(1) The residential hospice shall have a
full-time (working at least 32 hours per week) administrator. Any change of
administrators shall be reported in writing to the department within fifteen
(15) days. The administrator shall designate in writing an individual to act in
his/her absence in order to provide the residential hospice with administrative
direction at all times. The administrator shall assure the provision of
appropriate fiscal resources and personnel required to meet the needs of the
patients and/or residents.
residential hospice must organize, manage, and administer its hospice and HIV
care services to attain and maintain the highest obtainable quality of life for
each patient and resident in a manner consistent with acceptable standards of
(3) The residential
hospice shall ensure a framework for addressing issues related to care at the
end of life.
(4) The residential
hospice shall provide a process that assesses pain in all patients. There shall
be an appropriate and effective pain management program.
(5) Nursing services, physician services,
drugs and biologicals shall routinely be available on a 24-hour
(6) All other hospice
services shall be available on a 24-hour basis to the extent necessary to meet
the needs of individuals for care that is reasonable and necessary for the
palliation and management of terminal illness or conditions directly
attributable to the terminal diagnosis.
A residential hospice may contract for
another individual or entity to furnish services, other than core services, to
the residential hospice's patients or HIV residents. If services are provided
under agreement or contract, the residential hospice must meet the following
(a) Continuity of care. The
residential hospice assures the continuity of resident and patient/family
Written agreement. The
residential hospice has a legally binding written agreement for the provision
of contracted hospice services. The agreement must include at least the
1. Identification of the services
to be provided.
2. A stipulation
that services may be provided only with the express authorization of the
3. The manner
in which the contracted services are coordinated, supervised, and evaluated by
the residential hospice.
delineation of the role(s) of the residential hospice and the contractor in the
admission process, resident and patient/family assessment, and the
interdisciplinary group care conferences.
5. Requirements for documenting that services
are furnished in accordance with the agreement.
6. The qualifications of the personnel
providing the services.
(c) Professional management responsibility.
The residential hospice retains professional management responsibility for
those contracted services and ensures that they are furnished in a safe and
effective manner by persons meeting the qualifications of this part, and in
accordance with the patient's and/or HIV resident's plan of care and the other
requirements of this part.
Financial responsibility. The residential hospice retains responsibility for
payment for services.
(8) The facility shall make reasonable
efforts to safeguard personal property and promptly investigate complaints of
such loss. A record shall be prepared of all clothing, personal possessions,
and money brought by the patient and/or HIV resident to the residential hospice
at the time of admission. The record shall be filled out in duplicate. One copy
of the record shall be given to the patient or resident or the patient's or
resident's representative and the original shall be maintained in the
residential hospice record. This record shall be updated as additional personal
property is brought to the facility.
(9) If the facility keeps patient or resident
funds, such funds shall be kept in an account separate from the facility's
funds. Patient or resident funds shall not be used by the facility. The
facility shall maintain and allow each patient or resident access to a written
record of all financial arrangements and transactions involving the individual
patient's or resident's funds. The facility shall provide each patient and
resident or his/her representative with a written itemized statement at least
quarterly of all financial transactions involving the patient's or resident's
(10) Within thirty (30) days
of a patient's or resident's death, the facility shall provide an accounting of
the patient's or resident's funds held by the facility and an inventory of the
patient's or resident's personal property held by the facility to the patient's
or resident's executor, administrator or other person authorized by law to
receive the decedent's property. The facility shall obtain a signed receipt
from any person to whom the decedent's property is transferred.
(11) Upon the sale of the facility, the
seller shall provide written verification that all the patient's or resident's
funds and property have been transferred and shall obtain a signed receipt from
the new owner. Upon receipt, the buyer shall provide, to the patients and
resident's, an accounting of funds and property held on their behalf.
(12) When licensure is applicable for a
particular job, verification of the current license must be included as a part
of the personnel file. Each personnel file shall contain accurate information
as to the education, training, experience and personnel background of the
employee. Documentation that references were verified shall be on file.
Adequate medical screenings to exclude communicable disease shall be required
of each employee.
(13) Whenever the
rules and regulations of this chapter require that a licensee develop a written
policy, plan, procedure, technique, or system concerning a subject, the
licensee shall develop the required policy, maintain it and adhere to its
provisions. A residential hospice which violates a required policy also
violates the rule and regulation establishing the requirement.
(14) Policies and procedures shall be
consistent with professionally recognized standards of practice.
(15) No residential hospice shall retaliate
against or, in any manner, discriminate against any person because of a
complaint made in good faith and without malice to the board, the department,
the Department of Human Services Adult Protective Services, the long term care
ombudsman, the Comptroller of the State Treasury, or any government agency. A
residential hospice shall neither retaliate, nor discriminate, because of
information lawfully provided to these authorities, because of a person's
cooperation with them, or because a person is subpoenaed to testify at a
hearing involving one of these authorities.
(16) Each residential hospice shall adopt
safety policies for the protection of patients and residents from accident and
(17) A record pertaining to
the payment agreement between the residential hospice and the patient or
resident shall be accomplished prior to admission. A copy of the agreement
record shall be given to the patient or resident and the original shall be
maintained in the facility's records.
All health care facilities licensed
pursuant to T.C.A. §§
, et seq. shall post the
following in the main public entrance:
Contact information including statewide toll-free number of the division of
adult protective services, and the number for the local district attorney's
(b) A statement that a
person of advanced age who may be the victim of abuse, neglect, or exploitation
may seek assistance or file a complaint with the division concerning abuse,
neglect and exploitation; and
statement that any person, regardless of age, who may be the victim of domestic
violence may call the nationwide domestic violence hotline, with that number
printed in boldface type, for immediate assistance and posted on a sign no
smaller than eight and one-half inches (8½") in width and eleven inches
(11") in height.
Postings of (a) and (b) shall be on a sign no smaller than
eleven inches (11") in width and seventeen inches (17") in height.
(19) "No smoking" signs
or the international "No Smoking" symbol, consisting of a pictorial
representation of a burning cigarette enclosed in a red circle with a red bar
across it, shall be clearly and conspicuously posted at every
(20) The facility shall
develop a concise statement of its charity care policies and shall post such
statement in a place accessible to the public.