Hospice Patients' Bill of Rights Patients have a right to be notified in writing of their rights and obligations before 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: 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/primary caregivers. In addition, patients have the right: to have relationships with hospice organizations that are based on honesty and ethical standards of conduct; to 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 (to lodge complaints call the hospice); to know about the disposition of such complaints; and to voice their grievances without fear of discrimination or reprisal for having done so. Decisionmaking Patients have the right: to be notified in writing of the care that is to be furnished, the types (disciplines) of caregivers who will furnish the care, and the frequency of the services that are proposed to be furnished; to be advised of any change in the plan of care before the change is made; to 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; to refuse services and to be advised of the consequences of refusing care; and to 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 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; and to 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; to be informed of any charges that will not be covered by Medicare; to be informed of the charges for which the patient may be liable; to receive this information, orally and in writing, within 15 working days of the date the hospice organization becomes aware of any changes in charges; to have access, on request, to all bills for service received, regardless of whether they are paid out of pocket or by another party; and to be informed of the hospice's ownership status and its affiliation with any entities to which the patient is referred. Quality of Care Patients have the right: to receive care of the highest quality; to be admitted by a hospice organization only if it is assured that all necessary palliative and supportive services will be provided to promote the physical, psychological, social, and spiritual well-being of the dying patient. An organization with less than optimal resources may, however, admit the patient if a more appropriate hospice organization is not available-but only after fully informing the client of its limitations and the lack of suitable alternative arrangements; and to 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 group in conjunction with the patient, specifies the services to be provided and their frequency and duration; and all medically related personal care is provided by an appropriately trained home care aide who is supervised by a nurse or other qualified hospice professional.