Certificate of Need Related Laws
HOSPICE
400.606
License; application; renewal; conditional license or
permit; certificate of need.--
(3) The agency shall not
issue a license to a hospice that fails to receive a certificate of need under
the provisions of part I of chapter 408. A licensed hospice is a health care
facility as that term is used in s. 408.039 (5) and is entitled to initiate or
intervene in an administrative hearing.
(4) A freestanding hospice
facility that is primarily engaged in providing inpatient and related services
and that is not otherwise licensed as a health care facility shall be required
to obtain a certificate of need. However, a freestanding hospice facility with
six or fewer beds shall not be required to comply with institutional standards
such as, but not limited to, standards requiring sprinkler systems, emergency
electrical systems, or special lavatory devices.
(5) The agency may deny a
license to an applicant that fails to meet any condition for the provision of
hospice care or services imposed by the agency on a certificate of need by
final agency action, unless the applicant can demonstrate that good cause
exists for the applicant's failure to meet such condition.
400.6085
Contractual services.--A hospice may contract out for some
elements of its services. However, the core services, as set forth in s. 400.609
(1), with the exception of physician services, shall be provided directly by
the hospice. Any contract entered into between a hospice and a health care
facility or service provider must specify that the hospice retains the
responsibility for planning, coordinating, and prescribing hospice care and
services for the hospice patient and family. A hospice that contracts for any
hospice service is prohibited from charging fees for services provided directly
by the hospice care team that duplicate contractual services provided to the
patient and family.
(2) With respect to
contractual arrangements for inpatient hospice care:
(b) Hospices contracting
for inpatient care beds shall not be required to obtain an additional
certificate of need for the number of such designated beds. Such beds shall
remain licensed to the health care facility and be subject to the appropriate
inspections.
400.609 Hospice services.—Each
hospice shall provide a continuum of hospice services which afford the patient
and the family of the patient a range of service delivery which can be tailored
to specific needs and preferences of the patient and family at any point in
time throughout the length of care for the terminally ill patient and during
the bereavement period. These services must be available 24 hours a day, 7 days
a week, and must include:
(1) SERVICES.—
(a) The
hospice care team shall directly provide the following core services: nursing
services, social work services, pastoral or counseling services, dietary
counseling, and bereavement counseling services. Physician services may be
provided by the hospice directly or through contract. A hospice may also use
contracted staff if necessary to supplement hospice employees in order to meet
the needs of patients during periods of peak patient loads or under
extraordinary circumstances.
(b) Each
hospice must also provide or arrange for such additional services as are needed
to meet the palliative and support needs of the patient and family. These
services may include, but are not limited to, physical therapy, occupational
therapy, speech therapy, massage therapy, home health aide services, infusion
therapy, provision of medical supplies and durable medical equipment, day care,
homemaker and chore services, and funeral services.
(4) HOSPICE
INPATIENT CARE.—The inpatient component of care is a short-term adjunct to
hospice home care and hospice residential care and shall be used only for pain
control, symptom management, or respite care. The total number of inpatient
days for all hospice patients in any 12-month period may not exceed 20 percent
of the total number of hospice days for all the hospice patients of the
licensed hospice. Hospice inpatient care shall be under the direct
administration of the hospice, whether the inpatient facility is a freestanding
hospice facility or part of a facility licensed pursuant to chapter 395 or part
II of this chapter. The facility or rooms within a facility used for the
hospice inpatient component of care shall be arranged, administered, and managed
in such a manner as to provide privacy, dignity, comfort, warmth, and safety
for the terminally ill patient and the family. Every possible accommodation
must be made to create as homelike an atmosphere as practicable. To facilitate
overnight family visitation within the facility, rooms must be limited to no
more than double occupancy; and, whenever possible, both occupants must be
hospice patients. There must be a continuum of care and a continuity of
caregivers between the hospice home program and the inpatient aspect of care to
the extent practicable and compatible with the preferences of the patient and
his or her family. Fees charged for hospice inpatient care, whether provided
directly by the hospice or through contract, must be made available upon request
to the Agency for Health Care Administration. The hours for daily operation and
the location of the place where the services are provided must be determined,
to the extent practicable, by the accessibility of such services to the
patients and families served by the hospice.
