(A) Each hospice care program shall provide or arrange for the provision of short-term inpatient care to patients who require it for pain control, symptom management, or respite care. The program may operate its own inpatient facility or may contract with one or more other persons or public agencies that operate inpatient facilities for provision of inpatient care. The inpatient facility or facilities that the program uses to provide inpatient care shall be licensed, certified, or accredited in accordance with applicable Ohio law and this rule.
(B) The type of inpatient setting selected for a particular episode shall be based upon the needs of the patient. The program shall not place patients in an inpatient facility for the convenience of the program.
(C) Each inpatient facility used by a hospice care program to provide inpatient care to its patients shall provide nursing services twenty-four hours a day or the hospice care program shall provide or arrange for nursing services twenty-four hours a day.
(D) Inpatient care for pain control and symptom management shall be provided only in a hospice inpatient facility, hospital or a skilled nursing facility. Any such facility used by a hospice care program shall be certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301 , as amended, or accredited by an organization that the United States centers for medicare and medicaid services has given deeming authority. Each inpatient facility used by the hospice care program to provide pain control and symptom management shall:
(1) Have a registered nurse on staff and available at all times on each shift to render hands-on direct care; and
(2) Ensure that nursing services are sufficient to meet the total nursing needs of the hospice patients residing in the facility.
(E) Inpatient care for respite purposes shall be provided only:
(1) In a hospice inpatient facility, a hospital, a skilled nursing facility or nursing facility certified under Title XVIII or XIX of the Social Security Act, or a nursing home or residential care facility licensed under Chapter 3721. of the Revised Code that provides nursing services twenty-four hours a day or the hospice care program shall provide or arrange for nursing services twenty-four hours a day. Nursing services shall be sufficient to meet the needs of the hospice patients residing in the facility; and
(2) On an occasional basis and not for more than seven consecutive days unless further limited by payor.
(F) Each inpatient facility used by a hospice care program to provide inpatient care to its patients shall ensure that sufficient personnel are available to:
(1) Provide each patient's treatments, medications, and diets as prescribed;
(2) Keep each patient comfortable, clean, well-groomed (3) Assure that each patient's routine, special, and emergency needs are met at all times;
(4) Promptly respond to patient calls; and
(5) Protect each patient from accident, injury, and infection through the use of appropriate safety and infection control measures.
(G) Each inpatient facility used by a hospice care program to provide inpatient care to its patients shall:
(1) Have patient areas that are designed and equipped for the comfort and privacy of patients and their family members by:
(a) Maintaining adequate lighting levels in patient areas and designing patient areas that are devoid of glare and reflecting surfaces that produce discomfort;
(b) Minimizing sound level;
(c) Maintaining a comfortable temperature; and
(d) Providing adequate ventilation.
(2) Have physical space for private patient and family visiting;
(3) Provide accommodations for family members to remain with the patient throughout the night;
(4) Provide accommodations for family privacy after a patient's death;
(5) Have decor which is homelike in design and function;
(6) Permit patients to bring personal items into patient areas; and
(7) Permit patients to receive visitors at all times, including small children.
Five Year Review (FYR) Dates: 05/01/2019
Promulgated Under: 119.03
Statutory Authority: 3712.03
Rule Amplifies: 3712.01 , 3712.03 , 3712.04 , 3712.05 , 3712.06
Prior Effective Dates: 12/31/1990, 10/17/99, 8/23/09