INPATIENT HOSPICE REGULATIONS #box #hill #motel

#connecticut hospice

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By: Nicole Dube, Associate Analyst

You asked how the state regulates inpatient hospice facilities.

Hospice is a coordinated program of palliative and supportive care (physical, psychological, social, and spiritual) for dying persons and their families provided by an interdisciplinary team of professionals and volunteers. The Department of Public Health (DPH) regulates (1) hospices that are either free-standing or distinct units within a healthcare facility and (2) homecare programs offered by an institutionally-based hospice. DPH regulations define hospice under the broader category of short-term hospital, special hospice. Currently, two facilities are licensed under this category: (1) Connecticut Hospice, Inc. located in Branford and (2) Atlantic Inpatient Hospice Unit located in St. Mary ‘ s Hospital in Waterbury.

On March 1, 2011, the department issued proposed regulations that would have created a second-tier licensure category called hospice facilities. The proposal would have made facilities that met Medicare ‘ s minimum regulatory requirements for inpatient hospice facilities eligible for DPH licensure (42 CFR � 418.110). These requirements are less stringent than DPH’s short-term hospital special hospice regulations.

DPH held a public hearing on the proposed regulations in April 2011. The proposal was submitted to the Attorney General ‘ s office for final review in March 2012, after which it was submitted to the Regulations Review Committee for approval. In June 2012, the committee rejected the proposed regulations and asked DPH to make corrections; DPH has not yet resubmitted its corrected proposal for approval.

INPATIENT HOSPICE REGULATIONS

Current DPH regulations require inpatient hospice facilities to meet various requirements concerning physical plant, administration, staffing, records, and infection control. Home care programs offered by an institutionally-based hospice must also address the physical, psychological, and spiritual needs of the patient and family, and provide services 24 hours a day, seven days a week.

Each hospice must be managed by a governing board with full legal authority and responsibility for its conduct and the quality of medical care it provides. The board must adopt and enforce admission criteria on eligibility for hospice services, a patient bill of rights, medical by-laws, guidelines for community relations, and organizational rules and by-laws (Conn. Agencies Reg. � 19-13-D4b(b)).

The medical staff must include at least five physicians, one of whom serves as the chief, president, or medical director of the staff. All staff physicians must be licensed to practice medicine and surgery in Connecticut. The medical staff must adopt written by-laws and rules not inconsistent with those of the governing board. The medical director must ensure that (1) at least one physician is available on-site eight hours per day and (2) 24-hour on-call coverage is available (Conn. Agencies Reg. � 19-13-D4b(c)).

The hospice’s nursing services must be directed by the director of hospice patient services. That individual must be a Connecticut-licensed, registered nurse (RN) and further qualified by experience in hospice, home health agency, or community health work (Conn. Agencies Reg. � 19-13-D4b(e)). The hospice must maintain a 1:6 ratio of RNs to patients and a 1:3 ratio of nurses or nurse’s aides to patients.

The hospice must have a medical records department with adequate space and qualified personnel. A medical record, which must be kept confidential and secure, is maintained for everyone evaluated or treated as an out-patient or in-patient, or who received services in a hospice-based home care program (Conn. Agencies Reg. � 19-13-D4b(d)).

Each hospice is required to develop an infection prevention, surveillance, and control program to protect the patient, family, and personnel from infections and communicable diseases. The program must be approved by the facility ‘ s medical staff and the governing board (Conn. Agencies Reg. � 19-13-D4b(p)).

Other services hospice facilities must provide include pharmacy, social work, volunteer, artistic, palliative, respiratory care, specialized rehabilitative, pastoral care, dietary, and out-patient services (� 19-13-D4b(e) to (r)). Diagnostic and palliative services include the services of a clinical laboratory and radiological services meeting all health department standards. The hospice can also enter into written agreements for other services (e.g. blood bank and pathological services) as necessary. All contracts must specify a 24 hour on-call availability (Conn. Agencies Reg. � 19-13-D4b(k)).

Artistic services refers to artistic opportunities provided by the hospice to the patient and family on a scheduled and intermittent basis. Artistic experiences must be coordinated by a qualified arts representative with a graduate degree and clinical experience in the arts or pastoral care. The arts director is a full member of the hospice’s health care team (Conn. Agencies Reg. � 19-13-D4b(i)).

Pharmacy services must be directed by a licensed pharmacist (1) on a full-time basis if the hospice is a free-standing facility or (2) on a part-time basis if the hospice program is a dedicated unit within a healthcare facility. The scope of services must be consistent with patient needs as determined by the medical staff (Conn. Agencies Reg. � 19-13-D4b(f)).

Hospice facilities must meet a range of physical plant requirements. For example, nursing units can have no more than 30 beds, there can be no more than four patients in one room, single rooms must be at least 120 square feet, mutibedrooms must be at least 100 square feet per bed, and each patient must have access to a bathroom without entering the corridor (Conn. Agencies Reg. � 19-13-D4b(a)).

Hospice-Based Home Care Program Regulations

DPH regulations also address home care programs offered by institutionally-based hospices. They require health services to be of the highest quality and provided by a multidisciplinary, interactive, qualified hospice team. The program must address the physical, social, psychological, and spiritual needs of the patient and family and consist of 24 hours a day, seven days a week services (Conn. Agencies Reg. � 19-13-D4b(o)). The home care program must have the necessary personnel to meet patient needs including RNs, licensed practical nurses, and homemaker-home health aides. Personnel assigned by community service agencies must meet the qualification standards of the hospice for its employees. Accurate medical records must be kept for patients served under the home care program.





