{"pack":"tx-hospice","path":"/policies/texas/hospice/","name":"Texas Hospice Policy and Procedure Manual (HCSSA)","state":"Texas","service":"Hospice","license":"HCSSA license, Hospice services","count":59,"forms":47,"categories":[{"name":"Patient rights","count":4},{"name":"Service delivery","count":2},{"name":"Hospice care","count":17},{"name":"Clinical tasks","count":9},{"name":"Safeguarding","count":2},{"name":"Infection control","count":2},{"name":"Emergency preparedness","count":1},{"name":"Records","count":1},{"name":"Privacy","count":3},{"name":"Human resources","count":6},{"name":"Governance","count":7},{"name":"Quality","count":2},{"name":"Business","count":2},{"name":"Ethics","count":1}],"policies":[{"ref":"TX-HSP-CMP-01","path":"/policies/texas/hospice/complaints-and-grievances/","title":"Complaints and Grievances","category":"Patient rights","citation":"26 TAC §558.250(c)","summary":"Explains how patients, families, guardians and health care providers can complain about hospice care without fear of reprisal, how staff take and log every complaint, how the Agency acknowledges, investigates and resolves it within the time frames in this policy and Texas rule, and how patients can go directly to HHSC.","sample":true},{"ref":"TX-HSP-PR-01","path":"/policies/texas/hospice/patient-rights-and-responsibilities/","title":"Patient Rights and Responsibilities","category":"Patient rights","citation":"42 CFR §418.52","summary":"Sets out the rights every hospice patient has, how and when the Agency gives the patient spoken and written notice of those rights and responsibilities, how the patient’s signature and understanding are recorded, the extra notices Texas requires at admission (complaints, abuse reporting and, for patients aged 60 or over, the Rights of the Elderly), and how staff protect those rights in daily practice.","sample":false},{"ref":"TX-HSP-PR-02","path":"/policies/texas/hospice/patient-service-agreement-informed-consent-and-disclosures/","title":"Patient Service Agreement, Informed Consent and Disclosures","category":"Patient rights","citation":"26 TAC §558.292","summary":"Explains the written service agreement the Agency gives every patient, what it must contain, how informed consent is obtained and recorded, what the patient is told about payment before care starts, and the other written disclosures Texas requires at or after admission.","sample":false},{"ref":"TX-HSP-PR-03","path":"/policies/texas/hospice/advance-directives-and-out-of-hospital-do-not-resuscitate-orders/","title":"Advance Directives and Out-of-Hospital Do-Not-Resuscitate Orders","category":"Patient rights","citation":"26 TAC §558.283","summary":"Sets out how the Agency tells every patient about its advance directive policy and the patient’s rights under Texas law, when that notice is due and to whom it goes if the patient is incapacitated, how directives and out-of-hospital do-not-resuscitate orders are recorded and honored, and what the Agency is unable to provide or withhold.","sample":false},{"ref":"TX-HSP-SAF-01","path":"/policies/texas/hospice/staff-safety-and-emergencies-in-the-home/","title":"Staff Safety and Emergencies in the Home","category":"Service delivery","citation":"26 TAC §558.281","summary":"Sets out how the Agency keeps patients and staff safe in the home: the home safety assessment, what staff do in each kind of emergency during a visit, how staff stay safe on visits and on the road, the workplace violence prevention committee, policy and plan that Texas Health and Safety Code Chapter 331 requires while the Agency employs at least two registered nurses, how incidents of violence are handled, when visits may be stopped for safety, and how staff injuries and hazardous chemicals are managed.","sample":false},{"ref":"TX-HSP-SVC-01","path":"/policies/texas/hospice/24-hour-availability-on-call-and-backup-services/","title":"24-Hour Availability, On-Call and Backup Services","category":"Service delivery","citation":"26 TAC §558.290","summary":"Sets out how the Agency makes nursing, physician services and drugs available 24 hours a day, seven days a week, how patients are taught to reach the Agency after hours, how the on-call nurse responds, and how backup services are arranged when a scheduled staff member is not available.","sample":false},{"ref":"TX-HSP-ADM-01","path":"/policies/texas/hospice/referral-eligibility-screening-and-admission/","title":"Referral, Eligibility Screening and Admission","category":"Hospice care","citation":"42 CFR §418.25","summary":"Sets out how the Agency receives and screens referrals, the time frames it has set for starting care, how a physician recommends admission and how eligibility is decided, what happens at the admission visit, how the current patient list is kept, and the special steps for children, facility residents and patients near the edge of the service area.","sample":false},{"ref":"TX-HSP-ASM-01","path":"/policies/texas/hospice/initial-and-comprehensive-assessment-and-hospice-outcome-data/","title":"Initial and Comprehensive Assessment and Hospice Outcome Data","category":"Hospice