Unless a different meaning is required by the context, the following terms

Unless a different meaning is required by the context, the following terms as used in these rules and regulations shall have the meaning hereinafter respectively ascribed to them: 1. Administrator - Means the person, designated by the governing body, who is responsible for the management of the overall operation of the hospice. 2. Advance Directives – Directive from the patient/family (see definition of family) such as a durable power of attorney for health care, a directive pursuant to patient self-determination initiatives, a living will, or an oral directive which either states a person’s choices for medical treatment or, in the event the person is unable to make treatment choices, designates who shall make those decisions. 3. Attending/Primary Physician – A doctor of medicine or osteopathy licensed to practice medicine in the State of Mississippi, who is designated by the patient or responsible party as the physician responsible for his/her medical care. 4. Bereavement Services – Organized services provided under the supervision of a qualified counselor (see definition) to help the family cope with death related grief and loss. 5. Autonomous – Means a separate and distinct operational entity which functions under its own administration and bylaws, either within or independently of a parent organization. 6. Bed Capacity – Means the largest number which can be installed or set up in the freestanding hospice at any given time for use of patients. The bed capacity shall be based upon space designed and/or specifically intended for such use whether or not the beds are actually installed or set up. 7. Bed Count – Means the number of beds that are actually installed or set for patients in freestanding hospice at a given time. 8. Branch Office/Alternate Site –A location or site from which a hospice agency provides services within a portion of the total geographic area served by the parent agency. The branch is a part of the parent hospice agency and is located within the 50 mile radius of the parent agency and shares administration and supervision. No branch office site shall be opened unless the parent office has had full licensure for the immediately preceding 12 months and has admitted 10 patients within the last twelve (12) months. A branch office does not extend the Geographic Service Area of the Parent Agency. 9. Bureau – Mississippi State Department of Health, Bureaus of Health Facilities, Licensure and Certification. 10. Care Giver – The person whom the patient designates to provide his/her emotional support and/or physical care. 11. Chaplain – Means an individual representative of a specific spiritual belief who is qualified by education received through accredited academic or theological institutions, and/or experience thereof, to provide counseling and who serves as a consultant for and/or core member of the hospice care team. 12. Change of Ownership – Means but is not limited to, intervivos, gifts, transfers, leases, cash and/or stock transactions or other comparable arrangements whenever the person or entity acquires a majority interest (fifty percent (50%) or more) of the facility or service. Changes of ownership from partnerships, single proprietorships or corporations to another form of ownership are specifically included. Provided, however, “Change of Ownership” shall not include any inherited interest acquired as a result of a testamentary instrument or under the laws of descent and distribution of the State of Mississippi. The change of IRS exemption status also constitutes a change of ownership. 13. Community – A group of individuals or a defined geographic area served by a hospice. 14. Continuous Home Care – Care provided by the hospice during a period of crisis as necessary to maintain the terminally ill individual at home. A minimum of eight hours of care must be furnished on a particular day to be considered continuous home care. Nursing care must be provided for more than one-half of the period of care and must be provided by either a registered nurse or licensed practical nurse. Services may be provided by a homemaker or hospice aide to supplement the nursing care. When determining the necessity for continuous home care, a registered nurse must complete/document a thorough assessment and plan of care that includes participation of all necessary disciplines to meet the patient’s identified needs, prior to assigning a licensed practical nurse, homemaker, or a hospice aide to a patient requiring continuous home care. This assignment must comply with accepted professional standards of practice. 15. Contracted Services – Services provided to a hospice provider or its patients by a third party under a legally binding agreement that defines the roles and responsibilities of the hospice and service provider. 16. Core Services – Nursing services, physician services, medical social services, and counseling services, including bereavement counseling, spiritual counseling, and any other counseling services provided to meet the needs of the individual and family. These services must be provided by employees of the hospice, except that physician services and counseling services may be provided through contract. 