Care/Support
Treatment
Information/Privacy
Responsibilities
100

You have the right to receive effective _____  _____ and symptom control for conditions related to your terminal illness.

What is "pain management"?

100

You have the right to treatment without _______.

  • Treatment, regardless of race, creed, color, national origin, ancestry, religion, gender, sexual orientation, marital status, age, disability, source of payment, diagnosis, resuscitation status or any other protected status under law. 

  • Respect for cultural, spiritual and personal beliefs and preferences, within the limits of the law and without compromising your care or the care of other patients.

What is "discrimination"?

100

You have the right to express ______ to RCC, without fear of reprisal, about the services provided and to have the complaint investigated in accordance with an established procedure.   

What are "complaints"?

100

Treating all RCC staff with _____, _____ and tact.  This applies to you, your caregivers, family and visitors.  RCC does not permit any form of harassment, sexual or otherwise, intentional or unintentional, in the work environment.

What is "respect" and "courtesy"?

200

You have the right to be involved in developing, managing and changing your hospice _______.

What is "plan of care"?

200

You have the right to be free from ______ and ______  except as authorized in writing by the attending physician to provide palliative care for a specified and limited period of time and documented in the plan of care. 

What are "restraints and seclusion"?

200

You have the right to have your _______ be treated as private and confidential. Details of your condition and treatment will not be shared except with those who are allowed to receive the information.

What is "health information"?

200

Providing accurate, complete and _______ and financial information, as necessary to your and related to your hospice plan of care.

What is "up-to-date Health insurance"?

Will also accept accurate and complete "information about your health and healthcare".

300

Receive _____ at any hour, including children of any age, and to decide who may visit you.

What are "visitors"?

300

You have the right to be free from ________, _______, ________, _________, ______, ______, including injuries of unknown source and misappropriation of your property. Any such allegations against someone furnishing services on behalf of RCC are reported immediately to the hospice administrator. 

What are "mistreatment, neglect, or verbal, mental, sexual or physical abuse"?

4 out of 6 of these will score points.

300

You have the right to privately ___________ with others without restrictions.

What is "communicate"?

300

___________ when you do not understand your care, treatment or services provided to you.

What is "Ask questions"?

400

You have the right to choose your attending _____.

What is "physician"?

400

You have the right to be treated with _____, _____ and full recognition of your dignity and individuality and to choose physical and emotional privacy in treatment, living arrangements and the care of personal needs.

What is "courtesy and respect"?

400

You have the right to be informed, ________(when), of the types and scope of hospice services that RCC provides, including contracted services and specialized services for unique patient groups such as children, as well as specific limitations on those services. 

What is "prior to admission"?

400

Notifying RCC if you plan to leave the _____ for any reason.

What is "service area"?

500

You have the right to be fully ______ about:

-your condition, including any significant changes in your healthcare needs or status.

-criteria for discharge - see Discontinuation of Services Policy.

What is "informed"?

500

You have the right to receive information in a manner that you can ___________.

What is "understand"?

500

You have the right to request and receive a copy of your medical records. Access to or release of your medical records is handled in accordance with the __________________ (______) – see Notice of Privacy Practices.

Health Information Portability and Accountability Act (HIPAA)

500

Actively participating in developing and managing your ________ with your care team.

What is a "plan of care"?

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