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24-Hour Availability, On-Call and After-Hours Response

Explains how the Agency makes nursing services, physician services and drugs and biologicals routinely available 24 hours a day, 7 days a week, and other services around the clock when reasonable and necessary: how patients are taught to reach the Agency, how the on-call system works and the Agency's response standards, how after-hours drugs, supplies and equipment are obtained, what to do in emergencies, and how backup is arranged when scheduled staff are unavailable.

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About this policy
Policy number
PA-HSP-SVC-01
Version
1.0
Main rule
42 CFR §418.100(c)(2)
Library
Pennsylvania hospice · 60 policies
Category
Service delivery
Sections
20

In short

  • A nurse and a hospice physician are on call 24 hours a day, every day. The after-hours number is (717) 555-0199.
  • Teach every family when and how to call us, and to call us before 911 for problems related to the illness.
  • Call back within 15 minutes (5 minutes if the patient is in severe distress or has died). If a visit is needed, leave within 30 minutes.
  • Record every call in the on-call log and hand over to the RN coordinator by 9 a.m. the next working day.
  • If you cannot make a scheduled visit, tell the scheduler or clinical manager right away so backup can be arranged.

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 (42 CFR §418.100(c)(2))
  • 5. Teaching Patients How to Reach the Agency
  • 6. The On-Call System
  • 6.1 Response standards (Agency standards)
  • 6.2 Handling the call
  • 6.3 Drugs, supplies and equipment after hours
  • 7. Other Services Around the Clock
  • 8. Emergencies in the Home
  • 9. Backup When Scheduled Staff Are Not Available
  • 10. Responsibilities
  • 11. Records and Compliance Monitoring
  • 12. Staff Training
  • 13. References
  • 14. Related Policies and Forms
  • 15. Approval
  • 16. Revision History

An inspector may ask

  • Call your after-hours number now. Who answers, and how quickly does a nurse call back?
  • How did you teach this patient to reach you at night?

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