care","citation":"42 CFR §418.54","summary":"Sets out who completes the initial assessment and when, how the interdisciplinary group completes the comprehensive assessment within 5 calendar days and updates it at least every 15 days, what each assessment must cover, when a patient must be reassessed between updates, and how outcome data and the standardized hospice quality item set are collected.","sample":false},{"ref":"TX-HSP-BRV-01","path":"/policies/texas/hospice/bereavement-program/","title":"Bereavement Program","category":"Hospice care","citation":"42 CFR §418.64(d)(1)","summary":"Sets out the Agency’s organized bereavement program: who supervises it, how bereavement needs are assessed before and after the death, how each bereavement plan of care is written, and how services are offered to the family and others for up to one year after the patient’s death.","sample":false},{"ref":"TX-HSP-CNS-01","path":"/policies/texas/hospice/spiritual-and-dietary-counseling/","title":"Spiritual and Dietary Counseling","category":"Hospice care","citation":"42 CFR §418.64(d)","summary":"Sets out how the Agency makes counseling available to patients and families, and how spiritual counseling and dietary counseling are assessed, offered and provided in a way that respects each family’s beliefs and wishes.","sample":false},{"ref":"TX-HSP-DC-01","path":"/policies/texas/hospice/discharge-transfer-and-discharge-for-cause/","title":"Discharge, Transfer and Discharge for Cause","category":"Hospice care","citation":"42 CFR §418.26","summary":"Sets out the only reasons the Agency may discharge a patient, the steps required before a discharge for cause, the physician discharge order, discharge planning for patients who are no longer terminally ill, the Texas written notice and its timing, the Medicare notice of non-coverage and notice of termination, the discharge summary, and transfers to other providers.","sample":false},{"ref":"TX-HSP-DTH-01","path":"/policies/texas/hospice/death-in-the-home-pronouncement-of-death-and-post-death-care/","title":"Death in the Home, Pronouncement of Death and Post-Death Care","category":"Hospice care","citation":"26 TAC §558.302","summary":"Sets out how the Agency prepares families for an expected death at home, how a trained registered nurse determines and pronounces death under Texas Health and Safety Code §671.001, which deaths must be reported for an inquest, who is notified, how the death certificate is completed, and how post-death care is given.","sample":false},{"ref":"TX-HSP-ELC-01","path":"/policies/texas/hospice/election-of-the-hospice-benefit-and-notice-of-election/","title":"Election of the Hospice Benefit and Notice of Election","category":"Hospice care","citation":"42 CFR §418.24","summary":"Explains who may elect hospice, what the election statement must contain under Texas and Medicare rules, how the effective date is set, how and when the Agency gives the new election statement addendum \"Patient Notification of Hospice Non-Covered Items, Services, and Drugs\" for elections from October 1, 2026, how it is updated, and how the Notice of Election is filed on time.","sample":false},{"ref":"TX-HSP-ELC-02","path":"/policies/texas/hospice/certification-and-recertification-of-terminal-illness-and-face-to-face/","title":"Certification and Recertification of Terminal Illness and Face-to-Face Encounters","category":"Hospice care","citation":"42 CFR §418.22","summary":"Sets out how the Agency obtains written certification and recertification of terminal illness for every benefit period, the time limits for oral and written certification, who may certify, what the physician narrative must contain, and how face-to-face encounters before the third and later benefit periods are done, including the limits on telehealth encounters.","sample":false},{"ref":"TX-HSP-ELC-03","path":"/policies/texas/hospice/revocation-change-of-designated-hospice-and-change-of-attending/","title":"Revocation, Change of Designated Hospice and Change of Attending Physician","category":"Hospice care","citation":"42 CFR §418.28","summary":"Explains how a patient revokes the hospice election, changes to another hospice or changes attending physician, what each statement must contain, what the Agency must send to the attending physician or the new hospice, and the 5-calendar-day notice the Agency files with its Medicare contractor after a revocation.","sample":false},{"ref":"TX-HSP-FAC-01","path":"/policies/texas/hospice/hospice-care-for-residents-of-a-nursing-facility-or-icf-iid/","title":"Hospice Care for Residents of a Nursing Facility or ICF/IID","category":"Hospice care","citation":"42 CFR §418.112","summary":"Sets out how the Agency provides hospice care to residents of a skilled nursing facility, nursing facility or intermediate care facility for individuals with an intellectual disability or related conditions: the written agreement signed before care starts, professional management, a shared plan of care, the designated coordinating team member, the information packet given to the facility, orientation of facility