17. Counselor – Means an individual who has at least a bachelor’s degree in psychology, a master’s or bachelor’s degree from a school of social work accredited by the Council on Social Work Education, a bachelor’s degree in counseling; or the documented equivalent of any of the above in education, training in the spiritual care of the dying and end of life issues, and who is currently licensed in the state of Mississippi, if applicable. Verification of education and training must be maintained in the individual’s personnel file 18. Criminal History Record Check a. Affidavit -For the purpose of fingerprinting and criminal background history checks, the term “affidavit” means the use of Mississippi State Department of Health (MDH) form #210, or a copy thereof, which shall be placed in the individual’s personal file. b. Employee -For the purpose of fingerprinting and criminal background history checks, employee shall mean any individual employed by a covered entity. The term “employee” also includes any individual who by contract with a covered entity provides patient care in a patient’s, resident’s, or client’s room or in treatment rooms. c. The term employee does not include healthcare professional/ technical students, as defined in Section 37-29-232, performing clinical training in a licensed entity under contracts between their schools and the licensed entity, and does not include students at high schools who observe the treatment and care of patients in a licensed entity as part of the requirements of an allied health course taught in the school if: i. The student is under the supervision of a licensed healthcare provider; and ii. The student has signed the affidavit that is on file at the student’s school stating that he or she has not been convicted of or plead guilty or nolo contendere to a felony of possession or sale of drugs, murder, manslaughter, armed robbery, rape, sexual battery, any sex offenses listed in section 45-33- 23 (g), child abuse, arson, grand larceny, burglary, gratification of lust, aggravated assault, or felonious abuse and/or battery of a vulnerable adult, or that any such conviction or plea was reversed on appeal or a pardon was granted for the conviction or plea. iii. Further, applicants and employees of the University of Mississippi Medical Center for whom criminal history record checks and fingerprinting are obtained in accordance with Section 37-115-41 are exempt from application of the term employee under Section 43-11-13. d. Covered Entity - For the purpose of criminal history record checks, “covered entity” means a licensed entity or a healthcare professional staffing agency. e. Licensed Entity - For the purpose of criminal history record checks, the term “licensed entity” means a hospital, nursing home, personal care home, home health agency or hospice. f. Health Care Professional/Vocational Technical Academic Program - For purpose of criminal history record checks, “health care professional/vocational technical academic program” means an academic program in medicine, nursing , dentistry, occupational therapy, physical therapy, social services, speech therapy, or other allied-health professional whose purpose is to prepare professionals to render patient care services. g. Health Care Professional/Vocational Technical Student For purposes of criminal history record checks, the term means a student enrolled in a healthcare professional/vocational technical academic program. h. Direct Patient Care or Services - For the purposes of fingerprinting and criminal background history checks, the term “direct patient care” means direct hands-on medical patient care and services provided by an individual in a patient, resident or client’s room, treatment room or recovery room. Individuals providing direct patient care may be directly employed by the facility or provides patient care on a contractual basis. i. Documented disciplinary action - For the purpose of fingerprinting and criminal background history checks, the term “documented disciplinary action” means any action taken against an employee for abuse or neglect of a patient. 19. Department – Means the Mississippi State Department of Health (MDH). 20. Discharge – The point at which the patient’s active involvement with the hospice program is ended and the program no longer has active responsibility for the care of the patient. 21. Dietitian – Means a person who is registered by the Commission on Dietetic Registration of the American Dietetic Association or who has the documented equivalent in education, training and/or experience. 22. Do Not Resuscitate Orders (DNR) – Orders written by the patient’s physician which stipulate that in the event the patient has a cardiac or respiratory arrest, cardiopulmonary resuscitation will not be initiated or performed. 23. Emotional Support – Support provided to assist the person in coping with stress, grief and loss. 24. Family Unit – Means the terminally ill person and his or her family, which may include spouse, children, sibling, parents, and other with significant personal ties to the patient. 25. Freestanding Hospice– Freestanding Hospice means a hospice that is not a part of any other type of health care provider. 