Ohio Western Reserve National Cemetery – National Cemetery Administration #ohio #western #reserve


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National Cemetery Administration

HOURS

Office Hours: Monday thru Friday 8:00 a.m. to 4:30 p.m.
Closed federal holidays except Memorial Day.

Visitation Hours: Open daily during daylight hours.

BURIAL SPACE

This cemetery has space available to accommodate casketed and cremated remains.

ELIGIBILITY

Burial in a national cemetery is open to all members of the armed forces who have met a minimum active duty service requirement and were discharged under conditions other than dishonorable. A Veteran s spouse, widow or widower, minor dependent children, and under certain conditions, unmarried adult children with disabilities may also be eligible for burial. Eligible spouses and children may be buried even if they predecease the Veteran. Members of the reserve components of the armed forces who die while on active duty or who die while on training duty, or were eligible for retired pay, may also be eligible for burial. For more information visit our eligibility web page .

DIRECTIONS FROM NEAREST AIRPORT

When using any Computer Map Program (ex: Map Quest) use Zip Code 44273.

From the North: Cleveland / Cleveland Hopkins Airport Take Interstate 71 South to Interstate 76 East (exit 209). Take Interstate 76 East to Exit 2 (Route 3/Seville). Turn right onto Route 3. Go to the first traffic light, Greenwich Road. Turn Left onto Greenwich Road. Travel three miles to Rawiga Road. Turn Right onto Rawiga Road. Cemetery is 1 mile down on the left.

From the West: Lodi Take Interstate 76 East to Exit 2 (Route 3/Seville). Turn right onto Route 3. Go to the first traffic light, Greenwich Road. Turn left onto Greenwich Road. Travel three miles to Rawiga Road. Turn right onto Rawiga Road. Cemetery is 1 mile down on the left.

From the South: Columbus Take Interstate 71 North to Interstate 76 East (exit 209). Take Interstate 76 East to Exit 2 (Route 3/Seville). Turn right onto Route 3. Go to the first traffic light, Greenwich Road. Turn left onto Greenwich Road. Travel three miles to Rawiga Road. Turn right onto Rawiga Road. Cemetery is 1 mile down on the left

From the Southeast Canton or from Akron/Canton Airport: Take Interstate 77 North to State Route 224. Go West on Route 224; will merge with Interstate 76. Then follow Akron Directions

From East: Akron Take Interstate 76/Route 224 West to Exit 7 (Route 57/Rittman). Turn left onto Route 57. Go to the first traffic light, Seville Road. Turn right onto Seville Road. Travel three miles to Rawiga Road. Turn left onto Rawiga Road. Cemetery is mile down on the left.

SCHEDULE A BURIAL

Fax all discharge documentation to the National Cemetery Scheduling Office at 1-866-900-6417 and follow-up with a phone call to 1-800-535-1117.

For information on scheduled burials in our national cemeteries, please go to the Daily Burial Schedule .

GENERAL INFORMATION

The Public Information Center at the cemetery is staffed with volunteers Monday through Friday. If you would like to volunteer please call the cemetery office.

Military Funeral Honors
Various Veterans Service Organizations provide military funeral honors.

For educational materials and additional information on this cemetery, please visit the Education section. located below.

FLORAL/GROUNDS POLICY

Cemetery policies are conspicuously posted and readily visible to the public.

Up to three floral arrangements accompanying the casket or urn at the time of burial will be placed on the completed grave. Natural cut flowers may be placed on graves at any time of the year. They will be removed when they become unsightly or when it becomes necessary to facilitate cemetery operations such as mowing.

Artificial flowers will be permitted on graves from November 1 through April 15. Artificial flowers and potted plants will be allowed on graves for a period extending 10 days before through 10 days after Easter Sunday, Memorial Day.

Christmas wreaths, grave blankets and other seasonal adornments may be placed on graves from December 1 through January 20. They may not be secured to headstones or markers.

Permanent plantings, statues, vigil lights, breakable objects and similar items are not permitted on the graves. The Department of Veterans Affairs does not permit adornments that are considered offensive, inconsistent with the dignity of the cemetery or considered hazardous to cemetery personnel. For example, items incorporating beads or wires may become entangled in mowers or other equipment and cause injury.

Decorative items removed from graves remain the property of the donor but are under the custodianship of the cemetery. If not retrieved by donor, they are then governed by the rules for disposal of federal property.

WEAPONS POLICY

VA regulations 38 CFR 1.218 prohibit the carrying of firearms (either openly or concealed), explosives or other dangerous or deadly weapons while on VA property, except for official purposes, such as military funeral honors. Possession of firearms on any property under the charge and control of VA is prohibited. Offenders may be subject to a fine, removal from the premises, or arrest.

HISTORICAL INFORMATION

Ohio Western Reserve National Cemetery is the second national cemetery built in Ohio and the 119th in the national cemetery system.

Currently, there are more than one million veterans living in the State of Ohio and approximately 540,000 residing in the cemetery s service area. The first two phases of construction, covering 65 acres of 273-acre cemetery, included 21,000 gravesites, 10,100 columbaria niches and 3,800 in-ground garden niches for cremated remains. At full capacity, Ohio Western Reserve can provide burial space for 106,000 eligible veterans and dependents, beyond the year 2050.

Ohio Western Reserve National Cemetery lies approximately 45 miles south of Cleveland in Medina County near the town of Seville. The cemetery s name refers to the part of the Northwest Territory formerly known as the Connecticut Western Reserve, a tract of land in Northeast Ohio reserved by the State of Connecticut when it ceded its claims for western lands to the U.S. government in 1786.

Monuments and Memorials
Ohio Western Reserve National Cemetery features a pathway that is lined with memorials that honor America s veterans, which have been donated by various organizations. As of 2017, there were 139 memorials, most commemorating events and troops of 20th century war.