staff, reporting alleged violations, bereavement support for facility staff, and drug disposal.","sample":false},{"ref":"TX-HSP-FAC-02","path":"/policies/texas/hospice/short-term-inpatient-care-arrangements/","title":"Short-Term Inpatient Care Arrangements","category":"Hospice care","citation":"42 CFR §418.108","summary":"Sets out how the Agency makes short-term inpatient care available for pain control, symptom management and respite: which settings qualify, the written agreement each contracted facility must sign, criminal history checks for contracted staff, training of facility staff, records exchange, verification that the agreement is followed, and monitoring of the inpatient day limit.","sample":false},{"ref":"TX-HSP-FAC-03","path":"/policies/texas/hospice/hospice-inpatient-unit-operations/","title":"Hospice Inpatient Unit Operations","category":"Hospice care","citation":"42 CFR §418.110","summary":"Applies only if the Agency operates its own hospice inpatient unit. Sets out staffing and 24-hour nursing, the nurse call system, the physical environment and fire safety, patient areas and rooms, infection control, meals, restraint and seclusion with their time limits and death reporting, pharmacy services and controlled drugs, and the unit’s disaster plan and exercises.","sample":false},{"ref":"TX-HSP-IDG-01","path":"/policies/texas/hospice/interdisciplinary-group/","title":"Interdisciplinary Group","category":"Hospice care","citation":"42 CFR §418.56(a)","summary":"Sets out how the Agency designates its interdisciplinary group, who must be on it under Texas and Medicare rules, how a registered nurse is designated to coordinate each patient’s care, how the group meets, supervises care and records its work, and which group sets day-to-day policy if there is more than one.","sample":false},{"ref":"TX-HSP-IDG-02","path":"/policies/texas/hospice/plan-of-care-plan-of-care-review-and-caregiver-education/","title":"Plan of Care, Plan of Care Review and Caregiver Education","category":"Hospice care","citation":"42 CFR §418.56(b)-(d)","summary":"Sets out how the interdisciplinary group writes an individualized plan of care for every patient with the attending practitioner, patient and caregiver, what the plan must contain, how it is reviewed and revised at least every 15 calendar days, how patients and caregivers are taught to carry out their part of the plan, and how plan changes link to the election statement addendum.","sample":false},{"ref":"TX-HSP-IDG-03","path":"/policies/texas/hospice/coordination-of-services-and-receipt-of-physician-orders/","title":"Coordination of Services and Receipt of Physician Orders","category":"Hospice care","citation":"42 CFR §418.56(e)","summary":"Sets out the Agency’s system for sharing information among all disciplines and settings and with other providers, and the protocols staff follow when receiving physician and practitioner orders, including who may take verbal orders, how they are recorded, the Agency’s time frame for countersignature, and safeguards for faxed and electronic orders.","sample":false},{"ref":"TX-HSP-LOC-01","path":"/policies/texas/hospice/levels-of-care-routine-home-care-continuous-home-care-respite-and/","title":"Levels of Care: Routine Home Care, Continuous Home Care, Respite and General Inpatient Care","category":"Hospice care","citation":"42 CFR §418.302","summary":"Describes the four levels of hospice care (routine home care, continuous home care, inpatient respite care and general inpatient care), when each may be used, who decides, how a change in level of care is ordered and documented, where inpatient care may be provided, and the limits on respite and inpatient days.","sample":false},{"ref":"TX-HSP-PAIN-01","path":"/policies/texas/hospice/pain-and-symptom-management-and-care-of-the-actively-dying-patient/","title":"Pain and Symptom Management and Care of the Actively Dying Patient","category":"Hospice care","citation":"42 CFR §418.52(c)(1)","summary":"Sets out how the Agency assesses, plans for, treats and reassesses pain and other distressing symptoms, how symptom crises are escalated, and how the team cares for a patient who is actively dying and supports the family at the bedside.","sample":false},{"ref":"TX-HSP-AIDE-01","path":"/policies/texas/hospice/hospice-aide-and-homemaker-services/","title":"Hospice Aide and Homemaker Services","category":"Clinical tasks","citation":"42 CFR §418.76","summary":"Sets out who may work as a hospice aide or hospice homemaker for the Agency, the aide training, competency evaluation and in-service requirements, how aides are assigned and instructed, the registered nurse supervisory visits every 14 days and every year, and how homemaker and Medicaid personal care services are coordinated.","sample":false},{"ref":"TX-HSP-DME-01","path":"/policies/texas/hospice/medical-supplies-and-durable-medical-equipment/","title":"Medical Supplies and Durable Medical Equipment","category":"Clinical tasks","citation":"26 TAC §558.860","summary":"Sets out how the Agency provides medical supplies, appliances and durable medical equipment