1. (a) A full-service hospice agency shall have a physician or advanced practice registered nurse to serve as medical director and assume overall responsibility for each client's care program. The medical director shall be a member of and oversee the interdisciplinary team and the professional advisory committee. The medical director's duties include verifying that certification of terminal illness has been issued in accordance with 7 AAC 12.318(a)(2).

2. (b) The program director shall designate a registered nurse to serve as the nurse coordinator. The nurse coordinator shall

   1. (1) supervise the agency's employees and contracted staff;
   2. (2) be available at all times for consultation during regular office hours or have a qualified designee if the nurse coordinator is on leave status or otherwise unavailable to the agency;
   3. (3) ensure that the agency has sufficient staff to meet patient needs;
   4. (4) be responsible for the development of nursing objectives, policies, and procedures consistent with hospice philosophy;
   5. (5) establish staffing and on-call schedules for nursing staff to ensure the availability of nursing services 24 hours a day, seven days a week; and
   6. (6) participate in the developing job descriptions and making employment decisions affecting hospice personnel who provide direct services.

3. (c) The program director shall have authority over and responsibility for the

   1. (1) functions, activities, and evaluation of professional and ancillary staff to assure conformance with applicable state and federal laws, agency policies and procedures, and applicable professional standards; and
   2. (2) implementation of client care policies and procedures.

4. (d) The agency shall provide nursing care and services by or under the supervision of a registered nurse. Nursing services must be directed and staffed to assure that each client's nursing needs are met. Hospice nursing services include

   1. (1) identifying the physical, psychosocial, and environmental needs of the client and the client's family;
   2. (2) conducting detailed and comprehensive assessments of each client upon admission and when significant changes occur in the client's condition;
   3. (3) addressing symptom management and comfort care needs;
   4. (4) implementing client teaching based on the client's needs consistent with agency policies and procedures, including demonstration, supervision, and evaluation;
   5. (5) documenting problems, appropriate goals, interventions, and client and family response to hospice care;
   6. (6) coordination of all client and family services;
   7. (7) supervision of other nursing personnel; and
   8. (8) preparation of clinical progress notes.

(Eff. 5/24/2007, Register 182; am 5/14/2021, Register 238)

Authority: AS 47.32.010, AS 47.32.030