NOTABLE PERSONS

EDUCATION

We are developing educational content for this national cemetery, and will post new materials as they become available. Visit the Veterans Legacy Education Program for details, or the Veterans Legacy Program and NCA History Program for additional information. Thank you for your interest.


Hospice Law, Regulations and federal laws #red #deer #hospice

#hospice regulations

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HOSPICE LAW REGULATIONS
(FEDERAL STATE LAWS ON HOSPICE:
THE UNIFORM STANDARDS OF CARE)

You can rest assured that the Federal and State governments have specific standards of care written into law to protect you and your loved one. Federally recognized hospice care in the United States began with implementation of parts of the Social Security Act (including Sections 1102, 1861 and 1871/42 U.S.C. 1302 and 1395hh and other sections). Regulations governing the conditions under which hospice agencies may participate in the Medicare hospice benefit are spelled out in the US Code of Federal Regulations, hospice regulations originally published in the Federal Register.

Hospices must meet these Conditions of Participation to become licensed and certified by state regulators and to be allowed by the Centers for Medicare Services (CMS) to continue to particpate in the Medicare hospice program. Without certification as meeting these standards, hospices cannot receive reimbursement for enrolling patients in their program. Certification does not necessarily mean that a hospice actually will comply with all the standards in any one patient’s case; it simply means that after the last inspection, the regulators decided to certify the hospice as meeting the standards. There are many reasons why state inspectors may not find all violations occurring in any one particular hospice agency’s program of services.

Hospice administrators are extremely aware of what the regulations are, however hospice staff are not always fully informed about all the details of the standards of care. In the case of rogue hospices which choose to consciously violate the standards for their own financial benefit, you can be sure that most of the hospice staff do not really understand all the laws governing hospice (however well-motivated hospice staff may be).

The rogue hospice agencies take a calculated risk when they violate the standards, basically betting that these violations will not be discovered by inspectors, or that even if discovered, they can take actions to avoid being decertified. Their actions clearly show that they believe that they will, in the long run, benefit more financially by violating the standards than by complying with the standards. However, if you are fully informed about your rights, you can protect your loved one and yourself from exploitation and easily require the hospice to provide all the care needed for your loved one.

The Federal law on hospice can be found in any metropolitan public library in the books containing the Code of Federal Regulations (See 42 CFR ch iv. Part 418 which governs hospice). Ask your reference librarian for assistance. Federal laws governing hospice may also be directly found at the U.S. government printing office’s website https://www.gpo.gov/fdsys/pkg/FR-2014-08-22/pdf/2014-18506.pdf

State administrative rules governing hospice can be found at our list of state administrative rules governing hospice or by searching at your own state websites. Then look under Administrative Law – Hospice , Administrative Code – Hospice or Regulations – Hospice . or you can search at: p

Cornell University Law Library’s website
http://www.law.cornell.edu/wex/table_health
You can find links to your State’s laws on healthcare in general and then search on the state website for hospice at this site an excellent resource!





Hospice regulations #palomar #hotel

#hospice regulations

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Hospice

A public agency or private organization or unit of either providing to persons terminally ill and to their families, regardless of ability to pay, a centrally administered and autonomous continuum of palliative and supportive care, directed and coordinated by the hospice care team primarily in the patient’s home but may also be on an outpatient and short-term inpatient basis.

Am I in the right place?
  • Will your facility have a medical director? If Yes. continue; If No Click here .
  • Will your facility be providing care to those patients who have a diagnosis indicating that they are terminally ill? ( terminally ill designated as 6 months to live). If Yes. continue; If No Click here .
  • Will you be providing regularly scheduled care consisting of medical, nursing, social, spiritual, and volunteer and bereavement services? If Yes. continue; If No Click here .
  • Will the care being provided be under a written care plan established and periodically reviewed by the patient’s attending physician or the medical director of the hospice? If Yes. continue; If No Click here .
  • Will you have an inpatient (acute or short-term care on a 24 hours basis) or residential (non-acute palliative care on 24 hours basis) hospice facility? If Yes. continue; If No Click here .
Next Steps

Continue this process by reading the Rules Regulations;
Rules and Regulations for Hospice
. Chapter 111-8-62, et seq. Revised December 9, 2009
Enforcement of Licensing Requirements, Chapter 290-1-6, et seq. Effective August 16, 1993

Complete the Application Packet – In order to process your application, ALL of the documents included in the application packet must be submitted; and

Sign and return the Application Checklist with the entire Application Packet.





The Real Cost of Leasing vs #buying #solar #panels, #leasing, #solar #electric


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The Real Cost of Leasing vs. Buying Solar Panels

Buying solar panels requires an investment and more decision-making than leasing, but over the long term the benefits of owning your system are hard to beat.

Best Ways to Pay for Your Panels

Cash
Buying your solar electric system outright is best. It usually costs $15,000 to $20,000 after tax credits and can reduce your electricity bill by 70 to 100 percent, depending on the size and orientation of your roof and local regulations. Most systems pay for themselves in five to seven years.

Home Equity Loan
If you need to finance your solar panel purchase, the most cost-effective way to do it is to use a home equity loan or a home equity line of credit. Because your house serves as collateral, these options have low interest rates (currently about 3 to 5 percent). The interest you pay is tax deductible. Equity loans range from 5 to 20 years and usually have fixed interest rates. Equity lines last 10 years and have variable rates (so the interest may increase).

