Staffing

1. The facility shall maintain a sufficient number of qualified staff and volunteers who are trained and competent to provide the care and services necessary to meet the needs of the terminally ill patient. 2. The facility shall employ or contract with a registered nurse to supervise patient care to meet the needs of the patients at all times, either directly or indirectly. The facility shall employ, contract, or utilize volunteer services of a licensed nurse to respond to patient needs. 3. When utilizing volunteer services: a. The facility shall provide for appropriate orientation and training that is consistent with acceptable standards of end-of-life care. There must be an orientation that identifies the tasks the volunteer is expected to perform. The orientation program must include, at a minimum: (1) The facility goals, services, and philosophy; (2) Confidentiality and protection of patient and family rights; (3) Procedures to be followed in an emergency and following the death of a patient; and (4) Guidance related specifically to individual responsibilities. b. The facility shall establish a process to assure volunteers are effectively performing the duties and responsibilities assigned. c. A facility shall ensure a volunteer only provides direct patient care when the following provisions are met: (1) Tasks and responsibilities are specified in writing and do not exceed the volunteer's capability; (2) Care is consistent with the hospice service plan; (3) The volunteer shall be appropriately licensed, registered, or certified, if required; (4) Services rendered must be recorded in the patient's record; (5) The volunteer shall have a clear understanding of the volunteer's duties and responsibilities; and (6) Volunteers shall be informed to whom they report and whom to contact if assistance is needed in carrying out their responsibilities.