Fla. Admin. Code Ann. R. 59A-38.008 - Medical Direction
(1) The hospice
shall employ a medical director who shall be a hospice physician licensed in
the State of Florida pursuant to chapter 458 or 459, F.S., who has admission
privileges at one or more hospitals commonly serving patients in that hospice's
service area as defined in rule
59C-1.0355, F.A.C. Duties shall
be enumerated in a job description, including job qualifications, which shall
be kept in an administrative file.
(2)
(a) The
medical director or his or her designee, a physician licensed under chapter 458
or 459, F.S., must be a member of the hospice care team and must be responsible
for the direction and quality of the medical component of the care rendered to
the patient by the hospice care team. The patient's attending physician(s) may
remain the primary physician(s) to the patient, depending upon the preferences
of the patient and the patient's family. The patient and the patient's family
may elect to have the hospice medical director assume all or part of the
primary medical care functions, or act as a consultant to the patient's
attending physician(s). In either case, the hospice care team must maintain a
reporting relationship with the patient's attending physician(s).
(b) Duties of the medical director shall
include:
1. Reviewing clinical material of the
patient's attending physician(s) to document basic disease process, prescribed
medicines, assessment of patient's health at time of entry and the drug
regimen, or performing an admission history and physical for each
patient.
2. Validating the
attending physician(s)' prognosis and life expectancy for the
patient.
3. Assisting in developing
and medically validating the plan of care for each patient and family unit with
the coordination of the patient's attending physician(s).
4. Attending and actively participating in
patient and family care conferences.
5. Rendering or actively supervising medical
care for hospice patients and maintaining a record of such care.
6. Maintaining a regular schedule of
participation in all components of the hospice care program and maintaining
twenty-four (24) hours a day, seven (7) days a week coverage of and ready
availability to the hospice program through him or herself or his or her
licensed hospice physician designee.
7. Acting as a consultant to attending,
including personal, physicians and other members of the hospice care team;
helping to develop and review policies and procedures for delivering care and
services to the patient and family unit; serving on appropriate committees; and
reporting regularly to the hospice administrator regarding medical care
delivered to the hospice patients.
8. Maintaining liaison with the patient's
attending physician(s), who is encouraged to provide primary care to his or her
patient even though the patient also receives hospice care. The hospice
physician will provide palliative care to his or her patient.
9. Establishing written protocols for symptom
control, i.e., pain, nausea, vomiting, or other symptoms.
10. Assisting 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 physician(s) who shall
perform duties prescribed herein. Any appointed physician shall be subject to
the same licensing qualifications as the hospice medical director.
(4) The medical director shall assist the
administrator in developing, documenting and implementing policies and
procedures for regulating the delivery of physicians' services, for orientation
of new hospice physicians, and for continuing training and support of hospice
physicians. These policies and procedures shall:
(a) Ensure that a hospice physician is
on-call twenty-four (24) hours a day, seven (7) days a week; and
(b) Provide for the review and evaluation of
clinical practices within hospice inpatient, residential and home-care programs
in coordination with the QAUR/QAPI committee.
Notes
Rulemaking Authority 400.605 FS. Law Implemented 400.605, 400.610, 400.6105 FS.
New 5-6-82, Formerly 10A-12.14, 10A-12.014, Amended 4-27-94, Formerly 59A-2.014, Amended 6-5-97, 8-11-08, Formerly 58A-2.014, 7-1-19.
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