Solar Loan
There are unsecured and secured solar loans. With an unsecured loan, your house doesn’t act as collateral and the interest isn’t tax deductible. Many solar installers work with lenders that offer solar loans, but you’ll probably find better rates by directly checking with banks, and credit unions. Watch out for high origination fees. Fannie Mae also offers consumers financing for solar system installations through its HomeStyle Energy Mortgage Program when they buy a new house or refinance.

Why Leasing Isn’t a Bright Idea

The steep up-front costs for a residential solar system can make a leasing company’s sales pitch sound pretty appealing: Pay little or nothing and save hundreds of dollars per year on average. (The premise is that you save because the combination of your lease payment and your electric bill is less than what you currently pay for power.) Leasing can also look seductively simple compared with buying: There’s no need to shop separately for an installer and financing; you just sign on the dotted line. So it’s not surprising that 72 percent of the people who installed residential solar systems in 2014 did so through leasing or another type of third-party arrangement. But the reality is not quite so sunny.

Your Savings Will Be Modest
People who lease their solar systems save far less than those who buy them outright or with a loan (they also miss out on federal tax benefits and any local incentives). Many leases contain an escalator clause that can further reduce savings by increasing payments 3 percent per year. So if you’re paying 12 cents per kilowatt-hour in year one, with a 3 percent escalator, you’ll be paying 18.2 cents in year 15. That means that if the cost of energy doesn’t rise as quickly as the contracted lease payments increase, your savings could evaporate.

You Lose Control of Your Roof
Leasing companies want to maximize their profit, so there’s a chance you could wind up with more panels than you want and that they could be installed in highly visible places—such as facing the street—without any regard to appearance. To avoid that, check the final system design and placement before signing the lease. It could be different from the initial mock-up.

Leases Can Scare Off Home Buyers
If you put your house on the market before the lease is up (usually 20 years), you will either have to buy out the lease or the person purchasing your home will have to assume it—which some are reluctant to do.

That’s what happened to Andrew and Nora Barber, who had to buy out the lease on the solar system on their Clovis, Calif. home after two prospective buyers were frightened away by it. “I offered the solar company $16,000, which was the total of all the payments for the remainder of the contract,” Andrew says. “But $21,000 was the buyout price in the contract, and the company wouldn’t budge.”

Some solar leasing companies may offer to relocate their systems from one house to another. That could cost $500 for an initial audit and another $500 to transfer the panels, if the leasing company determines it can be done. You would also need approval from your utility and local landmarks commission or the condo or homeowner’s association, if applicable. Plus the new house must be able to accommodate the old system.

And remember: At the end of the lease, the solar company could remove the system—and your savings along with it.

Service Plans Don’t Serve You
Though leasing companies tout their service plans, maintenance is a red herring. “Generally, there’s really no scenario where the maintenance plan is going to kick in,” says Joshua Pearce, an engineering professor and solar expert at the Michigan Tech Open Sustainability Technology Lab. Equipment problems aren’t covered by the maintenance plan, they’re covered by the warranty. And if a storm destroys your panels, the damage may be covered by your homeowners insurance.

That’s why—whether you buy or lease—it’s essential that you inform your insurer. (Roof-mounted solar is generally added as part of a standard homeowners policy at no additional cost; ground-mounted solar may require an insurance rider.)


INPATIENT HOSPICE REGULATIONS #motels #in #brooklyn

#connecticut hospice

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By: Nicole Dube, Associate Analyst

You asked how the state regulates inpatient hospice facilities.

Hospice is a coordinated program of palliative and supportive care (physical, psychological, social, and spiritual) for dying persons and their families provided by an interdisciplinary team of professionals and volunteers. The Department of Public Health (DPH) regulates (1) hospices that are either free-standing or distinct units within a healthcare facility and (2) homecare programs offered by an institutionally-based hospice. DPH regulations define hospice under the broader category of short-term hospital, special hospice. Currently, two facilities are licensed under this category: (1) Connecticut Hospice, Inc. located in Branford and (2) Atlantic Inpatient Hospice Unit located in St. Mary ‘ s Hospital in Waterbury.

On March 1, 2011, the department issued proposed regulations that would have created a second-tier licensure category called hospice facilities. The proposal would have made facilities that met Medicare ‘ s minimum regulatory requirements for inpatient hospice facilities eligible for DPH licensure (42 CFR � 418.110). These requirements are less stringent than DPH’s short-term hospital special hospice regulations.

DPH held a public hearing on the proposed regulations in April 2011. The proposal was submitted to the Attorney General ‘ s office for final review in March 2012, after which it was submitted to the Regulations Review Committee for approval. In June 2012, the committee rejected the proposed regulations and asked DPH to make corrections; DPH has not yet resubmitted its corrected proposal for approval.

INPATIENT HOSPICE REGULATIONS

Current DPH regulations require inpatient hospice facilities to meet various requirements concerning physical plant, administration, staffing, records, and infection control. Home care programs offered by an institutionally-based hospice must also address the physical, psychological, and spiritual needs of the patient and family, and provide services 24 hours a day, seven days a week.

Each hospice must be managed by a governing board with full legal authority and responsibility for its conduct and the quality of medical care it provides. The board must adopt and enforce admission criteria on eligibility for hospice services, a patient bill of rights, medical by-laws, guidelines for community relations, and organizational rules and by-laws (Conn. Agencies Reg. � 19-13-D4b(b)).

The medical staff must include at least five physicians, one of whom serves as the chief, president, or medical director of the staff. All staff physicians must be licensed to practice medicine and surgery in Connecticut. The medical staff must adopt written by-laws and rules not inconsistent with those of the governing board. The medical director must ensure that (1) at least one physician is available on-site eight hours per day and (2) 24-hour on-call coverage is available (Conn. Agencies Reg. � 19-13-D4b(c)).

