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PATIENT’S BILL OF RIGHTS/RESPONSIBILITIES As a patient of Yarrow Hospice, you have a right to be notified in writing of your rights and responsibilities in advance of receiving care and to exercise those rights. Your legal representative may exercise these rights when you are incapacitated. As a patient of Yarrow Hospice you have the right to: Receive information about the services covered under your Hospice benefit, including any limitations of benefits. Be cared for by a team of professionals who are qualified through education and experience to address yours and your family’s unique care and service needs. Have a clear understanding of the availability and accessibility of the Yarrow Hospice team members – 24 hours each 7 days. Be informed of your health condition and participate in planning your care. Appropriate and compassionate care, regardless of diagnosis, ethnicity, age, gender, creed, disability, sexual orientation or place of residence. You have a right to have your cultural, psychosocial, spiritual and personal values, beliefs and preferences respected. Effective management of pain and symptoms resulting from your terminal condition. Refuse care or treatment after the consequences of refusing care or treatment are fully presented, without reprisal or discrimination for the choices you make. Receive effective pain management and symptom control for conditions related to terminal condition. Be treated with dignity and respect for you, your family, caregivers and property; respect for your privacy in treatment and personal care. Be fully informed in advance about care/service to be provided, including the disciplines that furnish care and the frequency of visits, as well as any modifications to the plan of care and potential financial liability. Be able to identify visiting personnel members through proper identification. Choose a health care provider, including choosing an attending physician. Be informed of rights under state law to make decisions concerning medical care, including the right to accept or refuse any treatment and the right to formulate advance directives as permitted by state law. Have Yarrow Hospice act in accordance with my spoken and/or written choices Be treated with respect and be free from mistreatment and mental, physical, sexual and verbal abuse, neglect and exploitation, including injuries of unknown source and misappropriation of patient property by anyone. Voice complaints regarding care or treatment without fear of discrimination or reprisal for having done so and have the issue appropriately investigated. Access any insurance or entitlement program for which you may be eligible. Be advised of the telephone number and hours of operation of the state’s Home Health Hospice hotline (Utah Department of Health, Bureau of Health, Facility Licensing and Certification and Resident Assessment), which receives complaints or questions about local home care & hospice agencies. The hours of operation are Monday to Friday, 8 am to 5 pm. The telephone number is 800.662.4157 or 801.538.6158. The hotline also receives complaints about advance directives. Confidentiality and privacy of all information, including, but not limited to health, social and financial circumstances, contained in your record as required by law or authorized by the patient and to be informed of procedures for disclosure. Be fully informed of your responsibilities. Patients have the responsibility to: Properly use and dispose of controlled substances and biologicals. Use and maintain equipment and supplies provided by Hospice. Follow responsibilities that have been outlined in your interdisciplinary group (IDG) plan of care. Follow infection control procedures that are relevant to your care. Notify Hospice of any perceived risks in your care or unexpected changes in your condition, e.g., changes in the plan of care, symptoms to be reported, etc. Follow instructions and express any concerns you have about your ability to follow and comply with proposed IDG plan of care. Hospice will make every effort to adapt the plan to your specific needs and limitations. If such changes are not recommended, Hospice will inform you of the consequences of care alternatives. Provide accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters related to the patient’s health. Know that in the event of an emergency that disrupts Hospice’s services to patient, that Hospice will make every effort to visit or telephone patient. However, if patient has a medical emergency and is not able to contact Hospice, the patient should access the nearest emergency medical facility and/or call 911. Ask questions about care or services when you do not understand your care or what you are expected to do. Show respect and consideration for Hospice’s personnel and property.