A. The hospice care program shall maintain sufficient health care professionals and volunteers to meet patient care needs.
B. The hospice care program shall identify an interdisciplinary care team with responsibility for ensuring continuous assessment of the patient's and family's needs and implementation of an integrated plan of care. The hospice care program shall ensure that:
(1) A qualified health care professional coordinates the activities of the interdisciplinary care team;
(2) The number of individuals who perform interdisciplinary team services is consistent with the needs of patients and their families and the type of services provided by the hospice care program; and
(3) Each interdisciplinary care team consists of at least:
(a) The patient's attending physician;
(b) A physician with training in palliative care;
(c) A registered nurse with demonstrated experience in pain and symptom management and the performance of physical assessments;
(d) A master's degree-prepared social worker with clinical experience in counseling and casework for the terminally ill;
(e) A volunteer, or volunteers, supervised by an individual with management experience in a hospice care program; and
(f) A spiritual care counselor or counselors with education and experience in pastoral counseling.
C. An interdisciplinary care team may include additional specialized team members needed to meet specific needs of patients as outlined in the patient's plan of care. Specialized team members may include allied therapists, art and music therapists, registered dietitians or licensed nutritionists, pharmacists, or nursing assistants.
D. Specialized team members may be employees, volunteers, or contractual staff.
E. Personnel Records. For all employees, volunteers, and contractual staff, the administrator shall ensure that there is:
(1) An accurate, complete, and current personnel record that includes:
(a) Verification of required licenses or certification;
(b) A signed conflict of interest statement;
(c) Written performance reviews;
(d) Documentation of all required training; and
(2) A job description for each position.
F. Outside Agreements. If a hospice care program utilizes the services of an outside entity to provide certain hospice services, the hospice care program shall enter into a written agreement with that entity which includes at a minimum:
(1) The service or services to be provided;
(2) The roles, rights, and responsibilities of the contracting entity;
(3) The roles, rights, and responsibilities of the hospice care program; and
(4) A plan to ensure that any individual providing services under this section shall have at least comparable training to that required by this regulation.
G. Orientation and Training.
(1) The hospice care program shall ensure that all licensed staff receive orientation and training, which includes at a minimum:
(a) The purpose and philosophy of hospice care;
(b) The skills necessary to provide for the physical care of the patient;
(c) The skills necessary to provide for the psychosocial and spiritual needs of the patient and family; and
(d) The need and importance of maintaining professional boundaries with the patient and the patient's family.
(2) The hospice care program shall have written criteria and a clear process for recruiting, selecting, and supervising volunteers, ensuring that:
(a) Any volunteer who provides direct patient care receives appropriate orientation and at least 16 hours of training which includes, at a minimum:
(i) The purpose and philosophy of hospice care;
(ii) The role of the volunteer in hospice;
(iii) Concepts of death and dying;
(iv) Communication skills;
(v) Care and comfort measures;
(vi) The physical, psychosocial, and spiritual issues related to death and dying;
(vii) The concept of the hospice family;
(viii) Patient rights;
(xi) Infection control;
(xii) Safety; and
(xiii) Stress management; and
(b) A volunteer, other than those specified in §G(2)(a) of this regulation, receives appropriate orientation regarding the volunteer's role in the hospice care program.
(3) Training shall be specifically tailored to ensure that staff is capable of providing care to meet the individual needs of patients.
(4) The hospice care program shall provide continuing inservice education for all employees and volunteers providing direct patient services at least:
(a) Once a year for volunteers; and
(b) Four times a year for employees.