 2018, Proposed by #12642, Effective 10/9/2018, Expires 10/9/2028.