Florida Regulations 59A-38.008: Medical Direction
Current as of: 2024 | Check for updates
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(1) The hospice shall employ a medical director who shall be a hospice physician licensed in the State of Florida pursuant to chapter 458 or 459, F.S., who has admission privileges at one or more hospitals commonly serving patients in that hospice’s service area as defined in Fl. Admin. Code R. 59C-1.0355 Duties shall be enumerated in a job description, including job qualifications, which shall be kept in an administrative file.
(2)(a) The medical director or his or her designee, a physician licensed under chapter 458 or 459, F.S., must be a member of the hospice care team and must be responsible for the direction and quality of the medical component of the care rendered to the patient by the hospice care team. The patient’s attending physician(s) may remain the primary physician(s) to the patient, depending upon the preferences of the patient and the patient’s family. The patient and the patient’s family may elect to have the hospice medical director assume all or part of the primary medical care functions, or act as a consultant to the patient’s attending physician(s). In either case, the hospice care team must maintain a reporting relationship with the patient’s attending physician(s).
(b) Duties of the medical director shall include:
1. Reviewing clinical material of the patient’s attending physician(s) to document basic disease process, prescribed medicines, assessment of patient’s health at time of entry and the drug regimen, or performing an admission history and physical for each patient.
2. Validating the attending physician(s)’ prognosis and life expectancy for the patient.
3. Assisting in developing and medically validating the plan of care for each patient and family unit with the coordination of the patient’s attending physician(s).
4. Attending and actively participating in patient and family care conferences.
5. Rendering or actively supervising medical care for hospice patients and maintaining a record of such care.
6. Maintaining a regular schedule of participation in all components of the hospice care program and maintaining twenty-four (24) hours a day, seven (7) days a week coverage of and ready availability to the hospice program through him or herself or his or her licensed hospice physician designee.
7. Acting as a consultant to attending, including personal, physicians and other members of the hospice care team; helping to develop and review policies and procedures for delivering care and services to the patient and family unit; serving on appropriate committees; and reporting regularly to the hospice administrator regarding medical care delivered to the hospice patients.
8. Maintaining liaison with the patient’s attending physician(s), who is encouraged to provide primary care to his or her patient even though the patient also receives hospice care. The hospice physician will provide palliative care to his or her patient.
9. Establishing written protocols for symptom control, i.e., pain, nausea, vomiting, or other symptoms.
10. Assisting the administrator in developing, documenting and implementing a policy for discharge of patients from hospice care.
(3) In addition to the hospice medical director, the hospice may appoint additional hospice physician(s) who shall perform duties prescribed herein. Any appointed physician shall be subject to the same licensing qualifications as the hospice medical director.
(4) The medical director shall assist the administrator in developing, documenting and implementing policies and procedures for regulating the delivery of physicians’ services, for orientation of new hospice physicians, and for continuing training and support of hospice physicians. These policies and procedures shall:
(a) Ensure that a hospice physician is on-call twenty-four (24) hours a day, seven (7) days a week; and
(b) Provide for the review and evaluation of clinical practices within hospice inpatient, residential and home-care programs in coordination with the QAUR/QAPI committee.
Rulemaking Authority 400.605 FS. Law Implemented 400.605, 400.610, 400.6105 FS. History-New 5-6-82, Formerly 10A-12.14, 10A-12.014, Amended 4-27-94, Formerly 59A-2.014, Amended 6-5-97, 8-11-08, Formerly 58A-2.014, 7-1-19.
(b) Duties of the medical director shall include:
1. Reviewing clinical material of the patient’s attending physician(s) to document basic disease process, prescribed medicines, assessment of patient’s health at time of entry and the drug regimen, or performing an admission history and physical for each patient.
2. Validating the attending physician(s)’ prognosis and life expectancy for the patient.
3. Assisting in developing and medically validating the plan of care for each patient and family unit with the coordination of the patient’s attending physician(s).
4. Attending and actively participating in patient and family care conferences.
5. Rendering or actively supervising medical care for hospice patients and maintaining a record of such care.
6. Maintaining a regular schedule of participation in all components of the hospice care program and maintaining twenty-four (24) hours a day, seven (7) days a week coverage of and ready availability to the hospice program through him or herself or his or her licensed hospice physician designee.
7. Acting as a consultant to attending, including personal, physicians and other members of the hospice care team; helping to develop and review policies and procedures for delivering care and services to the patient and family unit; serving on appropriate committees; and reporting regularly to the hospice administrator regarding medical care delivered to the hospice patients.
8. Maintaining liaison with the patient’s attending physician(s), who is encouraged to provide primary care to his or her patient even though the patient also receives hospice care. The hospice physician will provide palliative care to his or her patient.
9. Establishing written protocols for symptom control, i.e., pain, nausea, vomiting, or other symptoms.
10. Assisting the administrator in developing, documenting and implementing a policy for discharge of patients from hospice care.
(3) In addition to the hospice medical director, the hospice may appoint additional hospice physician(s) who shall perform duties prescribed herein. Any appointed physician shall be subject to the same licensing qualifications as the hospice medical director.
(4) The medical director shall assist the administrator in developing, documenting and implementing policies and procedures for regulating the delivery of physicians’ services, for orientation of new hospice physicians, and for continuing training and support of hospice physicians. These policies and procedures shall:
(a) Ensure that a hospice physician is on-call twenty-four (24) hours a day, seven (7) days a week; and
(b) Provide for the review and evaluation of clinical practices within hospice inpatient, residential and home-care programs in coordination with the QAUR/QAPI committee.
Rulemaking Authority 400.605 FS. Law Implemented 400.605, 400.610, 400.6105 FS. History-New 5-6-82, Formerly 10A-12.14, 10A-12.014, Amended 4-27-94, Formerly 59A-2.014, Amended 6-5-97, 8-11-08, Formerly 58A-2.014, 7-1-19.