Or. Admin. R. 410-142-0020 - Definitions
(1)
Accredited/Accreditation: A designation by an accrediting organization that a
hospice program has met standards that have been developed to indicate a
quality program.
(2) Ancillary
staff: Staff that provides additional services to support or supplement hospice
care.
(3) Assessment: Procedures
by which strengths, weaknesses, problems, and needs are identified and
addressed.
(4) Attending
physician: A physician who is a doctor of medicine or osteopathy and is
identified by the client, at the time he or she elects to receive hospice care,
as having the most significant role in the determination and delivery of the
client's medical care.
(5)
Bereavement counseling: Counseling services provided to the client's family
before and after the client's death. Bereavement counseling is required to be
offered per the Conditions of Participation and is a non-reimbursable hospice
service.
(6) Bundled Rate: the
Nursing Facility (NF) rate as defined in 411-070-0085.
(7) Client-family unit includes a client who
has a life threatening disease with a limited prognosis and all others sharing
housing, common ancestry or a common personal commitment with the client.
(8) Conditions of Participation
(CoPs): The applicable federal regulations that hospice programs are required
to comply with in order to participate in the federal Medicare and Medicaid
programs.
(9) Coordinated: When
used in conjunction with the phrase "hospice program," means the integration of
the interdisciplinary services provided by client-family care staff, other
providers and volunteers directed toward meeting the hospice needs of the
client.
(10) Coordination of Care
(COC): The federal regulations for coordination of client care between the
hospice and the nursing facility that hospice programs are required to comply
with in order to serve hospice clients in a nursing facility and participate in
the federal Medicare and Medicaid programs.
(11) Coordinator: A registered nurse
designated to coordinate and implement the care plan for each hospice client.
(12) Counseling: A relationship in
which a person endeavors to help another understand and cope with problems as a
part of the hospice plan of care.
(13) Curative: Medical intervention used to
ameliorate the disease.
(14)
Dying: The progressive failure of the body systems to retain normal
functioning, thereby limiting the remaining life span.
(15) Family: The relatives and/or other
significantly important persons who provide psychological, emotional, and
spiritual support of the client. The "family" need not be blood relatives to be
an integral part of the hospice care plan.
(16) Hospice: A public agency or private
organization or subdivision of either that is primarily engaged in providing
care to terminally ill clients, and is certified by the federal Centers for
Medicare and Medicaid Services as a program of hospice services meeting current
standards for Medicare and Medicaid reimbursement and Medicare Conditions of
Participation; and currently licensed by the Oregon Health Authority
(Authority), Public Health Division.
(17) Hospice continuity of care: Services
that are organized, coordinated and provided in a way that is responsive at all
times to client/family needs, and which are structured to assure that the
hospice is accountable for its care and services in all settings according to
the hospice plan of care.
(18)
Hospice routine home care: Formally organized services designed to provide and
coordinate hospice interdisciplinary team services to client/family in the
place of residence. The hospice will deliver at least 80 percent of the care in
the place of residence.
(19)
Hospice philosophy: Hospice recognizes dying as part of the normal process of
living and focuses on maintaining the quality of life. Hospice exists in the
hope and belief that through appropriate care and the promotion of a caring
community sensitive to their needs, clients and their families may be free to
attain a degree of mental and spiritual preparation for death that is
satisfactory to them.
(20) Hospice
Program: A coordinated program of home and inpatient care, available 24 hours a
day, that uses an interdisciplinary team of personnel trained to provide
palliative and supportive services to a client-family unit experiencing a life
threatening disease with a limited prognosis. A hospice program is an
institution for purposes of ORS
(21) Hospice Program registry: A registry of
all licensed hospice programs maintained by the Authority, Public Health
Division.
(22) Hospice services:
Items and services provided to a client/family unit by a hospice program or by
other clients or community agencies under a consulting or contractual
arrangement with a hospice program. Hospice services include home care,
inpatient care for acute pain and symptom management or respite, and
bereavement services provided to meet the physical, psychosocial, emotional,
spiritual and other special needs of the client/family unit during the final
stages of illness, dying and the bereavement period.
(23) Illness: The condition of being sick,
diseased or with injury.
(24)
Interdisciplinary team: A group of individuals working together in a
coordinated manner to provide hospice care. An interdisciplinary team includes,
but is not limited to, the client-family unit, the client's attending physician
or clinician and one or more of the following hospice program personnel:
Physician, nurse practitioner, nurse, hospice aide (nurse's aide), occupational
therapist, physical therapist, trained lay volunteer, clergy or spiritual
counselor, and credentialed mental health professional such as psychiatrist,
psychologist, psychiatric nurse or social worker.
(25) Medical director: The medical director
must be a hospice employee who is a doctor of medicine or osteopathy who
assumes overall responsibility for the medical component of the hospice's
client care program.
(26) Medicare
certification: Licensed and certified by the Authority, Public Health Division
as a program of services eligible for reimbursement.
(27) Nursing facility: A facility licensed
and certified by the Department of Human Services (Department) as a nursing
facility and defined in OAR 411-070.
(28) Nursing facility services: The bundled
rate of services which incorporates all services, including room and board, for
which the nursing facility is paid per OAR 411-070.
(29) Pain and Symptom Management: For the
hospice program, the focus of intervention is to maximize the quality of the
remaining life through the provision of palliative services that control pain
and symptoms. Hospice programs recognize that when a client/family is faced
with terminal illness, stress and concerns may arise in many aspects of their
lives. Symptom management includes assessing and responding to the physical,
emotional, social and spiritual needs of the client/family.
(30) Palliative services: Comfort services of
intervention that focus primarily on reduction or abatement of the physical,
psychosocial and spiritual symptoms of terminal illness. Palliative therapy:
(a) Active: Is treatment to prolong survival,
arrest the growth or progression of disease. The person is willing to accept
moderate side-effects and psychologically is fighting the disease. This person
is not likely to be a client for hospice;
(b) Symptomatic: Is treatment for comfort,
symptom control of the disease and improves the quality of life. The person is
willing to accept minor side-effects and psychologically wants to live with the
disease in comfort. This person would have requested and been admitted to a
hospice.
(31) Period of
crisis: A period in which the client requires continuous care to achieve
palliation or management of acute medical symptoms.
(32) Physician designee: Means a doctor of
medicine or osteopathy designated by the hospice who assumes the same
responsibilities and obligations as the medical director when the medical
director is not available.
(33)
Primary caregiver: The person designated by the client or representative. This
person may be family, a client who has personal significance to the client but
no blood or legal relationship (e.g., significant other), such as a neighbor,
friend or other person. The primary caregiver assumes responsibility for care
of the client as needed. If the client has no designated primary caregiver the
hospice may, according to client program policy, make an effort to designate a
primary caregiver.
(34) Prognosis:
The amount of time set for the prediction of a probable outcome of a disease.
(35) Representative: An individual
who has been authorized under state law to terminate medical care or to elect
or revoke the election of hospice care on behalf of a terminally ill client who
is mentally or physically incapacitated.
(36) Terminal illness: An illness or injury
which is forecast to result in the death of the client, for which treatment
directed toward cure is no longer believed appropriate or effective.
(37) Terminally Ill means that the client has
a medical prognosis that his or her life expectancy is six months or less if
the illness runs its normal course.
(38) Volunteer: An individual who agrees to
provide services to a hospice program without monetary compensation.
Notes
Stat. Auth.: ORS 413.042
Stats. Implemented: ORS 414.065
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