{"ref":"PA-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, plans for, treats and reassesses pain and other distressing symptoms, how symptom crises are escalated to continuous home care or general inpatient care, and how the team cares for a patient who is actively dying and supports the family at the bedside.","inShort":["Every patient has the right to effective pain and symptom control. Assess pain at every visit and every on-call call.","If the patient cannot tell you, use an observation scale such as PAINAD, and use the same tool each time.","After any change for uncontrolled pain, follow up by the next day at the latest.","Tell families to call the Agency at any hour, not to wait for the next visit.","Report sedation, confusion or slow breathing to the prescriber at once."],"primaryCitation":"42 CFR §418.52(c)(1)","citations":["35 P.S. §448.802a","55 Pa. Code §1130.63(a)"],"federalCitations":["42 CFR §418.52(c)(1)","42 CFR §418.54(c)","42 CFR §418.54(c)(4)-(5)","42 CFR §418.56(c)","42 CFR §418.56(c)(1)","42 CFR §418.100(c)(2)","42 CFR §418.108","42 CFR §418.202(e)","42 CFR §418.204(a)"],"surveyorAsks":["How do you assess pain in a patient who cannot tell you about it?","Show me the pain and symptom interventions in this patient's plan of care and how you know they are working."],"forms":[],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.52(c)(1))","5. Assessing Pain and Symptoms","6. Planning Care","7. Treating and Reassessing","8. Symptom Crises and Escalation","9. Care of the Actively Dying Patient","10. Palliative Sedation","11. Responsibilities","12. Records and Compliance Monitoring","13. Staff Training","14. References","15. Related Policies and Forms","16. Approval","17. Revision History"],"version":"1.0","sample":false,"pack":"pa-hospice","state":"Pennsylvania","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}}