Hospice of Charles County Admissions Packet

Page 6

STATEMENT OF PATIENT AND FAMILY RIGHTS AND RESPONSIBILITIES MISSION STATEMENT The mission of Hospice of Charles County is to care for life during the journey with illness and loss. Our Chesapeake Life Center provides services to anyone in the community grieving a death. Our commitment is to provide high quality, cost effective care regardless of age, race, creed, gender, religion, sexual orientation, diagnosis, or ability to pay, with a goal of improving quality of life through comprehensive palliative and supportive services. ADMISSION CRITERIA Admission requirements are: * An attending physician who agrees to be responsible for the patient's care * The patient's desire for Hospice care * The availability of a care coordinator who is responsible for the patient's care twenty-four (24) hours a day. If patient has no care coordinator, must work with the team to develop a plan when no longer can safely care for self independently. * A life expectancy of six months or less Admission is based upon patient and family need without regard to ability to pay or race, creed, sex, age, national origin, sexual orientation, or handicap. BILL OF RIGHTS We believe that it is our obligation to promote and protect your rights, as well as those of each patient under our care, including each of the following: 1. 2. 3. 4. 5. 6.

The right to a verbal and written explanation of your rights as a patient and the right to receive information in a manner that you understand. The right to exercise your rights as a patient of this agency and to have your property treated with respect. The right to have your cultural, psychosocial, spiritual, and personal values, beliefs, and preferences respected. Right to be free from physical and or/or mental abuse and neglect. The right to effective pain and symptom management, and the right to receive information about factors that affect palliation and comfort. The right to be informed of the policies concerning the management and disposal of controlled substances.

7.

The right to make an advance directive and to receive Hospice's policy respecting the implementation of

8.

that right. The right to be fully informed in advance about the care and treatment to be furnished by this agency and any changes in the care and treatment that may affect your wellbeing. As a patient, you may FINAL 2/16/2021


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Reminder

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page 47

Wash Your Hands Flyer

3min
pages 42-44

Medication Management Policy

3min
pages 38-39

Be Red Cross Ready Flyer

5min
page 46

Healthcare Decision Making Worksheet and MOLST

19min
pages 30-37

Discrimination is Against the Law Notice Flyer

4min
page 28

HIPAA Notice of Privacy Practices

7min
pages 24-26

HIPAA Notice of Privacy Practices Acknowledgement Form

1min
page 27

Election of Hospice Benefit

2min
page 21

Patient Notification of Hospice Non-Covered Items, Services and Drugs

1min
page 23

Basic Home Safety Standards

2min
pages 18-19

Ethics Committee Mission Statement

0
page 17

Admissions Checklist and Consent Form

1min
page 22

Spiritual Care

1min
page 16

Volunteers and Guidelines for Medication Administration

3min
pages 14-15

Complaints and Grievances

1min
page 8

Your Interdisciplinary Team Detailed Description

2min
pages 12-13

Patient and Hospice Agreement

2min
page 11

Interdisciplinary Team, Care Coordinator, Withdrawal from Hospice

1min
page 4

Covered Services and Services which Require Pre-Authorization

1min
page 5

Patient and Family Rights and Responsibilities

3min
pages 6-7

Patient Self-Determination Policy

2min
pages 9-10

Purpose of Hospice, Choice of Care, Levels of Care

2min
page 3
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