Texas Administrative Code

Texas Administrative Code

TITLE 26	HEALTH AND HUMAN SERVICES
PART 1	HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 558	LICENSING STANDARDS FOR HOME AND COMMUNITY SUPPORT SERVICES AGENCIES
SUBCHAPTER H	STANDARDS SPECIFIC TO AGENCIES LICENSED TO PROVIDE HOSPICE SERVICES
DIVISION 6	HOSPICE ORGANIZATION AND ADMINISTRATION OF SERVICES
RULE §558.858	Hospice Medical Director

(a) A hospice must designate in writing one physician to serve as its medical director. The medical director must be a doctor of medicine or osteopathy who is an employee or under contract with the hospice. The medical director may also be a volunteer physician under the control of the hospice.

(b) A hospice must designate in writing a physician designee to assume the same responsibilities and obligations as the medical director when the medical director is not available.

(c) A hospice may contract for a physician to serve as its medical director with either a self-employed physician or a physician employed by a professional entity or physicians group. The contract for medical director services must specify the name of the physician who assumes the medical director responsibilities and obligations.

(d) The medical director or physician designee assumes responsibility for the medical component of a hospice's client care program.

(e) The medical director or physician designee must review a client's clinical information and provide written initial certification that the client's life expectancy is anticipated to be six months or less if the client's terminal illness runs its normal course.

(f) Before each recertification period for the client, the medical director or physician designee must review the client's clinical information and provide written recertification of the client's terminal illness.

(g) When determining the client's life expectancy is six months or less, the medical director or physician designee must consider:

(1) the primary terminal condition;

(2) related diagnoses, if any;

(3) current subjective and objective medical findings;

(4) current medication and treatment orders; and

(5) information about the medical management of any of the client's conditions unrelated to the terminal illness.

Source Note: The provisions of this §558.858 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