26. Geographic Service Area – Area around the Parent Office, which is within 50 miles radius of the Parent Office premises. Each hospice must designate the geographic service area in which the agency will provide services. Should any portion of a county fall within a 50 mile radius of the Parent, then the entire county may fall within the geographic service area of the Parent. Nothing herein is intended to automatically expand the service area of any existing Parent. A hospice shall seek approval of the Department for any expansion of their service area. The full range of hospice services, as specified, must be provided to the entire designated geographic services area. 27. Governing Body- A hospice program shall have a clearly defined organized governing body that has autonomous authority for the conduct of the hospice program. (Section: 41-85-19) This governing body is not required to meet more often than quarterly. 28. Hospice Aide-An individual who is currently qualified in the State of Mississippi to provide personal care services to hospice patients under the direction of a registered nurse of the hospice. 29. Hospice Inpatient Facility – Organized facilities where specific levels of care ranging from residential to acute, including respite, are provided on a 24-hour basis within the confines of a licensed hospital, nursing home, or freestanding hospice in order to meet the needs of the patient/family. A hospice inpatient facility shall meet the Condition of Participation for providing inpatient care directly as specified in Title 42, Section 418.100 of the Code of Federal Regulations. 30. Hospice – Means an autonomous, centrally administered, nonprofit or for profit medically directed, nurse-coordinated program providing a continuum of home, outpatient and homelike inpatient care for not less than four (4) terminally ill patients and their families. It employs a hospice care team (see definition of hospice care team) to assist in providing palliative and supportive care to meet the special needs arising out of the physical, emotional, spiritual, social and economic stresses which are experienced during the final stages of illness and during dying and bereavement. This care is available twenty-four (24) hours a day, seven (7) days a week, and is provided on the basis of need regardless of inability to pay. (Section 41-85-3) 31. Hospice Physician – A doctor of medicine or osteopathy who is currently and legally authorized to practice medicine in the State of Mississippi and is designated by the hospice to provide medical care to hospice patients, in coordination with the patient’s primary physician. 32. Hospice Premises – The physical site where the hospice maintains staff to perform administrative functions, maintains its personnel records, maintains its client service records, and holds itself out to the public as being a location for receipt of client referrals. A hospice must be physically located within the State of Mississippi. A license for a hospice program shall not be issued if the hospice is to be located in an area in violation of any local zoning ordinance or regulation\ 33. Informed Consent – A documented process in which information regarding the potential and actual benefits and risks of a given procedure or program of care is exchanged between provider and patient. 34. Inpatient Services – Care available for General Inpatient Care or Respite Care that is provided in an Inpatient Hospice Facility, hospital, or SNF that meets the Condition of Participation for providing inpatient care directly as specified in Title 42, Section 418.100 of the Code of Federal Regulations. 35. Interdisciplinary Team (IDT) – An interdisciplinary team or group(s) designated by the hospice, composed of representatives from all the core services. The Interdisciplinary Team must include at least a doctor of medicine or osteopathy, a registered nurse, a social worker, and a pastoral or other counselor. The interdisciplinary team is responsible for participation in the establishment of the plan of care; provision or supervision of hospice care and services; periodic review and updating of the plan of care for each individual receiving hospice care, and establishment of policies governing the day-to-day provision of hospice care and services. If a hospice has more than one interdisciplinary team; it must designate, in advance, the team it chooses to execute the establishment of policies governing the day-to-day provision of hospice care and services. 36. Interdisciplinary Team Conferences – Regularly scheduled periodic meetings of specific members of the interdisciplinary team (see Rule 1.3.36) to review the most current patient/family assessment, evaluate care needs, and update the plan of care. 37. Level of Care – Hospice care is divided into four categories of care rendered to the hospice patient. a. Routine home care b. Continuous home care c. Inpatient respite care d. General inpatient care 38. License (Hospice) – A document permitting an organization to practice hospice care for a specific period of time under the rules and regulations set forth by the State of Mississippi. 39. Licensing Agency- Means the Mississippi State Department of Health. 40. Life-Threatening – Causes or has the potential to cause serious bodily harm or death of an individual. 