Ga. Comp. R. & Regs. 111-8-37-.17

Current through Rules and Regulations filed through December 24, 2024

Rule 111-8-37-.17 - Medical Services

(1) Medical services must be under the direction of the medical director. In addition to palliation and management of the terminal illness and related conditions, physicians of the hospice, including the physician members of the hospice care team, must also address the basic medical needs of the patients to the extent that such needs are not met by each patient's attending physician or other physician of the patient's choice.

(2)Medical Director. The medical director for the hospice must be a physician licensed to practice in this state and must have at least one year of documented experience on a hospice care team or in another setting managing the care of terminally ill patients. The medical director must:

(a) Be either an employee of the hospice or work under a written agreement with the hospice;

(b) Have admission privileges at one or more hospitals commonly serving patients in the hospice's geographical area;

(c) Be responsible for the direction and quality of the medical component of the care provided to patients by the hospice care team, including designating a licensed physician, employed by the hospice or working under a written agreement, to act on his or her behalf in the medical director's absence;

(d) Participate in the interdisciplinary plan of care reviews, patient case review conferences, comprehensive patient assessment and reassessment, and the quality improvement and utilization reviews;

(e) Review the clinical material of the patient's attending physician that documents basic disease process, prescribed medicines, assessment of patient's health at time of entry and the drug regimen;

(f) Ensure that each terminally ill patient receives a face-to-face assessment, by either the medical director or the terminally ill patient's attending physician, or is measured by a generally accepted life-expectancy predictability scale for continued admission eligibility at least every six months, as documented by a written certification from the medical director or the terminally ill patient's attending physician that includes:

1.The statement that the terminally ill patient's medical prognosis is for a life expectancy of six months or less if the terminal illness runs its natural course;

2.The specific current clinical finding and other documentation supporting a life expectancy of six months or less if the illness takes its natural course for the terminally ill patient; and

3.The signature of the physician.

(g) Communicate with each patient's attending physician and act as a consultant to attending physicians and other members of the hospice care team;

(h) Help to develop and review policies and procedures for delivering care and services to the patients and their family units;

(i) Serve on appropriate committees and report regularly to the hospice administrator regarding the quality and appropriateness of medical care;

(j) Ensure written protocols for symptom control and medication management are available; and

(k) Assist the administrator in developing, documenting and implementing a policy for discharge of patients from hospice care.

(3) In addition to the hospice medical director, the hospice may appoint additional hospice physicians who shall assist the medical director in the performance of his or her duties, as prescribed by the hospice.

(4) The medical director must assist the administrator in developing, documenting, and implementing effective policies and procedures for the delivery of physicians' services, for orientation of new hospice physicians, and for continuing training and support of hospice physicians. These policies and procedures must:

(a) Ensure that a hospice physician is on-call 24 hours a day, seven days a week; and

(b) Provide for the review and evaluation of clinical practices within home care, residential, and inpatient hospices in coordination with the quality management, utilization, and peer review committee.

(5) Verbal orders for medications and controlled substances shall only be given to appropriately licensed staff members, acting within the scope of their licenses, and must be immediately recorded, signed, and dated by the licensed staff member receiving such order.

(a) The individual receiving the order shall immediately repeat the order and the prescribing physician must verify that the repeated order is correct. The individual receiving the order must document in the patient's medical record that the order was "repeated and verified."

(b) The hospice must provide a written copy of the order to the prescribing physician within 24 hours of such order or by the end of the next business day.

Ga. Comp. R. & Regs. R. 111-8-37-.17

O.C.G.A. §§ 31-7-170et seq.

Original Rule entitled "Medical Services" adopted. F. May 26, 2015; eff. June 15, 2015.