Hospice patients have a right to be notified in writing of their rights and obligations before treatment begins and to exercise those rights. The patient’s family or guardian may exercise the patient’s rights when the patient has been judged incompetent. Gulfside Healthcare Services has an obligation to protect and promote the rights of their patients, including the following rights

• Dignity & Respect

  Hospice patients and their caregivers have a right to not be discriminated against based on race, color, religion, national origin, age, sex, or handicap. Furthermore, patients and caregivers have a right to mutual respect and dignity, including respect for property. Gulfside Healthcare Services associates are prohibited from accepting personal gifts and borrowing from patients.

  Patients have the right:

  • to have relationships with hospice staff that are based on honesty and ethical standards of conduct
  • to be involved and receive support in the resolution of ethical issues concerning their hospice care
  • to be offered a qualified sign/language interpreter to assist you in communicating with us

• Decision Making

  Patients have the right:

  • to be notified in advance about the care that is to be furnished, the types of caregivers who will provide care, and the frequency of the visits that are proposed
  • to be advised of any change in the plan of care before the change is made
  • to be informed of the hospice medical diagnosis and prognosis for care
  • 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 be informed in writing of rights under state law to make decisions concerning medical care, including the right to  accept or refuse treatment and the right to formulate advance directives
  • to be informed in writing of policies and procedures for implementing advance directives, including any limitations if the  provider cannot implement an advance directive on the basis of conscience
  • to have health care providers comply with advance directives in accordance with state law requirements
  • to receive care without condition on, or discrimination based on, the execution of advance directives
  • to refuse service without fear of reprisal or discrimination
  • to be involved in decisions to withhold resuscitation and forego or withdraw life sustaining care

• Nondiscrimination & Grievance

  Patients have the right:

  • to be informed of the procedure they can follow to report a complaint to the hospice provider about the care that is, or fails to be, furnished and about a lack of respect for property
  • to know about the disposition of such complaints
  • to voice their grievances without fear of discrimination or reprisal for having done so
  • to be advised of the telephone number and hours of operation of the state’s hospice “hot line” which receives questions and complaints about local hospice agencies, including implementation of advance directive requirements: 
    

  
  

  Florida Hospice & Palliative Care Association
  2000 Apalachee Parkway, Suite 200
  Tallahassee, FL  32301
  Office: 850-878-2632, Fax: 850-878-5688
  Toll-Free Consumer Hotline: 800-282-6560

  Florida Medical Quality Assurance Organization
  5201 W. Kennedy Blvd., Suite 900
  Tampa, FL 33609-1822
  Appeals: 866-800-8768
  Main Phone: 813-354-9111
  Medicare Beneficiary Helpline: 800-844-0795
  Provider Access: 800-564-7490, Mon-Fri 8 a.m.-4:30 p.m. EST

• Discrimination is Against the Law

  Gulfside Healthcare Services (GHS) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)

  Gulfside Healthcare Services does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.  

  Gulfside Healthcare Services:

  • Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as qualified sign language interpreters, written information in other formats (large print, audio, accessible electronic formats, other formats)
  • Provides free language assistance services to people whose primary language is not English, which may include qualified interpreters, and/or information written in other languages

  If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact the Director of Quality & Compliance or the VP of Quality, Compliance, and HIM.

  If you believe that GHS has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with the Director of Quality & Compliance or the VP of Quality, Compliance, and HIM, 2061 Collier Parkway, Land O’ Lakes, FL 34639, phone 1-800-561-4883, fax 813-406-4963, or email compliance@gulfside.org. You can file a grievance in person or by mail, fax, or email.

  If you need help filing a grievance, the Director of Quality & Compliance or the VP of Quality, Compliance, and HIM is available to help you.

  You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https:// ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

  U.S. Department of Health and Human Services
  200 Independence Avenue, SW Room 509F, HHH Building
  Washington, D.C. 20201
  1-800-368-1019, 800-537-7697 (TDD)

  Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

• Quality of Care

  Patients have the right:

  • to receive care of the highest quality
  • to be admitted by Gulfside Healthcare Services only if it has the resources needed to provide the care safely and at the required level of intensity, as determined by a professional assessment; and by informing the patient of any limitations so an informed decision can be made regarding service
  • to appropriate assessment and management of pain and other symptoms
  • to be told what to do in the case of emergency

• Financial Responsibility

  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 home care provider
  • to be informed of the 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, before the care is initiated and within 30 calendar days of the date the hospice provider becomes aware of any changes
  • to have access, upon request, to all bills for service the patient has received regardless of whether the bills are paid out-of-pocket or by another party