Minimum Standards

PHPCN considers the following to be Minimum Standards for recognition as a hospice program in Pennsylvania:

Accountability

Hospice programs, as integral parts of the community health care delivery system, are accountable to those served and the community at large. They must meet applicable requirements according to local, state and federal regulations concerning program operation.

Accessibility

Hospice service is available to identified patients and families 24 hours a day, 7 days a week. To the maximum extent possible, programs will provide care regardless of diagnosis or ability to pay for service. Access to inpatient care is available either directly or through a contractual arrangement with an inpatient facility.

Continuity of Care

Services are structured and organized to assure continuity of care, according to the hospice plan of care in both the home and inpatient setting. Provision must be made for the appropriate transfers of information between settings.

Patient/Family Unit

The unit of care is the patient and the patient's family or primary careperson; the interdisciplinary team care plan is developed with and includes specific goals and support for both the patient and family. Patient, family and caregiver's beliefs and values are acknowledged and respected.

Interdisciplinary Team

Interdisciplinary team services are available in the home and inpatient setting. Services include physician, nursing, psychological/social, pastoral, and bereavement care. The medical care of each patient is the responsibility of a designated attending physician. Services are provided by qualified personnel. Written policies and procedures govern the scope and conduct of care provided by each interdisciplinary team member. Goals of care include optimal pain and symptom management, as well as responding to other defined areas of need.

Volunteer Support

The hospice program includes volunteers specifically trained to augment staff services. They are not engaged in lieu of staff. Volunteer support is offered to each patient and assistance may be in direct support to families or through indirect assistance in office or other related areas.

Medical Records

An accurate and current medical record that includes documentation of the plan of care and the services provided is maintained on each patient/family unit. Clinical records must include a signed informed consent and define actions, consistent with the patient's wishes, to be taken when life-threatening situations occur. Records are to be secured and access appropriately limited to assure confidentiality.

Bereavement Support

Hospice services include assessment and support of the needs of the bereaved both before and for one year following patient death. Services also include the development of programs and resources to meet those needs. A tool for risk assessment should be incorporated into the written bereavement plan of care and appropriate referrals made to community professionals when high risk is identified.

Quality Assurance and Utilization Review

The hospice program has defined quality assurance and utilization review activities to regularly monitor and evaluate services. This will assure that high quality care is provided and that available resources are appropriately utilized.

Program Management and Administration

The hospice program is managed effectively by a director who initiates the required measures to assure that the program:

• complies with applicable laws and regulations
• adheres to all program policies and procedures
• adheres to all state and national standards

Governing Body

An organized governing body is identified and has overall responsibility for establishing policy, maintaining quality patient/family care, and providing for management and planning for the hospice program. Bylaws specify the responsibility, organization and structure of the hospice program.