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Advance Directives

Planning for End-of-Life Care

Early Hospice Referral

Patient's Bill of Rights

Preparing for Death

Hospice Patients’ Bill of Rights

    Patients have the right to be notified in writing of their rights and obligations before their hospice care begins. Consistent with state laws, the patient’s family or guardian may exercise the patient’s rights when the patient is unable to do so. Hospice organizations have an obligation to protect and promote the rights of their patients, including the following:

Patients and Providers Have a Right to Dignity and Respect

    Patients and their hospice caregivers have a right to mutual respect and dignity. Caregivers are prohibited from accepting personal gifts and borrowing from patients, families or primary caregivers.

Patients have the right to:

• have relationships with hospice organizations that are based on honesty and ethical standards of conduct.
• be informed of the procedures they can follow to lodge complaints with the hospice organization about the care that is, or fails to be, furnished, and regarding a lack of respect for property.
• know about the disposition of such complaints.
• voice their grievances without fear of discrimination or reprisal for having done so.

Decision Making

Patients have the right to:

• be notified in writing of the care that is to be furnished, the types (disciplines) of the caregivers who will furnish the care, and the frequency of the services that are proposed to be furnished.
• be advised of any change in the plan of care before the change is made.
• participate in the planning of the care and in planning changes in the care, and to be advised that they have the right to do so.
• refuse services and to be advised of the consequences of refusing care.
• request a change in caregiver without fear of reprisal or discrimination.

The hospice organization or the patient’s physician may be forced to refer the patient to another source of care if the client’s refusal to comply with the plan of care threatens to compromise the provider’s commitment to quality of care.

Privacy

Patients have the right to:

• confidentiality with regard to information about their health, social and financial circumstances and about what takes place in the home.
• expect the hospice organization to release information only as consistent with its internal policy, required by law or authorized by the client.

Financial

Patients have the right to:

• be informed of the extent to which payment may be expected from Medicare, Medicaid or any other payor known to the hospice organization.
• be informed of any charges that will not be covered by Medicare.
• be informed of the charges for which the patient may be liable.
• receive this information, orally and in writing, within fifteen working days of the hospice organization becoming aware of any changes in charges.
• have access, upon request, to all bills for services the patient has received regardless of whether they are paid out of pocket or by another party.

Quality of Care

Patients have the right to:

• receive care of the highest quality.
• in general, be admitted by a hospice organization only if it is assured that all necessary palliative and supportive services will be provided which are necessary to promote the physical, psychological, social and spiritual well being of the dying patient; however, an organization with less than optimal resources may nevertheless admit the patient if a more appropriate hospice organization is available, but only after fully informing the client of its limitations and the lack of suitable alternative arrangements.
• be told what to do in the case of an emergency.

The Hospice organization shall assure that:
• all medically related hospice care is provided in accordance with physician’s orders and that a plan of care which is developed by the patient’s physician and the hospice interdisciplinary team specifies the services to be provided and their frequency and duration.
• all medically related personal care is provided by an appropriately trained homemaker-home health aide who is supervised by a nurse or other qualified hospice professional.