Rule 111-8-37-.24 - Hospice Care Facilities(1) Hospices providing home care services may establish, as optional services, small home-like residential facilities or units, in order to provide 24-hour non-acute palliative hospice care, and/or inpatient units, in order to provide short-term, 24-hour acute hospice care to terminally ill hospice patients. Residential hospices built, or undergoing major renovations after the effective date of these rules must meet the Facility Guidelines Institute, Guidelines for Design and Construction of Residential Health, Care, and Support Facilities, including the provisions specifically applicable to hospices.(2) The environment of the hospice care facility must be designed, equipped, and maintained in accordance with applicable life safety code requirements to provide for the comfort, privacy, and safety of no more than 25 patients and family members in any one self-contained, home-like unit. A hospice may operate multiple self-contained, home-like units of no more than 25 beds each, either at the same location or separate locations, provided that each unit is fully staffed to meet the needs of the hospice patients in that unit, the locations are within 35 miles of the principal location and the governing body does not have a history of poor compliance with licensure requirements. Hospice care facilities, whether residential, inpatient, or residential and inpatient facilities, must provide: (a) An emergency power source capable of providing electrical service for communication systems, alarm systems, egress lighting, and patient care areas;(b) Décor and room configuration that is home-like in design and function;(c) Space accommodations, other than patient rooms, for private patient/family visiting and grieving;(d) Accommodations for at least one family member to remain with the patient throughout the night;(e) Separate restrooms for staff and public use;(f) A program to inspect, monitor and maintain biomedical, electrical equipment in proper and safe working order;(g) Procedures that prevent infestations of insects, rodents, or other vermin or vectors;(h) Security procedures sufficient for the protection of patients;(i) Procedures for the safe management of medical gases;(j) Procedures for infection control, including isolation of patients, in accordance with accepted standards;(k) An environment that is clean, in good repair, and designed and equipped to minimize the spread of infection;(l) Adequate lighting, ventilation, and control of temperature and air humidity; and(m) An alternative power source to support the needs of the patients.(3) Patient rooms and bathrooms must be designed and equipped to allow for easy access to the patient and for the comfort and safety of patients.(4) Each residential and/or inpatient hospice care facility must provide rooms that:(a) Measure at least 100 square feet for a single patient room or 80 square feet for each patient for a multi-patient room;(b) Are private rooms, unless consent for a roommate is obtained and then only if the following requirements are met:1.The hospice must provide an alternative temporary accommodation for a patient whose roommate is in a crisis situation;2.In no case shall more than two patients share a room;(c) Are equipped with a bathroom with an adequate supply of hot water and with automatically regulated temperature control of the hot water;(d) Are at or above grade level and have a window to the outside;(e) Contain a suitable bed and mattress for each patient, suitable furniture that allows family to remain in the room overnight, chairs for seating, and closets or furniture for storage of personal belongings;(f) Are equipped with a system for patients to summon for assistance when needed;(g) Are equipped with a telephone in each room or telephones located in private areas convenient to bedrooms; and(h) Have an adequate amount of clean bed linens, towels, and washcloths.(5) In addition to complying with all other requirements of these rules and regulations, each facility that is newly constructed or expands its existing facility after the date these rules and regulations take effect shall also provide a tub or shower in each patient room.(6) In addition to the hospice's applicable home-care policies and procedures, hospice care facilities must develop and implement additional policies and procedures for post-mortem care and for pronouncement of deaths, in accordance with applicable law.(7) Hospice care facilities must have policies regarding smoking which apply to employees, volunteers, patients, and visitors.(8) Hospice care facilities must ensure adequate staff are on duty at all times in order to meet the needs of patients, in accordance with patients' plans of care and in accordance with accepted standards of nursing and hospice care. Residential and/or inpatient hospice care facilities must provide: (a) At least two staff members on duty 24 hours per day, seven days per week, with additional staff as needed to meet the needs of patients; and(b) A registered nurse must direct and supervise all patient care in accordance with the needs of patients and the individual plans of care. 1.Residential hospice care facilities may utilize licensed practical nurses for patient care provided that a registered nurse supervises the care and is available on call at all times.2.Inpatient hospice care facilities must have a registered nurse present during each shift who provides direct patient care.(9) Meals must be provided in accordance with established dietary practice and the dietary needs and wishes of patients. The hospice must: (a) Serve three meals a day with not more than 14 hours between a substantial evening meal and breakfast, unless medically contraindicated;(b) Have a system for providing meals for patients outside the normal meal service hours, when requested;(c) Have snacks available between meals and at night, as appropriate to each patient's needs and medical condition;(d) Purchase, store, prepare, and serve food in a manner that prevents food borne illness;(e) Ensure patient diets follow the orders of physicians;(f) Ensure that a qualified staff member plans and supervises meals to ensure meals meet patient's nutritional needs and to ensure meals follow recommended dietary allowances and menu plans; and(g) Ensure the services of a licensed dietitian to review meal plans and to consult in practical freedom of choice diets to ensure that patients' favorite foods are included in their diets whenever possible.Ga. Comp. R. & Regs. R. 111-8-37-.24
O.C.G.A. §§ 31-7-170et seq.
Original Rule entitled "Hospice Care Facilities" adopted. F. May 26, 2015; eff. June 15, 2015.