The hospice’s nursing services must be directed by the director of hospice patient services. That individual must be a Connecticut-licensed, registered nurse (RN) and further qualified by experience in hospice, home health agency, or community health work (Conn. Agencies Reg. � 19-13-D4b(e)). The hospice must maintain a 1:6 ratio of RNs to patients and a 1:3 ratio of nurses or nurse’s aides to patients.

The hospice must have a medical records department with adequate space and qualified personnel. A medical record, which must be kept confidential and secure, is maintained for everyone evaluated or treated as an out-patient or in-patient, or who received services in a hospice-based home care program (Conn. Agencies Reg. � 19-13-D4b(d)).

Each hospice is required to develop an infection prevention, surveillance, and control program to protect the patient, family, and personnel from infections and communicable diseases. The program must be approved by the facility ‘ s medical staff and the governing board (Conn. Agencies Reg. � 19-13-D4b(p)).

Other services hospice facilities must provide include pharmacy, social work, volunteer, artistic, palliative, respiratory care, specialized rehabilitative, pastoral care, dietary, and out-patient services (� 19-13-D4b(e) to (r)). Diagnostic and palliative services include the services of a clinical laboratory and radiological services meeting all health department standards. The hospice can also enter into written agreements for other services (e.g. blood bank and pathological services) as necessary. All contracts must specify a 24 hour on-call availability (Conn. Agencies Reg. � 19-13-D4b(k)).

Artistic services refers to artistic opportunities provided by the hospice to the patient and family on a scheduled and intermittent basis. Artistic experiences must be coordinated by a qualified arts representative with a graduate degree and clinical experience in the arts or pastoral care. The arts director is a full member of the hospice’s health care team (Conn. Agencies Reg. � 19-13-D4b(i)).

Pharmacy services must be directed by a licensed pharmacist (1) on a full-time basis if the hospice is a free-standing facility or (2) on a part-time basis if the hospice program is a dedicated unit within a healthcare facility. The scope of services must be consistent with patient needs as determined by the medical staff (Conn. Agencies Reg. � 19-13-D4b(f)).

Hospice facilities must meet a range of physical plant requirements. For example, nursing units can have no more than 30 beds, there can be no more than four patients in one room, single rooms must be at least 120 square feet, mutibedrooms must be at least 100 square feet per bed, and each patient must have access to a bathroom without entering the corridor (Conn. Agencies Reg. � 19-13-D4b(a)).

Hospice-Based Home Care Program Regulations

DPH regulations also address home care programs offered by institutionally-based hospices. They require health services to be of the highest quality and provided by a multidisciplinary, interactive, qualified hospice team. The program must address the physical, social, psychological, and spiritual needs of the patient and family and consist of 24 hours a day, seven days a week services (Conn. Agencies Reg. � 19-13-D4b(o)). The home care program must have the necessary personnel to meet patient needs including RNs, licensed practical nurses, and homemaker-home health aides. Personnel assigned by community service agencies must meet the qualification standards of the hospice for its employees. Accurate medical records must be kept for patients served under the home care program.





Home Health and Hospice – OASIS-C1, home health regulations and reimbursement, home

#beacon hospice

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Home Health & Hospice

Beacon Institute Resources

Top Stories

This is allowed, per Chapter 7, since eligibility has been confirmed. Now, if something happens and the qualifying service never had a chance to see the patient, there would be no payment. The following is from Chapter 7:

The ability to show the impact of care begins with an accurate assessment at the beginning of the episode. According to the Medicare Conditions of Participation (CoP 484.55), A registered nurse must conduct an initial assessment visit to determine the immediate care and support needs of the patient; and, for Medicare patients, to determine eligibility for the Medicare home health benefit, including homebound status. In cases that include nursing and therapy services, the registered nurse is required to complete the admission visit regardless of patient diagnosis or staffing availability. CoP 484.55 goes on to add, When rehabilitation therapy service (speech language pathology, physical therapy, or occupational therapy) is the only service ordered by the physician, and if the need for that service establishes program eligibility, the initial assessment visit may be made by the appropriate rehabilitation skilled professional.

In this week’s roundup:

  • Home health class lawsuit denied. Collective action lawsuits have increased since federal overtime laws that affect home health care workers and their overtime have come into effect.
  • Public-private partnership of remote patient monitoring hints at patient satisfaction. Two years ago, the Visiting Nurse Association launched its remote patient monitoring (RPM) project, which targeted a congested heart failure population with extremely high hospital readmission rate.
  • Stakeholders: Home health ‘PPS’ spells ‘pay cut’ (again) for CY 2017. CMS’ proposed changes for the Medicare Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2017 include the expected a reduction in payment but nothing that will turn the home health benefit upside down.
  • Amedysis founder dies in floods. Amedisys Inc. one of the largest home health companies in the nation, has suffered greatly after the flooding in and near Baton Rouge, Louisiana: The company s founder and former CEO, William Bill Borne, 58, die in the floods.

Read full stories.

You can use ranges on hospice patients. Missed visits are only needed if the agency does not meet the minimum of the range so in this example, you would only notify the physician if the patient was not seen at least once in a month.

When our patients are admitted to an inpatient facility and we complete a transfer OASIS, we normally will choose not to discharge the patients and await their return home, resuming care at that time. We have a question about what happens if a patient dies while hospitalized and now needs to be discharged from home health. When we enter our discharge reason for home health, is it that the patient was transferred to an inpatient facility, or is the discharge reason that the patient expired?