41. Medically Directed – Means that the delivery of medical care is directed by a licensed physician who is employed by the hospice for the purpose of providing ongoing palliative care as a participating caregiver on the hospice care team. 42. Medical Social Services – Include a comprehensive psychosocial assessment; ongoing support for the patient and family; and assistance with coping skills, anticipatory grief, and grief reactions. 43. Non-Core Services- Services provided directly by hospice employees or under arrangement that are not considered Core Services. These services include, but are not limited to: a. Hospice aide and homemaker b. Physical therapy services c. Occupational therapy services d. Speech-language pathology services e. General inpatient care f. Respite care g. Medical supplies and appliances including drugs and biologicals. 44. Nurse Practitioner/Physician Assistant – Shall mean a nurse who is currently licensed as such in the State of Mississippi and is performing duties in accordance with the Mississippi Nurse Practice Act or a physician assistant who is currently licensed as such in the State of Mississippi and is performing duties in accordance with the Mississippi Physician Assistants Act. 45. Occupational Therapist – Means a person licensed to practice Occupational Therapy in the State of Mississippi. 46. Outpatient Care- Means any care rendered or coordinated by the hospice care team that is not “home care” or “inpatient care”. 47. Palliative Care – Means the reduction or abatement of pain and other troubling symptoms by appropriate coordination of all elements of the hospice care team needed to achieve needed relief of distress. 48. Parent Office – The primary location or site from which a hospice agency provides services within a Geographic Service Area. The Parent Office is used to determine the base of the Geographic Service Area. 49. Patient – Shall mean the terminally ill individual who meets criteria as defined per State law. 50. Period of Crisis – A period in which a patient required predominately nursing care to achieve palliation or management of acute medical problems. 51. Physical Therapist – Means an individual who is currently licensed to practice physical therapy in the State of Mississippi. 52. Plan of Care (POC) – A written document established and maintained for each individual admitted to a hospice program. Care provided to an individual must be in accordance with the plan. The plan must include a comprehensive assessment of the individual’s needs and identification of the care/services including the management of discomfort and symptom relief. 53. Primary Care person – A person designated by the patient who agrees to give continuing support and/or care. 54. Registered Nurse – An individual who is currently licensed in the State of Mississippi or in accordance with criteria established per the Nurse Compact Act and is performing nursing duties in accordance with the Mississippi Nurse Practice Act. 55. Representative – An individual who has been authorized under State law to terminate medical care or to elect or revoke the election of hospice care on behalf of a terminally ill individual who is mentally or physically incapacitated. 56. Residential Care- Hospice care provided in a nursing facility or any residence or facility other than the patient’s private residence. 57. Respite Care- Short-term care provided in an Inpatient Hospice Facility, hospital, or SNF that meets the Condition of Participation for providing inpatient care directly as specified in Title 42, Section 418.100 of the Code of Federal Regulations. Respite care is short-term inpatient care provided to the patient only when necessary to relieve the family members or other persons caring for the patient. Respite care may be provided only on an occasional basis and may not be reimbursed for more than five consecutive days at a time. 58. Social Worker – An individual who has a degree from a school of social work accredited by the Council on Social Work Education and is licensed by the State of Mississippi. 59. Speech Pathologist – Shall mean an individual who meets the educational and experience requirements for a Certificate of Clinical Competence granted by the American Speech and Hearing Association and is currently licensed as a Speech and Language Pathologist in the State of Mississippi. 60. Spiritual Services – Providing the availability of clergy, as needed, to address the patient’s/family’s spiritual needs and concerns. 61. Terminally Ill- A medical prognosis of limited expected survival of approximately six months or less, if the disease follows its normal course, of an individual who is experiencing an illness for which therapeutic strategies directed toward cure and control of the disease alone is no longer appropriate. 62. Volunteer – Means a trained individual who provides support and assistance to the patient, family or organization, without remuneration, in accord with the plan of care developed by the hospice core team and under the supervision of a member of the hospice staff appointed by the governing body or its designee. 63. Director of Volunteers - Means a person who directs the volunteer program in accordance with the acceptable standards of hospice practice.