{"ref":"MO-HSP-NUR-01","title":"Nursing Services, Registered Nurse Coordinator and LPN Supervision","category":"Clinical tasks","summary":"Sets out how the Agency provides nursing services through direct employees under Missouri's hospice rule: recognized standards of practice, staffing that meets every patient's nursing needs, a registered nurse initial assessment visit within 48 hours of election, the registered nurse's responsibility for ongoing assessment and planning, RN supervision of licensed practical nurses (available at least by phone and an on-site supervisory visit at least monthly), 24-hour nursing coverage, the role of the registered nurse coordinator and case manager, and when contracted nurses may be used.","inShort":["An RN makes the first assessment visit within 48 hours of the patient electing hospice. Tell the registered nurse coordinator at once if that time will be missed.","The RN plans and directs nursing care. LPNs give care under RN direction and report changes the same day.","An RN must be reachable by phone whenever an LPN is working or on call, and visits on site at least once a month to check the LPN's care.","A nurse is on call 24 hours a day for calls and visits. The medical director or physician designee backs up the on-call nurse.","Finish each visit note the same day if you can, and always within 24 hours."],"primaryCitation":"19 CSR 30-35.010(2)(G)1","citations":["19 CSR 30-35.010(2)(G)1","19 CSR 30-35.010(1)(A)20, 30, 31, 32","19 CSR 30-35.010(1)(E)2.A","19 CSR 30-35.010(2)(B)3","19 CSR 30-35.010(2)(E)1-3","19 CSR 30-35.010(2)(K)2, 4","19 CSR 30-35.010(2)(L)2.C","19 CSR 30-35.010(2)(M)3","RSMo §335.016(15)","RSMo §335.360","13 CSR 70-50.010(5)"],"federalCitations":["42 CFR §418.64(b)","42 CFR §418.56(a)(1)","42 CFR §418.54(a)","42 CFR §418.62","42 CFR §418.114(a)","42 CFR §418.76(h)"],"surveyorAsks":["Show me the RN initial assessment visit for this patient. Was it within 48 hours of election?","How is the LPN on this case supervised? Where are the monthly on-site supervisory visits documented?"],"forms":[{"ref":"MO-HSP-NUR-01-A","title":"LPN On-Site Supervisory Visit Record"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (19 CSR 30-35.010(2)(G)1; 42 CFR §418.64(b))","5. Organization of Nursing Services","6. Direct Employees and Contracted Nurses","7. Who Does What","8. The RN Initial Assessment Visit","9. Supervision of Licensed Practical Nurses (19 CSR 30-35.010(2)(G)1.D)","10. Ongoing Nursing Care","11. Twenty-Four-Hour Nursing Coverage","12. Licenses and Practice","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":"mo-hospice","state":"Missouri","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}}