(a) Hospice aide services must be provided by a hospice
aide who meets the training and competency evaluation requirements,
or the competency evaluation requirements specified in §558.843
of this division (relating to Hospice Aide Qualifications).
(b) A client's hospice aide services must be:
(1) ordered by the designated interdisciplinary team
(IDT);
(2) included in the client's plan of care;
(3) performed by a hospice aide in accordance with
State law and applicable rules, including 22 TAC Chapter 224 (relating
to Delegation of Nursing Tasks by Registered Professional Nurses to
Unlicensed Personnel for Clients with Acute Conditions or in Acute
Care Environments), and 22 TAC Chapter 225 (relating to RN Delegation
to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent
Living Environments For Clients with Stable and Predictable Conditions);
and
(4) consistent with a hospice aide's documented training
and competency skills.
(c) An RN who is a member of a client's designated
IDT must assign a hospice aide to a specific client. An RN who is
responsible for the supervision of a hospice aide, as specified in
subsection (d) of this section, must prepare written client-care instructions
for the hospice aide. The duties of a hospice aide include:
(1) providing hands-on personal care;
(2) performing simple procedures as an extension of
therapy or nursing services;
(3) assisting with ambulation or exercises;
(4) assisting with self-administered medication;
(5) reporting changes in a client's medical, nursing,
rehabilitative, and social needs to an RN as the changes relate to
the client's plan of care and the hospice's quality assessment and
improvement activities; and
(6) completing client record documentation in compliance
with the hospice's policies and procedures.
(d) An RN must make an on-site visit to a client's
home to supervise the hospice aide services at least every 14 days
to assess the quality of care and services provided by the hospice
aide and to ensure that services ordered by the hospice IDT meet the
client's needs. The hospice aide does not have to be present during
this visit.
(1) If the RN notes an area of concern in the care
provided by the aide, the RN must make an on-site visit to the location
where the client is receiving care to observe and assess the hospice
aide while the aide performs care.
(2) If, during the on-site visit to observe the hospice
aide, the RN confirms an area of concern in the aide's skills, the
hospice must ensure that the aide completes a competency evaluation
in accordance with §558.843 of this division.
(e) An RN must make an annual on-site visit to the
location where a hospice client is receiving care to observe and assess
each hospice aide while the aide performs care. During this on-site
visit, the RN must assess the aide's ability to demonstrate initial
and continued satisfactory performance in meeting outcome criteria
including:
(1) following the client's plan of care for completion
of tasks assigned to the hospice aide by an RN;
(2) creating successful interpersonal relationships
with the client and the client's family;
(3) demonstrating competency with assigned tasks;
(4) complying with infection control policies and procedures;
and
(5) reporting changes in the client's condition.
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Source Note: The provisions of this §558.842 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 |