{"ref":"GA-HSP-ADM-01","title":"Referral, Eligibility and Admission","category":"Hospice care","summary":"Sets the Agency’s written admission criteria and the steps from referral to admission for home hospice care: a physician referral based on a personal evaluation, an initial assessment, informed consent, written certification, residence in the service area, a designated primary caregiver or a detailed plan where there is none, an initial plan of care within 24 hours, and no exclusion for inability to pay. It points to the criteria for inpatient, residential and palliative care admissions.","inShort":["Log every referral the day it comes in and contact the family within four office hours.","Admit only with a physician referral, an initial assessment, written consent, written certification and an address in our service area.","Name a primary caregiver in writing (Form GA-HSP-ADM-01-B). If there is none, write a detailed plan for daily care and safety.","Finish the initial plan of care within 24 hours of admission.","Never turn down or delay a patient because they cannot pay."],"primaryCitation":"Ga. Comp. R. & Regs. 111-8-37-.14(1)-(2)","citations":["Ga. Comp. R. & Regs. 111-8-37-.14(1)-(4)","Ga. Comp. R. & Regs. 111-8-37-.03(k), (x), (ee)","Ga. Comp. R. & Regs. 111-8-37-.07(5)(i)","Ga. Comp. R. & Regs. 111-8-37-.16(1)"],"federalCitations":["42 CFR §418.20","42 CFR §418.25","42 CFR §418.54(a)","42 CFR §418.205","42 U.S.C. §1396d(o)(1)(C)"],"surveyorAsks":["Show me your written admission criteria for home hospice care, inpatient care, residential care and palliative care.","For this patient, show me the physician referral, the initial assessment, the written consent, the written certification and the initial plan of care made within 24 hours of admission."],"forms":[{"ref":"GA-HSP-ADM-01-A","title":"Referral and Admission Eligibility Record"},{"ref":"GA-HSP-ADM-01-B","title":"Primary Caregiver Designation"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (Ga. Comp. R. & Regs. 111-8-37-.14(1)-(2))","5. Admission Criteria for Home Hospice Care","6. Receiving a Referral","7. Physician Recommendation and Certification","8. The Admission Visit","9. Primary Caregiver or Detailed Plan","10. Other Kinds of Admission","11. Home Care Days","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"ga-hospice","state":"Georgia","service":"Hospice","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"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}