SECTION 558.832. Hospice Nursing Services

(a) A hospice must provide nursing services by or under the supervision of an RN. An RN must ensure that the nursing needs of a client are met as identified in the client's initial assessment, comprehensive assessment, and updated assessments.

(b) An advanced practice nurse providing nursing services to a client and acting within the nurse's scope of practice may write orders for the client in accordance with a hospice's written policies and applicable State law, including the Texas Occupations Code Chapter 157, Authority of Physician to Delegate Certain Medical Acts; Texas Occupations Code Chapter 301, Nurses; and Texas Health and Safety Code Chapter 481, Texas Controlled Substances Act, and Chapter 483, Dangerous Drugs.

(c) A hospice may provide highly specialized nursing services under contract if the hospice provides such nursing services to a client so infrequently that providing them by a hospice employee would be impracticable and prohibitively expensive. A hospice may determine that a nursing service, such as complex wound care, infusion specialties, and pediatric nursing, is highly specialized by the nature of the service and the level of nursing skill required to be proficient in the service.

Source Note: The provisions of this §558.832 adopted to be effective October 1, 2013, 38 TexReg 6628; transferred effective May 1, 2019, as published in the April 12, 2019 issue of the Texas Register, 44 TexReg 1893; amended to be effective April 25, 2021, 46 TexReg 2427