| (a) This subchapter applies to an agency licensed with
the hospice services category. An agency licensed to provide hospice
services must adopt and enforce written policies in accordance with
this subchapter.
(b) A hospice that provides inpatient care directly
in its own inpatient unit must comply with the additional standards
in Division 7 of this subchapter (relating to Hospice Inpatient Units).
(c) A hospice that provides hospice care to a resident
of a skilled nursing facility, nursing facility, or an intermediate
care facility for individuals with an intellectual disability or related
conditions, must comply with the additional standards in Division
8 of this subchapter (relating to Hospices that Provide Hospice Care
to Residents of a Skilled Nursing Facility, Nursing Facility, or Intermediate
Care Facility for Individuals with an Intellectual Disability or Related
Conditions).
(d) A Medicare-certified hospice agency must comply
with the Medicare Conditions of Participation in 42 CFR Part 418,
Hospice Care.
(e) A person who is not licensed to provide hospice
services may not use the word "hospice" in a title or description
of a facility, organization, program, service provider, or services
or use any other words, letters, abbreviations, or insignia indicating
or implying that the person holds a license to provide hospice services.
(f) For the purposes of this subchapter, the term "attending
practitioner:"
(1) includes a physician or an advanced practice nurse
identified by a hospice client at the time he or she elects to receive
hospice services as having the most significant role in the determination
and delivery of the client's medical care; and
(2) is synonymous with "attending physician," as defined
in 42 CFR §418.3.
(g) For the purposes of this subchapter, election of
hospice care occurs on the effective date included in a client's hospice
election statement. A hospice election statement must include:
(1) identification of the hospice that will provide
care to the client;
(2) the client's or the client's legal representative's
acknowledgement that he or she has been given a full understanding
of the palliative rather than curative nature of hospice care, as
it relates to the client's terminal illness, as well as the potential
availability of supportive palliative care options outside a hospice
setting;
(3) acknowledgement by Medicare beneficiaries that
certain Medicare services, as described in 42 CFR §418.24(d),
are waived by the hospice election;
(4) the effective date of the election of hospice care,
which may be later but not earlier than the date of the client's or
the client's legal representative's signature and may be the first
day of hospice care or a later date; and
(5) the signature of the client or legal representative.
(h) For the purposes of this subchapter, the term "comprehensive
assessment" means a thorough evaluation of a client's physical, psychosocial,
emotional, and spiritual status related to the terminal illness and
related conditions. This includes a thorough evaluation of the caregiver's
and family's willingness and capability to care for the client.
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| Source Note: The provisions of this §558.801 adopted to be effective October 1, 2013, 38 TexReg 6628; transferred effective May 1, 2019, as published in the April 12, 2019 issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427 |
