{"ref":"DC-HSP-PR-02","title":"Informed Consent, Description of Services and Charges","category":"Client rights","summary":"Sets how the Agency explains, before care starts, what hospice covers, what the Agency will and will not provide, and what the patient may owe; how it obtains informed consent from the patient or, when the patient’s incapacity has been certified under District law, from the right substitute decision-maker; and how it handles refusals of care.","inShort":["Explain what hospice covers, what we do not provide, and what the patient may owe, before care starts.","An adult decides for himself or herself unless two licensed professionals certify incapacity.","If the patient cannot decide, use the health care power of attorney, or the D.C. Code §21-2210 order of family and others.","A witness must be present when a family member or friend consents for the patient. Staff never decide for a patient.","Respect every refusal, record it, and tell the registered nurse coordinator the same day."],"primaryCitation":"42 CFR §418.52(c)(7)-(8)","citations":["D.C. Code §21-2202","D.C. Code §21-2203","D.C. Code §21-2204","D.C. Code §21-2206","D.C. Code §21-2210","29 DCMR §939.20"],"federalCitations":["42 CFR §418.52(a), (c)(3), (c)(7)-(8)","42 CFR §418.24(b)(5)","42 CFR §418.100(c)-(d)","42 CFR §418.400","42 CFR §447.15","45 CFR §164.506","45 CFR §164.508"],"surveyorAsks":["Show me the signed consent and description of services for this patient. When was it signed compared with the first visit?","How do you tell patients about the limits of your services, such as what you do not provide around the clock?"],"forms":[{"ref":"DC-HSP-PR-02-A","title":"Consent to Hospice Care and Description of Services"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §418.52(c)(7)-(8))","5. The Consent Conversation","6. When the Patient Decides","7. When the Patient Cannot Decide","8. What the Agency Provides, and Its Limits","9. What the Patient May Owe","10. Refusing Care","11. Sharing Information and Photographs","12. DC Medicaid (If the Agency Is Enrolled)","13. Responsibilities","14. Records and Compliance Monitoring","15. Staff Training","16. References","17. Related Policies and Forms","18. Approval","19. Revision History"],"version":"1.0","sample":false,"pack":"dc-hospice","state":"Washington, DC","service":"Hospice","guides":[{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}