Federal and state regulators as well as private payers are working hard to curb the costs of Medicare and Medicaid programs. Although the vast majority of hospice providers are operation within the law, regulators have identified some bad actors. For example, a recent Office of Inspector General (OIG) study of hospice care in ALFs raised concerns about the possibility of hospices focusing on certain types of patients under the current payment system. The OI study concluded that hospices have financial incentives to serve patients in ALFs because these patients tend to have diagnoses associated with longer stays (such as ill-defined conditions, mental disorders, or Alzheimer s disease) that often require less complex care and result in higher payments per patient for the provider.

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Assisted Living Laws and Regulations by State #motel #six #locations

#assisted living

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Assisted Living Laws by State: Know Your Rights

When parents move to assisted living, we want to be certain they are well cared for. Part of this peace of mind comes from understanding the rights of assisted living residents and the obligations of the assisted living community. But this task is made more challenging because assisted living communities are not regulated nationally like nursing homes. Instead, each U.S. state has its own laws, regulations and licensing standards for assisted living communities. For example, in some states, as many as 25 hours of training are required for caregiving staff while other states have no training requirements.

A community that looks dazzling may in fact be offering substandard care. And a community that looks a little rough around the edges could be a gem.

To help you make a fully informed decision, we are posting each state’s assisted living licensing and regulation requirements on our website. This guide is designed to help you answer questions such as:

  • How much training is required for staff?
  • How often are communities inspected, and what do the inspectors look for?
  • Is there a minimum staffing ratio?
  • What are the rights of the resident?
  • Can my parent be evicted?

We encourage you to familiarize yourself with your rights and the legal obligations of assisted living communities where you live. Click a state below to see its standards.

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Hospice regulations #motels #in #wisconsin #dells

#hospice regulations

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Hospice

A public agency or private organization or unit of either providing to persons terminally ill and to their families, regardless of ability to pay, a centrally administered and autonomous continuum of palliative and supportive care, directed and coordinated by the hospice care team primarily in the patient’s home but may also be on an outpatient and short-term inpatient basis.

Am I in the right place?
  • Will your facility have a medical director? If Yes. continue; If No Click here .
  • Will your facility be providing care to those patients who have a diagnosis indicating that they are terminally ill? ( terminally ill designated as 6 months to live). If Yes. continue; If No Click here .
  • Will you be providing regularly scheduled care consisting of medical, nursing, social, spiritual, and volunteer and bereavement services? If Yes. continue; If No Click here .
  • Will the care being provided be under a written care plan established and periodically reviewed by the patient’s attending physician or the medical director of the hospice? If Yes. continue; If No Click here .
  • Will you have an inpatient (acute or short-term care on a 24 hours basis) or residential (non-acute palliative care on 24 hours basis) hospice facility? If Yes. continue; If No Click here .
Next Steps

Continue this process by reading the Rules Regulations;
Rules and Regulations for Hospice
. Chapter 111-8-62, et seq. Revised December 9, 2009
Enforcement of Licensing Requirements, Chapter 290-1-6, et seq. Effective August 16, 1993

Complete the Application Packet – In order to process your application, ALL of the documents included in the application packet must be submitted; and

Sign and return the Application Checklist with the entire Application Packet.





Hospice Law, Regulations and federal laws #vitas #hospice #houston

#hospice regulations

#

HOSPICE LAW REGULATIONS
(FEDERAL STATE LAWS ON HOSPICE:
THE UNIFORM STANDARDS OF CARE)

You can rest assured that the Federal and State governments have specific standards of care written into law to protect you and your loved one. Federally recognized hospice care in the United States began with implementation of parts of the Social Security Act (including Sections 1102, 1861 and 1871/42 U.S.C. 1302 and 1395hh and other sections). Regulations governing the conditions under which hospice agencies may participate in the Medicare hospice benefit are spelled out in the US Code of Federal Regulations, hospice regulations originally published in the Federal Register.

Hospices must meet these Conditions of Participation to become licensed and certified by state regulators and to be allowed by the Centers for Medicare Services (CMS) to continue to particpate in the Medicare hospice program. Without certification as meeting these standards, hospices cannot receive reimbursement for enrolling patients in their program. Certification does not necessarily mean that a hospice actually will comply with all the standards in any one patient’s case; it simply means that after the last inspection, the regulators decided to certify the hospice as meeting the standards. There are many reasons why state inspectors may not find all violations occurring in any one particular hospice agency’s program of services.

Hospice administrators are extremely aware of what the regulations are, however hospice staff are not always fully informed about all the details of the standards of care. In the case of rogue hospices which choose to consciously violate the standards for their own financial benefit, you can be sure that most of the hospice staff do not really understand all the laws governing hospice (however well-motivated hospice staff may be).

The rogue hospice agencies take a calculated risk when they violate the standards, basically betting that these violations will not be discovered by inspectors, or that even if discovered, they can take actions to avoid being decertified. Their actions clearly show that they believe that they will, in the long run, benefit more financially by violating the standards than by complying with the standards. However, if you are fully informed about your rights, you can protect your loved one and yourself from exploitation and easily require the hospice to provide all the care needed for your loved one.

The Federal law on hospice can be found in any metropolitan public library in the books containing the Code of Federal Regulations (See 42 CFR ch iv. Part 418 which governs hospice). Ask your reference librarian for assistance. Federal laws governing hospice may also be directly found at the U.S. government printing office’s website https://www.gpo.gov/fdsys/pkg/FR-2014-08-22/pdf/2014-18506.pdf

State administrative rules governing hospice can be found at our list of state administrative rules governing hospice or by searching at your own state websites. Then look under Administrative Law – Hospice , Administrative Code – Hospice or Regulations – Hospice . or you can search at: p

Cornell University Law Library’s website
http://www.law.cornell.edu/wex/table_health
You can find links to your State’s laws on healthcare in general and then search on the state website for hospice at this site an excellent resource!





