Current through Register Vol. 42, No. 11, August 30, 2024
(1)
Policies and Procedures regarding the rights and responsibilities
of patients shall be written, implemented, and made available to patients, to
any guardians, to any sponsor, next-of-kin, sponsoring agency (or agencies),
representative payees, and to the public. Patients and sponsors will be
informed on patient rights and given the toll-free complaint telephone number
for the Alabama Department of Public Health, both verbally and in writing, at
the time of admission. This shall be documented in the patient's record. The
staff shall be trained and involved in the implementation of these policies and
procedures. Posters clearly stating patient rights will be visible in key
locations in the hospice. These posters will also include the toll-free
complaint telephone number. These patients' rights polices and procedures
ensure that, at least, each patient admitted to the hospice:
(a) Has the right to be fully informed, as
evidenced by the patient's written acknowledgment prior to or at the time of
admission and during stay, of these rights and of all rules and regulations
governing patient conduct and responsibilities.
(b) Be fully informed of services available
and of related charges including any charges for services not covered by third
party payers.
(c) Be fully informed
by a physician of his or her medical condition unless medically contraindicated
(as documented by a physician in the medical record); and, is afforded the
opportunity to participate in the planning of his or her medical treatment and
the right to refuse treatment or participation in experimental
research.
(d) Is not to be
transferred or discharged except when transfer or discharge is necessary for
the patient's welfare and the patient's needs can no longer be met or when the
patient presents a direct threat to the health or safety of others, for medical
reasons, or for his or her welfare or that of other patients, or for nonpayment
for his or her stay. The hospice shall discuss discharge plans with the patient
or their legal representative, the hospice Medical Director and/or attending
physician and the appropriate interdisciplinary team members prior to the
discharge. The hospice shall identify post hospice care needs and provide
adequate discharge planning. The hospice patient or their legal representative
shall be provided written discharge instructions on medication management and
procurement, durable medical equipment, availability of community resources and
other identified needs at the time of discharge. The required discharge forms
must be completed timely. Such actions shall be documented in the medical
record.
(e) Is encouraged and
assisted throughout the period of stay to exercise rights as a patient and as a
citizen, and to this end may voice grievances and recommend changes in policies
and services to hospice staff and/or to outside representative of his or her
choice without being subjected to restraint, interference, coercion,
discrimination, or reprisal.
(f)
May manage his or her personal financial affairs. Should a patient delegate
responsibility to the hospice for the management of his or her financial
affairs, said delegation shall be in writing, and the hospice shall provide the
patient with at least a quarterly accounting of financial transactions made on
his or her behalf.
(g) Is free from
mental and physical abuse; and free from chemical and (except in emergencies)
physical restraints, except as authorized in writing by a physician for a
specified and limited period of time, or when necessary to protect the patient
from injury to self or to others.
(h) Is assured confidential treatment of
personal and medical records, and may approve or refuse their release to any
individual outside the hospice except in case of transfer to another health
care institution or as required by law or third-party payment
contract.
(i) Is treated with
consideration, respect, and with full recognition of his or her dignity in
caring for personal needs.
(j) Is
not required to perform services for the hospice that are not included for
therapeutic purposes in the plan of care. The following apply to inpatient
hospices:
1. May associate and communicate
privately with persons of his or her choice, and send and receive personal mail
unopened.
2. May meet with and
participate in the activities of social, religious, and community groups at his
or her discretion.
3. May retain
and use personal clothing and possessions as space permits, unless to do so
would infringe upon rights of other patients.
(k) If married, is assured privacy for visits
by his/her spouse. If both are inpatients in the hospice, they are permitted to
share a room.
The following apply to all hospices:
(2)
Responsible Party
(Parties).
(a) In the case of a
patient adjudged incompetent under the laws of a state by a court of competent
jurisdiction, the rights of the resident are exercised by the person appointed
under state law to act on the resident's behalf.
(b) In the case of a patient who has not been
adjudged incompetent by the state court, any legal surrogate designated in
accordance with state law may exercise the resident's rights to the extent
provided by state law.
(3)
Notification of Changes in Patient
Status. The hospice shall have appropriate written policies and
procedures relating to notification of the patient's attending physician and
other responsible persons in the event of accident involving the patient, or
other significant change in the patient's physical, mental or emotional status.
Except in medical emergency, a patient shall not be transferred or discharged,
nor treatment altered radically, without consultation with the patient or, if
the patient is incompetent, without prior consultation with next-of-kin or
sponsor.
