PATIENT'S BILL OF RIGHTS
As an HQA patient, you have the right to:

• Receive a timely response from HQA regarding your request for hospice services.
• Receive information concerning hospice including policies (including admission & discharge); procedures; charges for services; identification, by name and title, of all caregivers; the nature and frequency of care to be furnished; the disciplines that will provide the care; any change in the provision of care before the change is made; any anticipated transfer or termination of care.
• Right to know about short term treatment options for pain control, symptom management and respite.
• Choose your hospice agency, refuse treatment within the confines of the law and be given information concerning the consequences of refusing treatment.
• Receive appropriate and professional quality hospice care services without fear of physical and mental abuse; neglect; or discrimination on the basis of race, creed, color, religion, sex, national origin, sexual preference, handicap or age.
• Have your person and property treated with courtesy and respect by all who provide hospice care services to you.  Have your cultural, psychosocial, spiritual, and personal values, beliefs and preferences respected.
• Receive a clear and understandable explanation of your medical problems, treatments and procedures needed, and of the expected outcome.
• Participate in the development of a plan of care that will meet your unique health care needs; receive updates and assessments of the plan; voice grievances; access the Ethics Advisory Committee if necessary to assist with treatment and care decisions; and suggest changes in services and staff without fear of threats, restraints or discrimination.   
• Right to have pain appropriately assessed and managed.
• Have your care treated confidentially and understand that no records are released without written authorization.  Be able to review your clinical record upon request.
• Be informed before care is initiated of the extent to which payment may be expected from Medicare or other sources, and the extent to which payment may be required from you.  Receive this information, orally and in writing, within thirty (30) days of the date the hospice care provider becomes aware of any changes in charges.
• Delegate authority to a family member or guardian to make decisions regarding your care.
• The patient's family or guardian may exercise the patient's rights when the patient has been judged incompetent.
• The agency’s policy on withholding of resuscitative services and the withdrawal of life sustaining treatment.

 PATIENT'S RESPONSIBILITIES

• Give accurate and complete health information concerning your past illnesses, hospitalization, medications, allergies and all pertinent items.
• Assist in developing and maintaining a courteous and safe environment.
• Inform HQA in a timely manner when you will not be able to keep a hospice/home health  care appointment and any changes in status (i.e., a change in symptoms and/or severity, phone number, address or hospitalization).
• Participate in the development of, adhere to, and accept the consequences of, the plan of care.
• Voice concerns or problems to HQA agency staff member and request further information concerning anything you do not understand.

COMPLAINT PROCEDURE
An essential ingredient of hospice care is active participation in decision-making by patient and family members.  Throughout your care by HQA, we encourage you to voice any complaints or problems to the members of your HQA team.  They will make every effort to resolve the problem.  The following steps are available to you:

• Discuss the problem with your primary nurse.
• Call the Coordinator of Clinical Services at 410-643-6609 to describe and discuss the complaint or grievance.  Patients can freely voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care, treatment and services.
• Call the HQA Executive Director at 410-643-6609 to describe the nature of the problem.  Complaints and grievances presented to the Hospice Executive Director will be resolved within ten (10) working days.  The Executive Director will notify the Board of Directors of the grievance and the resolution.
• Call or write to the Chairman of the Board of Directors, Hospice of Queen Anne’s, Inc., 423 Thompson Creek Road, Stevensville, MD  21666.  The phone number is 410-643-6609.

Call the:
Department of Health & Mental Hygiene
Office of Quality Management
4201 Patterson Avenue
Baltimore, Maryland  21215-2299
Hospice Hotline Number 1-800-492-6005
 
Contact the Joint Commission’s Office of Quality Monitoring to report any concerns about patient care and safety that has not been resolved by HQA.

Calls may be placed to 1-800-994-6610 or email to “complaint@jcaho.org”.