Wisconsin Administrative Code ch. HFS 131 Variances
PDF Version of DQA 08-028 (PDF,
23 KB)
| Date: |
November 25, 2008 -- DQA Memo 08-028 |
| To: |
Hospices HSPC 13 |
| From: |
Alfred C. Johnson, Director
Bureau of Licensing, Technology and Education |
| Via: |
Otis Woods, Administrator
Division of Quality Assurance
|
Wisconsin Administrative Code ch. HFS 131 Variances
This memo addresses three areas of Wisconsin Administrative Code ch. HFS
131 that require variances in order to be consistent with the Federal
Conditions of Participation (CoP) for Hospices.
Background
The Centers for Medicare and Medicaid Services (CMS) published revised
Hospice Conditions of Participation on June 5, 2008 with an effective date
of December 2, 2008 (except the Quality Assurance Condition at 42 CFR 418.66
which is effective March 2, 2009). The revised Hospice Conditions of
Participation are found at: http://www.cms.hhs.gov/center/hospice.asp
The Division of Quality Assurance (DQA) is currently working with hospice
providers and the HOPE (Hospice Organization and Palliative Experts)
association to revise and update HFS 131. The Department is issuing these
variances because the Administrative Rule process can be lengthy.
Issue 1
The hospice CoP at 42 CFR 418.3 provides a definition of "Attending
physician" based on section 1861(dd)(3)(B) of the Social Security Act.
The definition includes a nurse practitioner who meets specified training,
education and experience requirements and is identified by a hospice patient
as having the most significant role in determining and delivering the
patient's medical care.
A statewide variance for the following HFS 131 rules is issued effective
December 2, 2008 to allow a nurse practitioner to perform the duties of the
physician or attending physician as specified in the following:
HFS 131.21(2)(e) Rights of Patients
HFS 131.36(3)(f) Health Care Record content
HFS 131.42(2)(a)2. Plan of Care
HFS 131.42(3)(b)4. Plan of Care
HFS 131.43(3)(a)6. Services
Issue 2
The new hospice CoP at 42 CFR 418.56(d) Review of the Plan of Care,
requires plan of care review no less frequently than every 15 days.
Currently HFS 131.42(4)(a) requires a plan of care review at least every
2 weeks. A statewide variance of HFS 131.42(4)(a) is issued effective
December 2, 2008 to allow the plan of care review to be completed at least
every 15 days.
Issue 3
The new hospice CoP at 42 CFR 418.60 Infection Control requires the use
of standard precautions.
HFS 131.32(3) Universal Precautions, requires the use of universal
precautions which are no longer the standard of practice. A statewide
variance of HFS 131.32(3) is issued effective December 2, 2008, and requires
that the hospice must follow accepted standards of practice to prevent the
transmission of infection and communicable diseases, including the use of
standard precautions.
If you have questions regarding this information, please contact Marianne
Missfeldt, Nurse Consultant at marianne.missfeldt@dhs.wisconsin.gov
or at 715-836-4036.
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