6 Colo. Code Regs. § 1011-1-21-10

Current through Register Vol. 47, No. 11, June 10, 2024

Section 6 CCR 1011-1-21-10 - CONTRACTUAL SERVICES

10.1 The hospice may contract as defined by law with other health care providers for the provision of all but core services except the exclusions as outlined in Section 10.5.

10.2 A hospice that has a written agreement with another agency, individual, or organization to furnish any services under contract shall retain administrative and financial management, legal responsibility and oversight of staff and services for all contracted services, to ensure the provision of quality care.

10.3 Contracted services shall be supported by written agreements that require all services be:

(A) Authorized by the hospice;

(B) Furnished in a safe and effective manner by qualified personnel;

(C) Delivered in accordance with the patient's plan of care; and

(D) Evaluated as part of the quality management program.

10.4 If contract services are utilized, the contractor shall meet all applicable provisions of hospice regulations.

10.5 The hospice may use contracted staff to supplement hospice employees in order to meet the needs of patients under extraordinary or other non-routine circumstances. Circumstances under which a hospice may enter into a written arrangement for the provision of core services include: unanticipated periods of high patient loads, staffing shortages due to illness or other short-term temporary situations that interrupt patient care; and temporary travel of a patient outside of the hospice's service area.

10.6 Hospice Services Provided To Residents of Non-Hospice Licensed Facilities:

(A) When hospice services are provided in a long term care facility, assisted living residence or intermediate care facility for persons with developmental disabilities, there shall be a written agreement that specifies the provision of hospice services in the facility. The written agreement shall be signed by authorized representatives of the hospice and the non-hospice licensed facility prior to the provision of hospice services.

(B) The written agreement shall include at least the following:

(1) The manner in which the facility and the hospice are to communicate with each other and document such communication to ensure that the needs of the patient are addressed and met 24 hours a day;

(2) A provision that the facility shall immediately notify the hospice if:

(a) There is a significant change in the patient's physical, mental, social, or emotional status that may necessitate a change to the plan of care;

(b) There is a need to transfer the patient from the facility, in such case, the hospice shall coordinate any necessary care related to the terminal illness and related conditions; or

(c) The patient dies.

(3) A provision stating that the hospice assumes responsibility for determining the appropriate course of hospice care, including the determination to change the level of services provided, and

(4) A provision stating that it is the facility's responsibility to provide 24-hour room and board care and to provide services as defined by the facility's license.

10.7 Short-term Inpatient Care: The hospice shall ensure that short-term inpatient care is available to meet the acute and respite needs of the patient as determined by the hospice. This short-term inpatient care may be provided in a Hospital, Long-Term Care Facility, or Hospice Inpatient Facility.

(A) If the hospice has an arrangement with a facility to provide for short-term inpatient care, the arrangement is described in a written agreement, coordinated by the hospice, and at a minimum specifies that:

(1) The hospice supplies the inpatient provider a copy of the patient's plan of care and specifies the inpatient services to be furnished;

(2) The inpatient provider has established patient care policies consistent with those of the hospice and agrees to abide by the hospice plan of care;

(3) The hospice patient's inpatient clinical record includes all aspects of the patient's care, condition and services furnished during the patient's inpatient stay. A copy of the inpatient facility's discharge summary shall be provided to the hospice at the time of the inpatient facility's discharge. A copy of the inpatient facility's complete clinical record shall be available to the hospice; and

(4) The inpatient facility has identified an individual within the facility who is responsible for the implementation of the provisions of the written agreement.

6 CCR 1011-1-21-10