Ohio state insurance #ohio, #business #portal, #starting #a #business, #hiring, #training, #employees,


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Bureau of Workers’ Compensation monthly employer webinars

BWC is beginning a new series of brief, informative webinars on topics of interest to employers. Webinars will be offered twice a month and will be about 20-25 minutes. To kick things off, June webinars will cover policy year 2017 renewal, the 2-percent early pay discount and future dating of payments.

Ohio Materials Marketplace

The Ohio Materials Marketplace is a free online platform allowing businesses and organizations to connect and find reuse and recycling solutions for waste and by-product materials.

Ohio Business Central

File business documents online with Ohio Business Central. Available online forms include: articles of incorporation for domestic corporations, nonprofits, and professional associations; articles of organization for a domestic limited liability company; foreign for profit and nonprofit corporation application for license; foreign limited liability company registration; trade and fictitious name registration and renewal; and biennial reports for associations and limited liability partnerships, and more.

view all Gateway topics


Hospice rules and regulations #hospice #of #america

#hospice rules and regulations

#

Hospice

A public agency or private organization or unit of either providing to persons terminally ill and to their families, regardless of ability to pay, a centrally administered and autonomous continuum of palliative and supportive care, directed and coordinated by the hospice care team primarily in the patient’s home but may also be on an outpatient and short-term inpatient basis.

Am I in the right place?
  • Will your facility have a medical director? If Yes. continue; If No Click here .
  • Will your facility be providing care to those patients who have a diagnosis indicating that they are terminally ill? ( terminally ill designated as 6 months to live). If Yes. continue; If No Click here .
  • Will you be providing regularly scheduled care consisting of medical, nursing, social, spiritual, and volunteer and bereavement services? If Yes. continue; If No Click here .
  • Will the care being provided be under a written care plan established and periodically reviewed by the patient’s attending physician or the medical director of the hospice? If Yes. continue; If No Click here .
  • Will you have an inpatient (acute or short-term care on a 24 hours basis) or residential (non-acute palliative care on 24 hours basis) hospice facility? If Yes. continue; If No Click here .
Next Steps

Continue this process by reading the Rules Regulations;
Rules and Regulations for Hospice
. Chapter 111-8-62, et seq. Revised December 9, 2009
Enforcement of Licensing Requirements, Chapter 290-1-6, et seq. Effective August 16, 1993

Complete the Application Packet – In order to process your application, ALL of the documents included in the application packet must be submitted; and

Sign and return the Application Checklist with the entire Application Packet.





Medicare hospice regulations #what #is #terminally #ill

#medicare hospice regulations

#

Hospice

A public agency or private organization or unit of either providing to persons terminally ill and to their families, regardless of ability to pay, a centrally administered and autonomous continuum of palliative and supportive care, directed and coordinated by the hospice care team primarily in the patient’s home but may also be on an outpatient and short-term inpatient basis.

Am I in the right place?
  • Will your facility have a medical director? If Yes. continue; If No Click here .
  • Will your facility be providing care to those patients who have a diagnosis indicating that they are terminally ill? ( terminally ill designated as 6 months to live). If Yes. continue; If No Click here .
  • Will you be providing regularly scheduled care consisting of medical, nursing, social, spiritual, and volunteer and bereavement services? If Yes. continue; If No Click here .
  • Will the care being provided be under a written care plan established and periodically reviewed by the patient’s attending physician or the medical director of the hospice? If Yes. continue; If No Click here .
  • Will you have an inpatient (acute or short-term care on a 24 hours basis) or residential (non-acute palliative care on 24 hours basis) hospice facility? If Yes. continue; If No Click here .
Next Steps

Continue this process by reading the Rules Regulations;
Rules and Regulations for Hospice
. Chapter 111-8-62, et seq. Revised December 9, 2009
Enforcement of Licensing Requirements, Chapter 290-1-6, et seq. Effective August 16, 1993

Complete the Application Packet – In order to process your application, ALL of the documents included in the application packet must be submitted; and

Sign and return the Application Checklist with the entire Application Packet.





New Federal Regulations Affect Nursing Homes, Hospices #red #deer #hospice

#hospice regulations

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New Federal Regulations Affect Nursing Homes, Hospices

Long-term facilities such as skilled nursing homes or facilities for people with intellectual disabilities often work with hospices. In some cases it goes well. But in other cases, communication can go by the wayside, affecting quality of patient care.

New federal regulations from the Centers for Medicare and Medicaid hope to smooth the transition between the facilities as well as give the patient more choice.

They went into effect on Monday.

Patients in long-term care facilities basically now have two options:

  • Option 1: They can arrange for hospice services through an agreement with one or more Medicare-certified hospices.
  • Option 2: They can not arrange for hospice services at the facility they are at, and the facility has to assist the patient by transferring them to a facility that will arrange for the provision of hospice services when the patient requests that transfer.

“What it translates to for the patients and families that have a loved one residing in a nursing facility is that they cannot be denied access to care by regulation,” said Barbara Ivanko, president and CEO of Family Hospice and Palliative Care, one of hundreds of hospices in Pennsylvania. “By regulation, the nursing facility has to make sure that they are provided with care by the hospice of their choice even if that facility they themselves cannot provide it.”

These new rules are meant to work with rules from 2008 that established program requirements for hospices that provide hospice services to those at long-term care facilities.

There are other requirements in the contracts — that the hospice specify what services they’ll provide, including medical direction and management of the patient, nursing, counseling, medical supplies, medications and whatever else is needed to alleviate pain associated with terminal illness.

And there will be authorized contracts written before the patient enters hospice care specifying the role and responsibility of each entity.

