{"ref":"MI-HSP-PAIN-01","title":"Pain and Symptom Management and Care of the Actively Dying Patient","category":"Hospice care","summary":"Sets out how the Agency assesses, treats and reassesses pain and other distressing symptoms for every patient, the symptom management guidelines nurses and physicians use, safe opioid practice in the home, how a pain or symptom crisis is handled at any hour, and how the team cares for a patient who is actively dying and supports the family through the last days and hours.","inShort":["Every patient has a right to good pain and symptom control. Ask about pain and other symptoms at every visit.","Use the Agency's rating scale, or the observation tool if the patient cannot tell you.","Check whether an as-needed dose worked and write down the result.","If pain or another symptom is not controlled, call the hospice physician the same day, and at once if it is severe.","When death is near, visit more, teach the family what to expect, and remind them to call us first."],"primaryCitation":"MCL 333.20201(2)(o)","citations":["MCL 333.20201(2)(o)","Mich. Admin. Code R 325.45351(1)","Mich. Admin. Code R 325.45351(5)","Mich. Admin. Code R 325.45353(1)-(3)","Mich. Admin. Code R 325.45353(6)","Mich. Admin. Code R 325.45353(7)","Mich. Admin. Code R 325.45367(2)-(3)","MCL 333.21415(2)"],"federalCitations":["42 CFR §418.52(c)(1)","42 CFR §418.52(c)(3)","42 CFR §418.54(c)","42 CFR §418.54(d)","42 CFR §418.54(e)","42 CFR §418.56(c)(1)","42 CFR §418.56(b)","42 CFR §418.104(a)(3)","42 CFR §418.204(a)"],"surveyorAsks":["How do you assess pain in a patient who cannot tell you about it?","Show me how this patient's pain was reassessed after the as-needed dose and what the team changed when it did not work."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (MCL 333.20201(2)(o))","5. Assessment of Pain and Symptoms","6. Planning and Treatment","7. Reassessment After Treatment","8. Safe Opioid Practice","9. Pain and Symptom Crises at Any Hour","10. Care of the Actively Dying Patient","11. Facility Residents","12. Quality Monitoring","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"mi-hospice","state":"Michigan","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}}