Patient Rights and Responsibilities

Treasure Coast Hospice is committed to providing compassionate, high-quality hospice and palliative care to every patient we serve. As a condition of that care, you and your family have specific rights, and specific responsibilities, under federal and Florida law. This notice is provided to you and, when applicable, your legal representative, before or at the time your hospice care begins, in a language and manner you can understand.

As a patient of Treasure Coast Hospice, you have the right to:

• Receive a notice of your rights and responsibilities, in advance of receiving care, in a language and manner you understand.
• Receive effective pain management and symptom control for conditions related to your terminal illness.
• Be involved in developing your hospice plan of care, and to have that plan updated as your needs change.
• Refuse any care or treatment, except as otherwise provided by law, and to be informed of the likely medical consequences of that decision.
• Choose your attending physician.
• Have your property and person treated with respect.
• Be free from mistreatment, neglect, and verbal, mental, sexual, and physical abuse, including injuries of unknown source, and from misappropriation of your property by anyone furnishing services on behalf of the hospice.
• Receive information about the services covered under the Medicare hospice benefit, including the scope of services provided directly by Treasure Coast Hospice and those provided under arrangement, and upon request, full information and necessary counseling on the availability of known financial resources for your care.
• Receive information about any changes in the care or services you receive, before the change is made.
• Voice grievances or complaints about your care or treatment, violation of your rights as stated in Florida law, or the lack of respect for your property, without discrimination or reprisal for doing so, and to have those grievances investigated.
• Confidentiality of your clinical records, in accordance with applicable law and our Notice of Privacy Practices.
• Receive care without discrimination on the basis of race, color, national origin, age, disability, gender, sex, sexual orientation, diagnosis, cost of therapy, ability to pay, or life circumstances, consistent with our Notice of Non-Discrimination and Florida law.
• Have your values and belief systems respected without any value or belief system being imposed on you or your family.
• Be informed, in advance, of the care and services available and any limitations on those services.
• Formulate advance directives, including a Florida Do Not Resuscitate Order, and to have hospice staff comply with those directives, to the extent permitted by law.
• Be treated with courtesy and respect, with appreciation of your individual dignity, and with protection of your need for privacy.
• Receive a prompt and reasonable response to your questions and requests.
• Know who is providing medical services and who is responsible for your care.
• Know what patient support services are available, including whether an interpreter is available if you do not speak English.
• Bring a person of your choosing to patient-accessible areas of our facilities to accompany you during treatment or when consulting with your care team, unless doing so would risk the safety or health of you, other patients, or staff of the facility or cannot be reasonably accommodated.
• Know what facility rules and regulations apply to your conduct.
• Be given information concerning your diagnosis, planned course of treatment, alternatives, risks, and prognosis.
• Receive, upon request, a reasonable estimate of charges for medical care prior to treatment.
• Receive a copy of a reasonably clear and understandable, itemized bill and, upon request, have the charges explained.
• Impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
• Treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
• Know if medical treatment is for purposes of experimental research and to give your consent or refusal to participate in such experimental research

To help us provide you and your family with the best possible care, we ask that you and your family:

• Provide accurate and complete information about your health condition, medications, allergies, and any other matters relevant to your care, to the best of your knowledge.
• Communicate openly with your hospice team about your wishes, concerns, symptoms, and any changes in your condition.
• Ask questions if you do not understand your plan of care, your rights, or instructions given by the hospice team.
• Follow the plan of care you have agreed to, or communicate promptly if you wish to change it.
• Keep appointments, and when you are unable to do so, notify us in advance.
• Take responsibility for your actions if you refuse treatment or do not follow the instructions given by the hospice team.
• Ensure that the financial obligations of your care are fulfilled as promptly as possible.
• Treat hospice staff, volunteers, and other patients with courtesy and respect.
• Provide a safe environment for hospice staff to deliver care, to the extent reasonably within your or your family's control.
• Inform the hospice team of any other health care providers involved in your care, including other agencies or facilities.
• Maintain a supply of your medications in the home, as instructed by your hospice team.

If you believe your rights have not been honored, or you have a concern about your care, we want to hear from you. You may file a grievance in person, by phone, by mail, by fax, or by email, and you will not be discriminated against or subject to reprisal for doing so.

Contact Treasure Coast Hospice Quality Department

Quality Department
1201 SE Indian Street, Stuart, FL 34997
Phone: 772-403-4500 | TTY: 1-877-261-6608 | Fax: 772-403-4518
Email: quality@treasurehealth.org

A member of our Quality Department is available to help you file a grievance if you need assistance. We will investigate your grievance and respond to you within a reasonable time frame.

You May Also Contact:

• Florida Agency for Health Care Administration (AHCA) — the state agency that licenses hospice programs in Florida — Complaint Hotline: 1-888-419-3456, or online at ahca.myflorida.com.
• Medicare — 1-800-MEDICARE (1-800-633-4227) or medicare.gov, if your concern involves your Medicare hospice benefit.
• U.S. Department of Health and Human Services, Office for Civil Rights — for concerns involving discrimination — 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201, 1-800-368-1019, or the OCR Complaint Portal at ocrportal.hhs.gov/ocr/portal/lobby.jsf.

Filing a complaint with any of these organizations will not affect the care and services you receive from Treasure Coast Hospice.

You have the right to make decisions about your medical care, including the right to accept or refuse treatment, and the right to formulate advance directives, such as a living will, durable power of attorney for health care, or a Florida Do Not Resuscitate Order (DH Form 1896). We will not condition your admission or treatment on whether you execute or waive an advance directive. Please let your hospice team know if you have an advance directive so it can be included in your medical record, or if you would like information on how to create one.

If you have questions about any of the rights or responsibilities described in this notice, please contact your hospice care team or the Quality Department at the number above.

Treasure Coast Hospice, A Treasure Health Service
1201 SE Indian Street
Stuart, FL 34997
Phone: 772-403-4500
Email: quality@treasurehealth.org