related to the terminal illness, how it chooses suppliers, how equipment is kept safe and maintained, how patients and families are taught to use it, and the Agency’s oxygen safety practice.","sample":false},{"ref":"TX-HSP-LAB-01","path":"/policies/texas/hospice/laboratory-services-and-waived-testing/","title":"Laboratory Services and Waived Testing","category":"Clinical tasks","citation":"26 TAC §558.284","summary":"Sets out when hospice staff may do laboratory tests: helping a patient use their own FDA-approved home test, performing waived tests such as fingerstick blood glucose under the Agency’s CLIA Certificate of Waiver, and collecting specimens for a CLIA-certified reference laboratory. Covers the certificate, following manufacturer instructions, competency, quality checks, results and records.","sample":false},{"ref":"TX-HSP-MED-01","path":"/policies/texas/hospice/drugs-and-biologicals-ordering-drug-management-review-labeling-and/","title":"Drugs and Biologicals: Ordering, Drug Management Review, Labeling and Safe Use","category":"Clinical tasks","citation":"42 CFR §418.106","summary":"Sets out how the Agency provides drugs and biologicals related to the terminal illness, how the interdisciplinary group reviews each patient’s drugs with a person trained in drug management, who may order drugs, how verbal orders are handled, how drugs are obtained, labeled, administered and stored safely in the home, and how the Agency handles emergency drug containers, vaccines and adverse reactions.","sample":false},{"ref":"TX-HSP-MED-02","path":"/policies/texas/hospice/controlled-substances-in-the-home-management-and-disposal/","title":"Controlled Substances in the Home: Management and Disposal","category":"Clinical tasks","citation":"26 TAC §558.861","summary":"Sets out how the Agency manages controlled substance prescription drugs in patients’ homes: what the patient and family are given and told when a controlled substance is first ordered, how the drugs are kept safe, the governing body’s decision that Agency nurses will dispose of unused controlled substances, when and how disposal is done and recorded, and what happens if diversion is suspected.","sample":false},{"ref":"TX-HSP-NUR-01","path":"/policies/texas/hospice/nursing-services-and-nursing-practice/","title":"Nursing Services and Nursing Practice","category":"Clinical tasks","citation":"42 CFR §418.64(b)","summary":"Sets out how the Agency provides nursing services by or under the supervision of a registered nurse, what registered nurses, licensed vocational nurses and advanced practice registered nurses may do, how intravenous, procedural and psychiatric nursing are handled, and how the Agency makes sure every nurse practices within the Texas Board of Nursing rules.","sample":false},{"ref":"TX-HSP-NUR-02","path":"/policies/texas/hospice/rn-delegation-tasks-not-requiring-delegation-and-physician-delegation/","title":"RN Delegation, Tasks Not Requiring Delegation and Physician Delegation","category":"Clinical tasks","citation":"26 TAC §558.298","summary":"Sets out the Agency’s decisions on registered nurse delegation, tasks that do not require delegation, and physician delegation, and how a registered nurse decides whether a hospice aide may perform a nursing task for a particular patient under the Texas Board of Nursing rules in 22 TAC Chapters 224 and 225.","sample":false},{"ref":"TX-HSP-SW-01","path":"/policies/texas/hospice/medical-social-services/","title":"Medical Social Services","category":"Clinical tasks","citation":"42 CFR §418.64(c)","summary":"Sets out who may provide medical social services for the Agency, how the social worker assesses the patient’s and family’s psychosocial needs, what services the social worker provides under physician direction, and how social work is documented and supervised.","sample":false},{"ref":"TX-HSP-THR-01","path":"/policies/texas/hospice/physical-therapy-occupational-therapy-and-speech-language-pathology/","title":"Physical Therapy, Occupational Therapy and Speech-Language Pathology","category":"Clinical tasks","citation":"42 CFR §418.72","summary":"Sets out how the Agency makes physical therapy, occupational therapy and speech-language pathology available to hospice patients, who may provide them, when they are used, and how therapy is ordered, planned, delivered and documented.","sample":false},{"ref":"TX-HSP-ANE-01","path":"/policies/texas/hospice/recognizing-and-reporting-abuse-neglect-and-exploitation/","title":"Recognizing and Reporting Abuse, Neglect and Exploitation","category":"Safeguarding","citation":"26 TAC §558.249","summary":"Tells every employee, contractor and volunteer how to recognize abuse, neglect and exploitation of a hospice patient and exactly whom to tell: HHSC immediately when Agency staff are suspected, DFPS when someone else is suspected or the patient is self-neglecting, the facility administrator when a resident is harmed by non-hospice staff, and the Administrator every time. Gives every patient a written notice of how to