Okla. Admin. Code § 310:661-5-2.2 - Core Services
(a)
General. A hospice must provide substantially all core services
directly by hospice trained and oriented employees. These services include
nursing services, medical social services, and bereavement and spiritual
counseling. The hospice may contract for physician services.
(b)
Physician services. The
hospice medical advisor, physician employees, and contracted physician(s) of
the hospice, in conjunction with the patient's attending physician , are
responsible for the palliation and management of the terminal illness and
conditions related to the terminal illness.
(1) All physician employees and those under
contract, must function under the supervision of the hospice medical
advisor.
(2) All physician
employees and those under contract must meet this requirement by either
providing the services directly or through coordinating patient care with the
attending physician .
(3) If the
attending physician is unavailable, the medical advisor, contracted physician,
and/or hospice physician employee is responsible for meeting the medical needs
of the patient.
(c)
Nursing services.
(1) The
hospice must provide nursing care by licensed nurses under the supervision of a
registered nurse . Nursing services must ensure that the nursing needs of the
patient are met as identified in the patient's initial assessment ,
comprehensive assessment , and updated assessments.
(2) If State law permits registered nurses to
see, treat, and write orders for patients, then registered nurses may provide
services to patients receiving hospice care.
(3) Highly specialized nursing services that
are provided so infrequently that the provision of such services by direct
hospice employees would be impracticable and prohibitively expensive, may be
provided under contract.
(d)
Medical social services.
Medical social services must be provided by a qualified social worker , under
the direction of a physician. Social work services must be based on the
patient's psychosocial assessment and the patient's and family's needs and
acceptance of these services.
(e)
Counseling services. Counseling services must be available to the
patient and family to assist the patient and family in minimizing the stress
and problems that arise from the terminal illness, related conditions, and the
dying process. Counseling services will include, but are not limited to, the
following:
(1)
Bereavement
counseling . The hospice must:
(A) Have
an organized program for the provision of bereavement services furnished under
the supervision of a qualified professional with experience or education in
grief or loss counseling;
(B) Make
bereavement services available to the family and other individuals in the
bereavement plan of care up to one (1) year following the death of the patient.
Bereavement counseling also extends to residents of a care facility when
appropriate and identified in the bereavement plan of care;
(C) Ensure that bereavement services reflect
the needs of the bereaved; and
(D)
Develop a bereavement plan of care that notes the kind of bereavement services
to be offered and the frequency of service delivery.
(2)
Dietary counseling . Dietary
counseling , when identified in the plan of care, must be performed by a
qualified individual, which include dietitians as well as nurses and other
individuals who are able to address and assure that the dietary needs of the
patient are met.
(3)
Spiritual counseling. The hospice must:
(A) Provide an assessment of the patient's
and family's spiritual needs;
(B)
Provide spiritual counseling to meet these needs in accordance with the
patient's and family's acceptance of this service, and in a manner consistent
with patient and family beliefs and desires;
(C) Make all reasonable efforts to facilitate
visits by local clergy, pastoral counselors, or other individuals who can
support the patient's spiritual needs to the best of its ability; and
(D) Advise the patient and family of this
service.
Notes
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