Consent Legalities
Hospice Patient and Caregiver Handbook
Hospice Consent Forms
Hospice Admission Packet
MISC
100

How far in advanced of an admission, can consent paperwork legally be signed by the patient and/or authorized representative?

What is: Up to two weeks prior to the date of scheduled admission.

100

**** TRIPLE JEOPARDY **** A patient / auth rep has a problem, or complaint about their care. They have discussed it with their nurse and with the PCC or Ops Manager listed inside the front cover of the handbook. Who do they contact if they are still not satisfied with the way their concern has been handled?

Who is: State Specific Toll Free Hotline indicated in Handbook.

100

As indicated on the Election of Hospice Benefit, what is the patient and/or authorized representative responsible for reporting immediately.

What are: any changes in the condition of the patient which will affect the plan of care AND of any decision to seek or obtain treatment or services on included in the Hospice Plan of Care.

100

According to the Disposal of Home Pharmaceuticals handout included in a hospice admission packet, what should be done to the bottles after a family member destroys the medications?

What is: Remove or cover any identifying information on the pill bottle before discarding.

100

Who is responsible for making an APS report when there are identified concerns of potential / witnessed abuse and /or neglect.

What is: the individual team member who witness / identified the abuse / neglect.

200
What two consent documents are required to be signed by patient and/or authorized representative, before any hands-on assessment of patient can occur?
What are: The Election of Hospice Benefit and Informed Consent forms.
200
A patient or authorized representative wishes to contact the Toll Free Hotline for their appropriate state. When will their call be answered and complaint / concern investigated?
What is: 7 days per week, 24 hours per day.
200

Which of the consents indicate that the patient and/or authorized representative may refuse to sign the specific form AND that their refusal to sign will not affect their ability to obtain treatment or payment or eligibility for benefits.

What is: the Release of Medical Records Authorization form.

200

What should be done with the hospice packet, when the patient resides in a skilled nursing facility?

What is: be placed in uppermost available drawer of night stand, for reference when family members present and in event of an audit.

200

How do you document inservice time on your DAR?

What is:  Inservice NOT PPV.

300
What must be documented, for anyone other than the RN Case Manager to be present at time of initial visit.
What is: permission by the patient and/or authorized representative for anyone other than RN CM making admission visit.
300
Once the admission is completed and handbook is initially reviewed, what should we encourage the patient / representatives to do with the admission packets / hospice handbooks.
What is: put them in a location where patient / authorized representative / caregivers can locate at any given time, in order to be used for teaching and review by all disciplines making visits and in event of an audit.
300

On the Informed Consent document, under the heading Medications, what is the patient and primary care person responsible for?

What is: the safe-keeping of the medications, correct administration of the medication per prescription and direction of the nurse, and disposal at the time of death/discharge.

300

During your second social work visit, you notice numerous cords on the floors that you almost trip over and it seems darker inside the home, than you remembered during your initial visit. You ask them to bring you the hospice folder so you can use it during your visit. Why?

What is: to use the Check For Safety booklet to do a Home Safety review.

300

You arrive for a visit and a patient or family member 'unloads' on you about how bad these hospice services are and starts hashing out a laundry list of complaints. What is one thing you DON'T DO and one thing you DO.

What is:  DON'T  -  document the interaction or complaints in your documentation.

DO - document a client concern and use as much direct quotations as able. 

400
When is the patient not expected / allowed to sign consent documentation?
What is: when he/she is determined not competent to make decisions or when he/she is physically unable to sign consent documents.
400
When, and how, does emergency preparedness begin?
What is: at the time of admission and through use of hospice patient and caregiver handbook.
400

***** DAILY DOUBLE ***** When is the verbal authorization permitted on behalf of a signature, on consent documents, in order to initiate hospice services?

What is: NEVER. A verbal election is never allowed. The signature of the individual and/or authorized representative is always required.

400

The hospice packet now contains two different letters included in it. What do these two letters address?

What is: prohibiting home care and hospice agency employees from smoking in their home, and requirement of face-to-face visit prior to 3rd certification period.

400

There is an extensive discussion among team members about the 'right way' to manage a discharge. How do you determine whose way is correct?

What is: refer to the Policies and Procedures.

500
What must Liberty Hospice must have in place and signed by an MD, prior to any visit with patient to discuss hospice services and/or consideration of admission?
What is: MD orders for evaluation and admission, on file.
500
Where, within the Hospice Patient and Caregiver Handbook, can you best review the after hours on call process?
What is: inside the front cover. This page can actually be copied and provided for patients / authorized representatives to place on their refrigerator for continuous reference.
500

What is required to be completed on all of the consents?

What is: every line should be filled out and every box should be checked off at completion of consent process.

500

You have a family member that needs a break from caregiving. You have educated them about In-patient respite and discuss it's availability of 5 days. The family member tells you 'we have friends who got 7 days with (Agency ZX) Hospice.' What document in the folder can be used to support your information.

What is: the Medicare Hospice Benefits booklet on page that describes Respite benefit of hospice.

500

What is the 'right' number of goals and interventions to have for each patient?

What is: there is not a set number; it is based on patient's wishes & needs. 
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