report.","sample":true},{"ref":"TX-HSP-ANE-02","path":"/policies/texas/hospice/agency-investigations-and-provider-investigation-reports/","title":"Agency Investigations and Provider Investigation Reports","category":"Safeguarding","citation":"26 TAC §558.250","summary":"Sets out how the Agency investigates allegations of abuse, neglect and exploitation and other alleged violations: starting immediately, protecting patients, completing and sending the HHSC Provider Investigation Report (Form 3613) no later than the 10th day after the report, finishing within 30 days unless a documented reasonable cause exists, reporting verified violations, and taking corrective action.","sample":false},{"ref":"TX-HSP-IC-01","path":"/policies/texas/hospice/infection-prevention-and-control-program-and-medical-waste/","title":"Infection Prevention and Control Program and Medical Waste","category":"Infection control","citation":"42 CFR §418.60","summary":"Sets out the Agency’s infection prevention and control program: standard and transmission-based precautions, staff health, surveillance and the patient infection log, reporting of notifiable conditions, infection control education for staff, volunteers, patients and families, and the safe handling and disposal of medical waste and sharps.","sample":true},{"ref":"TX-HSP-IC-02","path":"/policies/texas/hospice/bloodborne-pathogens-exposure-control-plan/","title":"Bloodborne Pathogens Exposure Control Plan","category":"Infection control","citation":"29 CFR §1910.1030","summary":"The Agency’s written Exposure Control Plan under the OSHA Bloodborne Pathogens standard: which jobs and tasks carry exposure, how exposure is prevented, the hepatitis B vaccination program, what happens after an exposure, training, and the medical, training and sharps injury records the Agency keeps.","sample":false},{"ref":"TX-HSP-EP-01","path":"/policies/texas/hospice/emergency-preparedness-program/","title":"Emergency Preparedness Program","category":"Emergency preparedness","citation":"42 CFR §418.113","summary":"Sets out the Agency’s all-hazards emergency preparedness program: the risk assessment and written plan, the disaster coordinator and alternate, continuity of operations, patient triage categories, help with STEAR registration, what each patient is told, communication with staff, patients, officials and HHSC, the emergency documentation system, arrangements with other hospices, training, exercises, and review.","sample":false},{"ref":"TX-HSP-REC-01","path":"/policies/texas/hospice/clinical-records-retention-and-patient-list/","title":"Clinical Records, Retention and Patient List","category":"Records","citation":"42 CFR §418.104","summary":"Sets out how the Agency keeps one complete, accurate and secure clinical record for every hospice patient: what goes in it, how entries are made, signed and corrected, where active records are kept, how long records are retained, how records are released and retrieved, what is sent when a patient is transferred or discharged, and how the current patient list is maintained.","sample":false},{"ref":"TX-HSP-PRV-01","path":"/policies/texas/hospice/hipaa-privacy-and-texas-medical-records-privacy/","title":"HIPAA Privacy and Texas Medical Records Privacy","category":"Privacy","citation":"45 CFR Part 164 Subpart E","summary":"Explains how staff protect the health information of hospice patients and their families: who may see it, when it may be shared with family, facilities and other providers, what patients may ask for, and how the Agency applies the HIPAA Privacy Rule together with the stricter Texas rules on electronic disclosure, training and the records of patients age 60 and over.","sample":false},{"ref":"TX-HSP-PRV-02","path":"/policies/texas/hospice/hipaa-security/","title":"HIPAA Security","category":"Privacy","citation":"45 CFR Part 164 Subpart C","summary":"Explains how the Agency keeps electronic patient information safe: the risk analysis, who has access, passwords and locked devices, the phones and tablets nurses carry, backups and the emergency medical documentation system, business associate agreements, and what staff do when a device is lost or something looks wrong.","sample":false},{"ref":"TX-HSP-PRV-03","path":"/policies/texas/hospice/breach-notification/","title":"Breach Notification","category":"Privacy","citation":"45 CFR Part 164 Subpart D","summary":"Explains what happens when patient information is lost, stolen, sent to the wrong person or seen by someone who should not see it: staff report it the same day, the Privacy Official assesses it, and the Agency notifies every individual, the federal government, the Texas Attorney General, the media and consumer reporting agencies when and as the law requires.","sample":false},{"ref":"TX-HSP-HR-01","path":"/policies/texas/hospice/staffing-orientation-competency-and-in-service-training/","title":"Staffing, Orientation, Competency and In-Service Training","category":"Human resources","citation":"26 TAC §558.245","summary":"The Agency’s written staffing policy: how it keeps enough qualified staff, the job descriptions it keeps, the hospice orientation everyone receives, how