Patient Rights & Responsibilities

Bill of Rights Policy No. 9-005

PURPOSE

To encourage awareness of patient rights and provide guidelines to assist patients in making decisions regarding care and for active participation in care planning.

POLICY

Each patient will be an active, informed participant in his/her plan of care. To ensure this process, the patient will be empowered with certain rights and responsibilities as described. A patient, who has not been judged to lack legal capacity, may designate someone (surrogate decision maker), to act as his/her representative. This representative, on behalf of the patient, may exercise any of the rights provided by the policies and procedures established by the organization.

If the patient has been judged to lack legal capacity to make health care decisions as established by state law by a court of proper jurisdiction:

1. The rights of the patient may be exercised by the person appointed by the state court to act on the patient’s behalf, OR

2. The patient may exercise his or her rights, or designate a legal representative to exercise his or her rights to the extent allowed by court order.

To assist with fully understanding patient rights, all policies will be available to the organization personnel, patients, and his/her representatives as well as other organizations and the interested public.

PROCEDURE

The Bill of Rights statement defines the right of the patient to:

A. Have his or her property and person treated with respect.

B. Voice grievances regarding treatment or care that is (or fails to be) furnished, or regarding the lack of respect for property by anyone who is furnishing services on behalf of the organization and must not be subjected to discrimination or reprisal for doing so.

C. Receive effective pain management and symptom control from the hospice for conditions related to the terminal illness.

D. Be advised in advance of the right to participate in planning the care or service and in planning changes in the care and service; hospice patients have the right to refuse care or treatment.

E. Be involved in developing his or her hospice plan of care.

F. Refuse care or treatment.

G. Choose his or her attending physician.

H. Have a confidential clinical record maintained by the organization. Access to or release of patient information and clinical records is permitted in accordance with 45 CFR parts 160 and 164.

I. Be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries from unknown source, and misappropriation of patient property.

J. Access to care/service is based upon nondiscrimination.

K. Have communication needs met.

L. Receive information about the services covered under the hospice benefit.

M. Receive information about the scope of services that the hospice will provide and specific limitations on those services.

N. Be advised that the Hospice Organization complies with Subpart 1 of 42 CFR 489 and receive a copy of the organization’s written policies and procedures regarding advance directives, including a description of an individual’s right under applicable state law and how such rights are implemented by the organization.

O. Use the hotlines to lodge complaints concerning the implementation of Advance Directive requirements.

P. Receive written information describing the organization’s grievance procedure which includes the contact information, contact phone number, hours of operation, and mechanism(s) for communication problems. The program shall describe in writing patient and family responsibilities and the mechanism to file a grievance and obtain a receipt that the information has been received by the patient or family.

Q. Receive an investigation by the organization of complaints made by the patient or the patient’s family or guardian regarding treatment or care that is (or fails to be) furnished, regarding the lack of respect for the patient’s property by anyone furnishing services on behalf of the organization; and that the organization will document the existence of the complaint and the resolution of the complaint.

R. Receive information addressing any beneficial relationship between the organization and referring entities.

S. Be informed verbally and in writing of any changes in payment information as soon as possible, but no later than 30 days from the date that the organization becomes aware of the change.

T. Be informed, verbally and in writing, of billing and reimbursement methodologies prior to the start of care/service and as changes occur, including fees for services/products provided, direct pay responsibilities, and notification of insurance coverage.

U. Receive in writing, prior to the start of care, the telephone numbers for the State Hotline and the CHAP Hotline, including hours of operation, and the purpose of the hotlines to receive complaints or questions about the organization.

V. Be assured that the personnel who provide care are qualified through education and experience to carry out the services for which they are responsible.

The patient and family/caregiver responsibilities will be explained upon admission and as needed. The patient and family/caregiver are responsible for:

A. Being fully informed by a physician of his or her medical condition, unless medically contraindicated and to be afforded the opportunity to participate in the planning of his or her medical treatment, including pain and symptom management and to refuse to participate in experimental research.

B. Cooperating with the primary doctor, program staff and other caregivers.

C. Advising the program of any problems or dissatisfaction with patient care.

D. Notifying the program of address or telephone changes or when unable to keep appointments.

E. Providing a safe environment in which care can be given. In the event that conduct occurs such that the patient’s or staff’s welfare or safety is threatened, service may be terminated.

F. Obtaining medications, supplies and equipment ordered by the patient’s physician if they cannot be obtained or supplied by the program.

G. Reporting unexpected changes in the patient’s condition.

H. Understanding and accepting the consequences for outcomes if the care, services and/or treatment plan are not followed.

3. Upon admission, the admitting clinician will provide each patient or his/her representative with a written copy of the Bill of Rights.

4. The Bill of Rights statement will be explained and distributed to the patient prior to the initiation of organization services. This explanation will be in a language or communication method he/she can reasonably be expected to understand.

5. The patient will be requested to sign the Bill of Rights form. The original form will be kept in the patient’s clinical record. A copy will be maintained by the patient. The patient’s refusal to sign will be documented in the clinical record, including the reason for refusal.

6. The admitting clinician will document that the patient has received a copy of the Bill of Rights.

A. If the patient is unable to understand his/her rights and responsibilities, documentation in the clinical note will be made.

B. In the event a communication barrier exists, if possible, special devices or interpreters will be made available.

C. Written information will be provided to patients in English and predominant non-English languages of the population served.

7. When the patient’s representative signs the Bill of Rights form, an explanation of that relationship must be documented and kept on file in the clinical record.

8. The family or guardian may exercise the patient’s rights when a patient is incompetent or a minor.

9. All organization personnel, both clinical and non-clinical, will be oriented to the patient’s rights and responsibilities prior to the end of their orientation program, as well as annually.