The Georgia Department of Community Health (DCH) has proposed to repeal the current Rules for Hospice, found at Chapter 290-9-43, and publish amended Hospice Rules under Chapter 111-8-37. The DCH Board is expected to vote on the proposed changes on May 14, 2015. The move from Title 290 to Title 111 will reflect that hospices are subject to regulation by the Department of Community Health rather than the Department of Human Resources, now named the Department of Human Services. Along with the change in location of the Rules, the Department also made changes to update the Rules. In doing so, the Department states it has sought to “not impose excessive regulatory costs on the regulated entities while supporting the quality of care being delivered and the health and safety of the participants receiving care.”

The primary substantive changes to the Hospice Rules include:

  • Modifying the definitions of hospice, family unit, home care, patient and palliative care in the rules, and adding a definition for “advanced and progressive diseases;”
  • Updating requirements regarding a hospice’s maintenance of a business e-mail address for the receipt from the Department of inspection reports and licensure communications;
  • Adding requirements that the hospice’s governing body ensure that its staff does not coerce any patient or family member to give or loan anything of value to persons affiliated with the hospice;
  • Requiring a description of services that discloses whether the hospice provides palliative care to patients who have not been determined to be terminally ill but who have an advanced and progressive disease;
  • Adding requirements for policies and procedures if the hospice provides palliative care to persons with advanced and progressive diseases;
  • Including a requirement to publicly post a copy of patients’ rights and contact information where a patient or responsible party may file a complaint with the Department;
  • Requiring that the Disaster Preparedness plan address communications with patients, their families, and emergency management agencies;
  • Clarifying that some requirements in the Admissions, Discharges and Transfers section of the Rules apply only to terminally ill hospice patients and adding palliative care admission requirements for persons with advanced and progressive diseases if the hospice chooses to provide palliative care;
  • Adding assisted living communities as another type of licensed facility in which the hospice may provide services to residents;
  • Updating the Rules to allow a registered nurse to pronounce the death of a hospice patient in the absence of the attending physician, provided the patient is not an organ donor as authorized in Georgia law;
  • Requiring policies and procedures for volunteers that address patient rights and the reporting of abuse and other serious incidents;
  • Requiring that: “Where the hospice contracts with a staffing agency to provide any services specified in a plan of care, the written contract must require the contracting agency to verify licensing credentials, where applicable, of contract workers to ensure that such workers meet the same qualifications and licensure requirements as specified for hospice employees providing such services directly. The hospice must retain a copy of the contract.”

The Department held public hearings on the proposed Rules in March and April 2015. AGG attended the April hearing, where no public comments were offered. The last opportunity to comment on the proposed Rules was via written comment on April 22, 2015. The comments received via e-mail, fax, or orally at the public hearings will be provided to the DCH Board prior to the May 14, 2015 Board meeting. The Board will vote on the proposed changes at 10:30 am on that date. While we expect that the Rules will go into effect as currently drafted, we will provide updated information should that change.

Once finalized, hospices should be mindful of the fact that the Medicare Conditions of Participation also govern the delivery of hospice services and must be complied with as well.