it checks the competence of everyone who gives care including volunteers, yearly evaluations and discipline, pediatric competency, and the in-service training record it must keep for the last 12 months.","sample":false},{"ref":"TX-HSP-HR-02","path":"/policies/texas/hospice/personnel-qualifications-and-license-verification/","title":"Personnel Qualifications and License Verification","category":"Human resources","citation":"42 CFR §418.114","summary":"Lists the minimum qualification for every hospice discipline under Texas and federal rules, explains that every professional must be legally authorized and work only within scope, and sets out how the Agency verifies licenses and credentials before work starts and keeps them current.","sample":false},{"ref":"TX-HSP-HR-03","path":"/policies/texas/hospice/criminal-history-checks-and-registry-searches/","title":"Criminal History Checks and Registry Searches","category":"Human resources","citation":"26 TAC §558.855","summary":"Sets out who must have a criminal history check and registry searches before working for the Agency, when the searches are repeated, what bars a person, what the Agency must give staff about the Employee Misconduct Registry, how contracted staff are covered, and what happens when a check comes back with a problem.","sample":false},{"ref":"TX-HSP-HR-04","path":"/policies/texas/hospice/personnel-records/","title":"Personnel Records","category":"Human resources","citation":"26 TAC §558.246","summary":"Lists what must be in the personnel record of every employee and volunteer, how records are kept, secured and produced for surveyors, what the Agency holds for contracted staff instead, and how long records are kept.","sample":false},{"ref":"TX-HSP-HR-05","path":"/policies/texas/hospice/drug-testing-policy/","title":"Drug Testing Policy","category":"Human resources","citation":"26 TAC §558.253","summary":"States the Agency’s decision on drug testing of staff who have direct contact with patients, describes the testing method, says what happens after a positive or refused test, and requires a copy of the policy to be given to everyone applying for services and anyone who asks.","sample":false},{"ref":"TX-HSP-VOL-01","path":"/policies/texas/hospice/volunteer-program/","title":"Volunteer Program","category":"Human resources","citation":"42 CFR §418.78","summary":"Sets out how the Agency recruits, screens, trains, assigns, supervises and keeps volunteers in defined administrative and patient care roles, how volunteers document their work, and how the Agency measures volunteer hours against the 5 percent level and records the cost savings volunteers provide.","sample":false},{"ref":"TX-HSP-GOV-01","path":"/policies/texas/hospice/governing-body-and-administrator/","title":"Governing Body and Administrator","category":"Governance","citation":"26 TAC §558.852","summary":"Sets out who holds legal authority for the hospice, what the governing body must do itself, how it appoints and supervises the Administrator and the Alternate Administrator, what the Administrator is responsible for every day, and how leadership stays reachable during operating hours and when the office is closed.","sample":false},{"ref":"TX-HSP-GOV-02","path":"/policies/texas/hospice/organizational-structure-branch-offices-and-alternate-delivery-sites/","title":"Organizational Structure, Branch Offices and Alternate Delivery Sites","category":"Governance","citation":"26 TAC §558.242","summary":"Requires a current written description of the Agency’s organization, from the governing body down to the patient care level, and sets out how any alternate delivery site is supervised by the parent office so that every location is run as one hospice with one line of authority.","sample":false},{"ref":"TX-HSP-GOV-03","path":"/policies/texas/hospice/administrator-alternate-administrator-and-supervising-nurse/","title":"Administrator, Alternate Administrator and Supervising Nurse Qualifications and Training","category":"Governance","citation":"26 TAC §558.244","summary":"States who may be appointed Administrator, Alternate Administrator, supervising nurse and alternate supervising nurse of a Texas hospice, the conditions that bar a person, the 24 hours of initial training and 12 hours of yearly continuing education the administrators must complete, and how the Agency proves all of it.","sample":false},{"ref":"TX-HSP-GOV-04","path":"/policies/texas/hospice/licensure-medicare-enrollment-and-reporting-changes/","title":"Licensure, Medicare Enrollment and Reporting Changes","category":"Governance","citation":"26 TAC §558.208","summary":"Keeps the Agency’s license and, if certified, its Medicare enrollment accurate by setting out every change that must be reported to HHSC or CMS, the deadline the rule sets for each, and who files it, and by covering display of the license, the service area, and use of the word hospice.","sample":false},{"ref":"TX-HSP-GOV-05","path":"/policies/texas/hospice/agency-closure-suspension-of-operations-and-dissolution/","title":"Agency Closure, Suspension of Operations and