§ 2600.29a. Hospice care and services—statement of policy.

 (a)  If a personal care home elects to provide assistance with IADLs or ADLs for a resident who receives hospice care and services in accordance with §  2600.29 (relating to hospice care and services), the home shall provide for the resident’s personal care needs, as well as meet the needs directed by the hospice agency for the time period that hospice service staff are not physically present in the home, and in accordance with the resident’s medical evaluation, assessment and support plan.

 (b)  A home that elects to serve one or more residents who receive hospice care and services in accordance with §  2600.29 is not required to evacuate a resident who is actively dying, during a fire drill, if all of the following are met:

   (1)  A physician, who is not an employee or contractor of the home, has certified in writing that the resident is actively dying and may suffer bodily injury or a hastened death as a result of participation in a fire drill.

   (2)  The resident, the resident’s power of attorney for health care, the resident’s legal guardian or the resident’s health care representative has provided written informed consent that the person is not to evacuate in a fire drill.

   (3)  If practicable, the home is to locate the bedroom of a resident receiving hospice care and services on the ground level of the building and near to an exit or fire-safe area as defined in §  2600.132(d) (relating to fire drills).

   (4)  During a fire drill, the one designated person at the home who has knowledge in advance of the fire drill is to immediately upon setting off the fire alarm to begin the fire drill, go to the room of the resident who meets the conditions of paragraphs (1)—(3), and notify the affected resident and any staff person who attempts to evacuate the resident, that this is a fire drill and the resident is not to be evacuated.

   (5)  If the provisions of paragraph (4) are initiated, the informed staff person is to immediately practice a fire drill evacuation in accordance with the following:

     (i)   Access a mode of transport such as a bed on wheels, a chair on wheels or a drag mat in the resident’s bedroom or nearby area, which is not currently occupied by the resident.

     (ii)   Reasonably simulate the level of effort required to move the resident and proceed to practice evacuation to the nearest unblocked exit or fire safe area. The simulation will include the number of staff persons that is required during an evacuation to safely move the resident.

   (6)  If the provisions of paragraph (4) are not initiated, staff persons will proceed to evacuate the resident. All staff persons are to be trained to follow this evacuation procedure.

   (7)  The home is to maintain sufficient staffing at all times to provide for the safe evacuation of all residents, including the resident who is actively dying while receiving hospice care and services, in accordance with the fire drill practice requirements specified in paragraph (5) and §  2600.132(a)—(j). A resident who meets the conditions of paragraphs (1)—(3) is a resident with mobility needs in accordance with §  2600.4 (relating to definitions).

   (8)  A hospice agency staff person may participate in the fire drill if the staff person is physically present in the home continuously on a 24-hour basis during the active dying process.

   (9)  The total time to evacuate all residents, including the practice provision of paragraph (5), may not exceed the time allotted under §  2600.132(d).

   (10)  The resident’s assessment and support plan are to be kept current and specify the requirements of this section as it relates to the specific resident.

   (11)  Documentation of compliance with this section is to be kept in the fire drill record, as well as in the resident’s record. The documentation is to include the following:

     (i)   A copy of the Department of Health license for the hospice agency.

     (ii)   Written certification by the physician as specified in paragraph (1).

     (iii)   Written informed consent as specified in paragraph (2).

     (iv)   Written documentation of the home’s consideration of relocation of the resident’s bedroom as specified in paragraph (3).

Source

   The provisions of this §  2600.29a adopted March 12, 2010, effective April 12, 2010, 40 Pa.B. 1411.



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