Nursing Services, Registered Nurse Coordinator and LPN Supervision

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.

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About this policy

Policy number: MO-HSP-NUR-01
Version: 1.0
Main rule: 19 CSR 30-35.010(2)(G)1
Library: Missouri hospice · 59 policies
Category: Clinical tasks
Sections: 20

In short

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.

What's inside

20 sections. The full text comes with the One-time Policy Pack.

Full text with a package

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

An inspector may ask

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?

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Rules it follows

19 CSR 30-35.010(2)(G)119 CSR 30-35.010(1)(A)20, 30, 31, 3219 CSR 30-35.010(1)(E)2.A19 CSR 30-35.010(2)(B)319 CSR 30-35.010(2)(E)1-319 CSR 30-35.010(2)(K)2, 419 CSR 30-35.010(2)(L)2.C19 CSR 30-35.010(2)(M)3RSMo §335.016(15)RSMo §335.36013 CSR 70-50.010(5)42 CFR §418.64(b)42 CFR §418.56(a)(1)42 CFR §418.54(a)42 CFR §418.6242 CFR §418.114(a)42 CFR §418.76(h)

Forms included

MO-HSP-NUR-01-A LPN On-Site Supervisory Visit Record

Read a sample in full

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