Dissolution","category":"Governance","citation":"26 TAC §558.291","summary":"The Agency’s written contingency plan for dissolution: how patients are told and transferred safely, what HHSC and CMS must be told and when, how a temporary suspension of operations is handled, and how patient records are kept safe after the Agency stops operating.","sample":false},{"ref":"TX-HSP-GOV-06","path":"/policies/texas/hospice/hospice-program-scope-of-services-and-client-care-policies/","title":"Hospice Program, Scope of Services and Client Care Policies","category":"Governance","citation":"26 TAC §558.850","summary":"Describes the hospice program the Agency runs: whom it serves, where, which services it must provide and which must be available around the clock, which services are provided by employees and which may be contracted, and an index showing which Agency policy covers each client care element that 26 TAC §558.281 requires.","sample":false},{"ref":"TX-HSP-MD-01","path":"/policies/texas/hospice/medical-director-and-physician-services/","title":"Medical Director and Physician Services","category":"Governance","citation":"42 CFR §418.102","summary":"Sets out how the Agency designates its medical director and the physician designee who covers when the medical director is unavailable, what the medical director is responsible for, how hospice physicians work with each patient’s attending practitioner, and how physician services are made available around the clock.","sample":false},{"ref":"TX-HSP-QA-01","path":"/policies/texas/hospice/quality-assessment-and-performance-improvement/","title":"Quality Assessment and Performance Improvement","category":"Quality","citation":"42 CFR §418.58","summary":"Sets out the Agency’s hospice-wide, data-driven quality assessment and performance improvement (QAPI) program: the QAPI Committee, the measures it tracks (including adverse events, complaints, infections and medication errors), how incidents are reported on Form TX-HSP-QA-01-A, performance improvement projects, hospice quality reporting to CMS, the annual evaluation, and the governing body’s role.","sample":false},{"ref":"TX-HSP-QA-02","path":"/policies/texas/hospice/peer-review-and-professional-practice-reporting/","title":"Peer Review and Professional Practice Reporting","category":"Quality","citation":"26 TAC §558.251","summary":"Makes sure every licensed discipline at the Agency follows its own practice act on reporting and peer review: when nurses and the Agency must report a nurse to the Texas Board of Nursing, when the Agency must have a nursing peer review committee, how a nurse may ask for safe harbor peer review, and how conduct by other licensed professionals and by unlicensed staff is reported.","sample":false},{"ref":"TX-HSP-CON-01","path":"/policies/texas/hospice/contracted-services-and-professional-management-responsibility/","title":"Contracted Services and Professional Management Responsibility","category":"Business","citation":"26 TAC §558.854","summary":"Sets out when the Agency may contract for hospice services, what every contract must say, and how the Agency keeps administrative and financial management and oversight of contracted staff and services so that the patient receives the same quality of care as from Agency employees.","sample":false},{"ref":"TX-HSP-FIN-01","path":"/policies/texas/hospice/financial-solvency-billing-and-continuation-of-care/","title":"Financial Solvency, Billing and Continuation of Care","category":"Business","citation":"26 TAC §558.252","summary":"Requires the Agency to stay financially able to carry out its functions and meet payroll, keep accurate business records, submit accurate bills and claims, file Medicare election and termination notices on time, never charge patients for covered care, and never stop or reduce care to a Medicare or Medicaid patient because the patient cannot pay.","sample":false},{"ref":"TX-HSP-ETH-01","path":"/policies/texas/hospice/compliance-program-solicitation-and-referral-integrity/","title":"Compliance Program, Solicitation and Referral Integrity","category":"Ethics","citation":"26 TAC §558.255","summary":"The Agency’s written policy to comply with the Texas law against soliciting patients, and its compliance program covering kickbacks, referral relationships, marketing, eligibility integrity, exclusion screening, reporting concerns without retaliation, and responding to problems.","sample":false}],"copy":{"reviewed":"2026-11-08","intro":"For Texas agencies licensed by HHSC as a Home and Community Support Services Agency (HCSSA) in the Hospice category. The manual has 59 policies and 47 forms, with the patient forms in English and Spanish, written to 26 TAC Chapter 558, the HCSSA licensing rules, and, for Medicare-certified hospices, the hospice Conditions of Participation (42 CFR Part 418). Each policy opens with a plain-English summary and names the rule section it follows, and every one is filled in with your hospice's name and details. You get Word and PDF files to keep, and your team signs off on their phones.","rulesTitle":"What 26 TAC Chapter 558 asks your