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Contact Information

7090 Peak Ave.
Morgan Hill, California 95037
Phone: (408) 993-9268
Fax:     (408) 947-1923

Hospice Care

Hospice Policy

Vila Monte shall be permitted to retain up to 4 terminally ill residents who receive hospice services from a hospice agency in the facility providing all of the following conditions are met:

  • Vila Monte has received a hospice care waiver from the department.
  • Vila Monte remains in substantial compliance with the requirements of Title 22.
  • Hospice agency services are contracted for by each terminally ill resident individually or the resident’s Health Care Surrogate Decision Maker if the resident is incapacitated, not by the licensee on behalf of a resident. These hospice agency services must be provided by a hospice agency both licensed by the state and certified by the federal Medicare program.
  • A written hospice care plan is developed for each terminally ill resident by that resident’s hospice agency, and agreed to by the licensee and the resident, or the resident’s Health Care Surrogate Decision Maker, if any, prior to the initiation of hospice services in the facility for that resident, and all hospice care plans are fully implemented by the licensee and by the hospice(s).
  • The retention of any terminally ill resident in the facility does not represent a threat to the health and safety of any facility resident, or result in a violation of the personal rights of any facility resident.
  • The hospice agency and the resident agree to provide the licensee with all information necessary to allow the licensee to comply with all regulations and to assure that the resident’s needs are met.

Our hospice care plan shall be maintained in the facility for each hospice resident and shall include the following:

  • The name, office address, business telephone number, and 24-hour emergency telephone number of the hospice agency and the resident’s physician.
  • A description of the services to be provided in the facility by the hospice agency including but not limited to the type and frequency of services to be provided.
  • Designation of the resident’s primary contact person at the hospice agency, and resident’s primary and alternate care giver at the facility.
  • A description of the area of licensee’s responsibility for implementing the plan including, but not limited to, facility staff duties; record keeping; and communication with the hospice agency, resident’s physician, and the resident’s responsible person(s), if any. This description shall include the type and frequency of the tasks to be performed by the facility.
  • A description of all hospice services to be provided or arranged in the facility by persons other than the licensee, facility personnel, or the hospice agency including, but not limited to, clergy and the resident’s family members and friends.
  • On call (24/7) hospice nurse
  • Hospice nurse will perform procedures as needed not allowed by unlicensed staff (injections, dressing changes, medication titration, wound care, etc.
  • Hospice nurse may pronounce death
  • Agency will contact and arrange mortuary services
  • Agency will provide counseling and spiritual support
  • Agency will arrange for equipment as needed (hospital bed, mattress foam pads, etc.)
  • Agency will provide emergency medication packet

The licensee shall submit a report to the Department when a terminally ill resident’s hospice services are interrupted or discontinued for any reason other than the death of the resident, including refusal of hospice care or discharge from hospice. The licensee shall also report any deviation from the resident’s hospice care plan, or other incident, which threatens the health and safety of any resident. Such reports shall be made by telephone within one working day, and in writing within five working days, and shall specify all of the following:

  • The name, age, sex of each affected resident.
  • The date and nature of the event and explanatory background information leading up to the event.
  • The name and business telephone number of the hospice agency.
  • Actions taken by the licensee and any other parties to resolve the reportable event and to prevent similar occurrences in the future.

For each terminally ill resident receiving hospice services in the facility, the licensee shall maintain the following in the resident’s record:

  • The resident’s or the resident’s Health Care Surrogate Decision Maker’s written request for retention and hospice services in the facility, along with any Advance Health Care Directive, Request to Forego Resuscitative Measures, and/or Do-Not-Resuscitate Form executed by the resident or (in certain instances) the resident’s Health Care Surrogate Decision Maker.
  • The name, address, telephone number, and 24-hour emergency telephone number of the hospice agency and the resident’s Health Care Surrogate Decision Maker, if any, in a manner that is readily available to the resident, the licensee, and facility staff.
  • A copy of the written certification statement of the resident’s terminal illness from the medical director of the hospice or the physician member of the hospice interdisciplinary group and the individual’s attending physician, if the individual has an attending physician.
  • A copy of the resident’s current hospice care plan approved by the licensee, the hospice agency, and the resident, or the resident’s Health Care Surrogate Decision Maker if the resident is incapacitated.
  • A statement signed by the resident’s roommate, if any, indicating his or her acknowledgment that the resident intends to receive hospice care in the facility for the remainder of the resident’s life, and the roommate’s voluntary agreement to grant access to the shared living space to hospice caregivers, and the resident’s support network of family members, friends, clergy, and others. If the roommate withdraws the agreement verbally or in writing, the licensee shall make alternative arrangements which fully meet the needs of the hospice resident.