NAC 449.0185  Requirements for a program of hospice care.A program of hospice care must comply with the following requirements:

     1.  A qualified person must be available when required to evaluate the dietary patterns of each patient and plan diets to meet the individual nutritional needs of each patient.

     2.  Each patient must be advised regarding the availability of pastoral care.

     3.  Bereavement services must be available to each member of a patient’s family after the patient dies to provide appropriate counseling.

     4.  Nursing care must be provided by a registered nurse or under the supervision of a registered nurse.

     5.  A social worker must provide social services to each patient in the program under the direction of the interdisciplinary team.

     6.  The services of:

     (a) A physical therapist;

     (b) An occupational therapist; and

     (c) A speech-language pathologist,

Ê must be provided when such services are prescribed for a patient by his or her physician.

     7.  Home health aide and homemaker services must be available to each patient and provided at intervals which meet the needs of each patient. A registered nurse must:

     (a) Supervise the persons providing such services; and

     (b) Prepare written instructions for the persons providing such services which identify the duties they are to perform.

     8.  Arrangements must be made to provide any medical supplies and appliances which are required by a patient, including any drug or biological needed for palliative services.

     NAC 449.0186  Requirements for plan of care. 

     1.  The medical director of a program of hospice care shall cause a written plan of care to be established for each patient in the program. Any person who furnishes care for the patient shall adhere to the plan.

     2.  A plan of care must:

     (a) Be established by the physician of the patient or by the medical director of the program of hospice care, and the interdisciplinary team which provides the hospice care;

     (b) Include an assessment of the needs of the patient and identify the services required by the patient, which must include the management of discomfort and relief of symptoms of the patient;

     (c) State the scope and frequency of each service to be provided to the patient and members of his or her family; and

     (d) Be reviewed and updated at intervals that are specified in the plan by the person who established the plan. The review must be documented in writing.

     NAC 449.0187  Requirements for operation of facility for hospice care. A facility for hospice care must comply with the following requirements:

     1.  A program of hospice care must be provided for each inpatient pursuant to a written plan of care established pursuant to NAC 449.0186.

     2.  Nursing services must be provided 24 hours per day in accordance with the plan of care for each patient.

     3.  Medication must be dispensed to each patient according to the instructions of the patient’s physician or the medical director.

     4.  Treatment must be administered to a patient pursuant to the instructions of the physician of the patient or the plan of care for the patient.

     5.  Each patient must be maintained in a clean and well-groomed manner.

     6.  Each patient must be protected from accidents, injuries and infections.

     7.  At least one registered nurse must be on duty for each work shift, providing direct care to patients.

     8.  A written plan of the procedures to be followed during a local disaster, a widespread disaster or a disaster which occurs within the facility for hospice care must be adopted. The plan must:

     (a) Provide procedures designed to protect each patient and to care for any casualty which may arise from such a disaster;

     (b) Be reviewed and the procedures set forth therein rehearsed by all members of the staff at least once in each quarter of the year; and

     (c) Be approved by the Division.

     9.  A private room with an adjoining bath must be provided for each patient.

     10.  An anteroom, a room adjoining the room of each patient or a private area must be provided and furnished with a bed and chairs for use by the members of the patient’s family.