policies to cover","rules":[{"head":"Comprehensive assessment.","text":"Completed by the interdisciplinary group within 5 calendar days after the patient elects hospice, and updated at least every 15 days.","cite":"26 TAC §558.811(b) and §558.812(a)"},{"head":"Care around the clock.","text":"Nursing, physician services and drugs available 24 hours a day, seven days a week, and backup when a scheduled staff member cannot make a visit.","cite":"26 TAC §558.850(d); §558.290"},{"head":"Hospice aides.","text":"An RN supervisory visit in the home at least every 14 days, and at least 12 hours of in-service training in each 12-month period.","cite":"26 TAC §558.842(d) and §558.843(e)"},{"head":"Controlled drugs in the home.","text":"Written procedures for when a controlled drug is first ordered, discontinued or newly ordered and when the patient dies, and the governing body's decision on whether staff dispose of unused drugs.","cite":"26 TAC §558.861"},{"head":"Abuse, neglect and exploitation.","text":"Staff report at once. Abuse by agency staff goes to HHSC immediately, never later than 24 hours, and HHSC Form 3613 follows no later than the 10th day after the report.","cite":"26 TAC §558.249; §558.250(b)(3)"},{"head":"Bereavement.","text":"An organized program, supervised by a qualified professional, with services to the family for up to one year after the patient's death.","cite":"26 TAC §558.834(b)(1)"}],"asks":[{"ref":"TX-HSP-PR-01","title":"Patient Rights and Responsibilities","category":"Patient rights","q":"This patient is over 60. Where is the acknowledgment of the Rights of the Elderly?","path":"/policies/texas/hospice/patient-rights-and-responsibilities/"},{"ref":"TX-HSP-ELC-01","title":"Election of the Hospice Benefit and Notice of Election","category":"Hospice care","q":"This election began after October 1, 2026. Where is the election statement addendum, when was it furnished, and is it signed?","path":"/policies/texas/hospice/election-of-the-hospice-benefit-and-notice-of-election/"},{"ref":"TX-HSP-MED-02","title":"Controlled Substances in the Home: Management and Disposal","category":"Clinical tasks","q":"Does your agency dispose of patients’ unused controlled substances? Where is that decision written?","path":"/policies/texas/hospice/controlled-substances-in-the-home-management-and-disposal/"},{"ref":"TX-HSP-SVC-01","title":"24-Hour Availability, On-Call and Backup Services","category":"Service delivery","q":"Call your after-hours number now. Who answers, and how quickly does a nurse call back?","path":"/policies/texas/hospice/24-hour-availability-on-call-and-backup-services/"},{"ref":"TX-HSP-ANE-01","title":"Recognizing and Reporting Abuse, Neglect and Exploitation","category":"Safeguarding","q":"Ask an aide: a patient tells you the night caregiver from your agency slapped her. Whom do you call, and how fast?","path":"/policies/texas/hospice/recognizing-and-reporting-abuse-neglect-and-exploitation/"}],"faq":[{"q":"Is this the right manual for my license?","a":"It is for HCSSAs licensed in the Hospice category, whether or not they are Medicare-certified. Agencies licensed for Personal Assistance Services or for home health (LHHS or LCHHS) need the Texas PAS or Texas home health manual."},{"q":"Who may pronounce death?","a":"Texas lets a registered nurse or advanced practice registered nurse pronounce death, except where artificial life support prevents it, if the hospice's written policies permit it (Health and Safety Code §671.001(d); 26 TAC §558.302). Policy TX-HSP-DTH-01 is that written policy, approved by the supervising nurse and the medical director."},{"q":"Does it cover workplace violence prevention?","a":"Yes. Since S.B. 463 (effective September 1, 2025), Health and Safety Code Chapter 331 applies to a hospice that employs two or more registered nurses, with compliance due September 1, 2026. Policy TX-HSP-SAF-01 sets out the committee, the written policy and plan, how incidents are handled and the yearly review."},{"q":"What about HHSC's proposed rewrite of Chapter 558?","a":"HHSC proposed a rewrite of most of Chapter 558 in the Texas Register on September 18, 2026. It was not in force when this manual was last reviewed, so the policies follow the rules in force today."},{"q":"What do the 59 policies cover?","a":"Patient rights (4), service delivery (2), hospice care (17), clinical tasks (9), safeguarding (2), infection control (2), emergency preparedness (1), records (1), privacy (3), human resources (6), governance (7), quality (2), business (2) and ethics (1)."}]},"guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"},{"path":"/guides/abuse-neglect-exploitation-reporting/","h1":"Abuse, neglect and exploitation policies: what each state requires"},{"path":"/guides/infection-control-policy/","h1":"What should a home care infection control policy include?"},{"path":"/guides/staff-policy-acknowledgment/","h1":"Staff policy acknowledgment: how read-and-sign works in home care"},{"path":"/guides/how-to-write-policies-and-procedures/","h1":"How to write policies and procedures for a home care agency"}]}