Section 131.26. Non-core services.

 

(1)   General requirements. A hospice is responsible for providing care and services to a patient and, as necessary, the patient's family, based on the plan of care developed by the core team. Volunteers shall participate in the delivery of program services. The hospice may provide other services as follows:

(a) Therapy services. Therapy services are provided in accordance with the plan of care for the patient and by individuals who meet qualification requirements for therapy service delivery such as evidence of current licensure or registration and academic training. Therapy services shall consist of all of the following:

1. Physical, occupational, speech and language pathology or respiratory therapy.

2. The provision of a patient assessment as directed by the plan of care.

3. The development of a therapy plan of care.

(b) Homemaker services. If homemaker services are provided, they shall be provided in accordance with the patient's plan of care and shall consist of:

1. Housekeeping activities.

2. Performing errands and shopping.

3. Providing transportation.

4. Preparing meals.

5. Other assigned tasks intended to maintain the capacity of the household.

(2)   Nurse aide services. The hospice may provide nurse aide services as follows:

(a) Assignment. Nurse aides are assigned to a specific patient by a registered nurse that is a member of the interdisciplinary group. Written patient care instructions for a nurse aide shall be prepared by a registered nurse who is responsible for the supervision of a nurse aide as specified under par. (c) .

(b) Plan of care. The nurse aide shall provide care in accordance with the patient's plan of care. Nurse aide services consist of, but are not be limited to all of the following:

1. Assisting patients with personal hygiene.

2. Assisting patients into and out of bed and with ambulation.

3. Assisting with prescribed exercises which patients and hospice aides have been taught by appropriate health care personnel.

4. Assisting patients to the bathroom or in using a bedpan.

5. Assisting patients with self-administration of medications.

6. Administering medications to patients if the aide has completed a state-approved medications administration course and has been delegated this responsibility in writing for the specific patient by a registered nurse.

7. Reporting changes in the patient's condition and needs.

8. Completing appropriate records.

(c) Supervision of nurse aides .

1. A registered nurse shall make an on-site visit to the patient's home no less frequently than every 14 days to assess the quality of care and services provided by the nurse aide and to ensure that services ordered by the hospice interdisciplinary group meet the patient's needs. The nurse aide does not have to be present during this visit.

2. If an area of concern is noted by the supervising nurse, then the hospice shall make an on-site visit to the location where the patient is receiving care in order to observe and assess the aide while the aide is performing care.

3. If an area of concern is verified by the hospice during the on-site visit, then the hospice shall conduct, and the nurse aide shall complete a competency evaluation.

4. A registered nurse shall make an annual on-site visit to the location where a patient is receiving care in order to observe and assess each aide while the aide is performing care.

(d) Assessment of aide. The supervising nurse shall assess an aide's ability to demonstrate initial and continued satisfactory performance in meeting outcome criteria that include all of the following, but is not limited to:

1. Following the patient's plan of care for completion of tasks assigned to the nurse aide by the registered nurse.

2. Creating successful interpersonal relationships with the patient and family.

3. Demonstrating competency with assigned tasks.

4. Complying with infection control policies and procedures.

5. Reporting changes in the patient's condition.

History: CR 10-034 : cr. Register September 2010 No. 657 , eff. 10-1-10.