{"ref":"OH-HSP-PR-02","title":"Informed Consent, Scope of Services, Limitations and Charges","category":"Client rights","summary":"Sets out how the Agency obtains the signed informed consent Ohio requires before hospice care, what the patient is told about the palliative nature of hospice care, the scope of services, their limitations and the charges, who may consent for a patient, and how the Agency honors refusals and the right to withdraw consent at any time.","inShort":["Before care starts, the patient or authorized representative signs the Ohio informed consent form.","Explain that hospice care is for comfort, not cure, and that the patient may withdraw consent at any time.","Explain what services we give, their limits and what the patient may have to pay.","Check who may sign for a patient who cannot decide. If unsure, ask the social worker and the Administrator.","Accept a refusal of any treatment, write it down and tell the RN coordinator. Never threaten discharge."],"primaryCitation":"OAC 3701-19-20(C)-(E)","citations":["OAC 3701-19-20(C)","OAC 3701-19-20(D)","OAC 3701-19-20(E)","OAC 3701-19-20(F)","OAC 3701-19-16(B)","OAC 3701-19-23(C)(3)","ORC 3712.01(A), (E)","ORC 3712.06(F), (H)","ORC 1337.13(A)","OAC 5160-56-02(H)(2)(c)","OAC 5160-56-06(D)","OAC 3701-19-22.1(C)-(E)"],"federalCitations":["42 CFR §418.52(a), (c)(3), (c)(7)-(8)","42 CFR §418.24(b)(2)-(5)","42 CFR §418.3","42 CFR §418.400","42 CFR §418.104(a)"],"surveyorAsks":["Show me the signed informed consent form for this patient. Where does it acknowledge the palliative rather than curative nature of hospice care and the right to withdraw consent?","What information did the patient receive about the scope of your services, their limitations and the charges?"],"forms":[{"ref":"OH-HSP-PR-02-A","title":"Informed Consent for Hospice Care"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (OAC 3701-19-20(C)-(E))","5. Who May Give Consent","6. Information Given Before Consent","7. Obtaining Written Consent","7.1 Steps at the Admission Visit","7.2 Language and Understanding","7.3 Re-admission and Changes","7.4 Urgent Admissions","8. Consent for Specific Treatments and Other Consents","9. Refusals and Withdrawal of Consent","10. Responsibilities","11. Records and Compliance Monitoring","12. Staff Training","13. References","14. Related Policies and Forms","15. Approval","16. Revision History"],"version":"1.0","sample":false,"pack":"oh-hospice","state":"Ohio","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}}