Franco Insana, chief financial officer at Family Hospice and Palliative Care, said the rules have not always been so clear.

“The Medicare regulations have been somewhat unclear,” he said. “Medicare regulations have several sections. There’s a section for instance that speaks solely to the requirements of hospices, another section that speaks to the requirements of skilled nursing facilities; there’s another section for hospitals, etc. and I think over time, those parts of the regulation have evolved and created some confusion.”

Occasionally this lack of clarity led to a decay in quality.

“Hospice providers and skilled nursing facilities were not always on the same page,” he said. “In some cases there were duplication of services, and in some cases there were gaps.”

Some hospices already have contracts in place with long-term care facilities that comply with these new conditions. Now they all will.





Hospice regulations #hospice #cops

#hospice regulations

#

Hospice

A public agency or private organization or unit of either providing to persons terminally ill and to their families, regardless of ability to pay, a centrally administered and autonomous continuum of palliative and supportive care, directed and coordinated by the hospice care team primarily in the patient’s home but may also be on an outpatient and short-term inpatient basis.

Am I in the right place?
  • Will your facility have a medical director? If Yes. continue; If No Click here .
  • Will your facility be providing care to those patients who have a diagnosis indicating that they are terminally ill? ( terminally ill designated as 6 months to live). If Yes. continue; If No Click here .
  • Will you be providing regularly scheduled care consisting of medical, nursing, social, spiritual, and volunteer and bereavement services? If Yes. continue; If No Click here .
  • Will the care being provided be under a written care plan established and periodically reviewed by the patient’s attending physician or the medical director of the hospice? If Yes. continue; If No Click here .
  • Will you have an inpatient (acute or short-term care on a 24 hours basis) or residential (non-acute palliative care on 24 hours basis) hospice facility? If Yes. continue; If No Click here .
Next Steps

Continue this process by reading the Rules Regulations;
Rules and Regulations for Hospice
. Chapter 111-8-62, et seq. Revised December 9, 2009
Enforcement of Licensing Requirements, Chapter 290-1-6, et seq. Effective August 16, 1993

Complete the Application Packet – In order to process your application, ALL of the documents included in the application packet must be submitted; and

Sign and return the Application Checklist with the entire Application Packet.





List of Websites for State Hospice Regulations #cheap #rooms

#hospice rules and regulations

#

Listing of Websites for Each State’s
Hospice Administrative Code and Regulations

DISCLAIMER — This webpage directly links to sites containing the Hospice Administrative Code of various states. Although every attempt is made to ensure that the links and information placed on this site is accurate and timely, the Hospice Patients Alliance cannot assure the accuracy of any specific online webpage which is linked to here. Some states post “unofficial” versions of their administrative codes (which are basically the same as the “official” version, except that if you order a printed “official” version of a code/law from a state’s administrative code office, you can be sure that you have the latest version with any updates or revisions which may have been made by state lawmakers or other officials.

If you are unable to find the information you need from these links to administrative code, you can look at your state website and searching for the department of health or human services (or other department) as needed. You can often email an official listed at the state website to give you either the answer you need or advice about who knows the answer to your questions. If you need the latest version of the code for a legal action, you are urged to consult the official printed versions of these publications or to contact legal counsel of your choice. This site cannot legally be cited as an official or authoritative source.

Quite often, an official copy of a state’s administrative code may be found at a city library. If you wish to see a hard copy of your state’s hospice Administrative Code/Rules, we suggest that you call your librarian and ask them if they have a copy of the state’s administrative code. They will be able to direct you to a copy of the hospice code for your state. In addition to state hospice administrative rules, all licensed hospices must comply with the provisions governing hospice in the U.S. Code of Federal Regulations: 42 CFR ch iv, part 418: Hospice
(effective Dec. 2, 2008)

Click on the First Letter of the State’s Name

Please report any changes to Hospice Patients Alliance.

State Administrative Code

Code Identifying Numbers

State Hospice Administrative Code Direct Links

Chapter 420-5-17 Hospices

Alaska Administrative Code

Title 18. Health, Safety, and Housing
Chapter 18. Hospice Care Programs

Arizona Administrative Code

Title 9 – Health Services
Chapter 10, Article 8 – Hospices

Arkansas Administrative Code

TITLE 22; Division 3;
Subdivision 1; Ch. 3
Article 2;
?51180

Colorado Administrative Code

Connecticut General Statutes

19-13-D72(b)
Patient Care Standards

District of Columbia Administrative Code

[NOTE: DC does not currently maintain a rules home page. However, a non-governmental webpage has information about accessing the DC rules





Compliance with Laws and Regulations #compare #hotel #prices

#hospice rules and regulations

#

Compliance with Laws and Regulations

Ensuring compliance with applicable laws, regulations, and professional standards of practice, implementing systems and processes that prevent fraud and abuse.

Compliance with Laws and Regulations includes the following aspects:

  • Compliance Program
  • Survey Preparedness
  • Addressing Program Deficiencies

Member hospices can evaluate their organization and operation with respect to compliance with laws and regulations through NHPCO’s Self-Assessment Checklist for Compliance with Laws and Regulations

Pathways to Success

Pathways to success for demonstrating compliance with laws and regulations include:

  • Having a procedure for reporting and investigating compliance concerns.
  • Utilizing the hospice compliance program developed by the Office of Inspector General (OIG).

NHPCO Standards of Practice for Hospice Programs

Resources and Tools

Members can view a wide range of documents and links to online information in Resources and Tools for Compliance with Laws and Regulations

Regulatory Members can access the resources in the Regulatory section of the website.

Background Material and Resources

The following publications support the many aspects of Compliance with Laws and Regulations: