Be informed of the procedure you can follow to lodge complaints with the provider about the care that is, or fails to be, furnished regarding a lack of respect for property.

Know about the disposition of such complaints and voice your grievances without fear of discrimination or reprisal for having done so.

Be advised of the agency's address, telephone number and hours of operation and request information about your diagnosis, prognosis, and treatment, including alternatives to care and risks involved, in terms that you and your family can readily understand so that you and they can stay informed.

Receive Georgia Department of Human Resources Hotline number and be free from abuse and neglect.

Be informed in advance of the care the hospice team will provide and be advised in any changes of the plan of care before the changes are implemented.

Refuse services, request a change of care giver without the fear of reprisal or discrimination

Be advised at least 5 days in advance of reduction or of discharge of service.

Confidential treatment of your medical records; and you may approve or refuse the release to an individual agency, except the case of transfer to another healthcare institution or agency, as required by law or third party payment contract.

Be advised before care is initiated of the extent to which payment for the agency's services may be expected from Medicare, Medicaid or any federally funded or aided program known to the agency, and to the extent that payment will be requested from you.

Be notified in writing for charges for which you may be responsible and of any changes to those charges within 15 working days from the date that the agency becomes aware of the change in payment.

Be admitted by the agency only if it has the adequate resources to provide safe care and receive the highest quality of care.

Know that the agency will not refuse service to any person regardless of age, race, color, religious preference, sex, handicap, marital status or national origin

Be treated with consideration, respect, including privacy in treatment and in care of your personal needs.

Be told what actions to take in case of emergency and be assured by the agency that all medically related care is provided in accordance with the physician's orders and receive care only by appropriate, qualified professionals of the agency.

Health History - Patient/family will provide information about past illness, treatment, and medications.

Cooperation - Patient and family will ask questions if directions and/or procedures are not well understood.

Communication - patient and family will inform hospice if there is a need to change a scheduled visit, if instructions are unclear, or if there is a change in the patient's condition

Care Plan - patient and family will participate in care planning.

Financial - following complete explanation of the financial implications of hospice care by a team member, the family/patient is responsible for payment of any cost not covered by insurance.

To voice grievances and recommend changes in policies and services without coercion, discrimination, reprisals, or unreasonable interruption of services, you should call or write the Administrator in charge for in-patient and in-home care (404-266-8040). IF the response or resolution is unsatisfactory, the State of Georgia maintains a toll free number for unresolved grievances (800-326-0291).

Language Barrier - Patient/Family will inform the hospice if written or verbal information is not understood in English; hospice will provide translation services in a language identified by the patient and family.

The patient shall have the right to religious freedom, including the right to impose no religious beliefs

Health Insurance Portability Accountability Act, or HIPAA, is a Federal law that applies specifically to health care providers [hospitals, nursing homes, hospices, physicians, pharmacists, dentists, home health agencies, etc], payers for health care [insurance companies Medicare, Medicaid, etc.] and health care clearinghouses. Congress passed HIPPA in 1996 and its regulations focus on Protected Health Information or PHI. PHI includes information about an individual's past, present or future health care and information about payment for that care.

Metropolitan Hospice abides by the HIPAA privacy act and may use the patient's protected health information for purposes of providing treatment, obtaining payment for care and conducting health care operations. Metropolitan Hospice has established a policy to guard against unnecessary disclosure of the health information; therefore, the health information may be used or disclosed only after Metropolitan has obtained written consent from the patient.

Back to top

When choosing to receive Hospice Care, a patient must understand the following:

Upon selection of the Medicare/Medicaid hospice benefit, regular coverage will not be active for care related to the terminal illness. Metropolitan Hospice will receive payment from Medicare/Medicaid for services rendered for the illness. The primary care physician will continue to receive payment for services rendered.

Medicare/Medicaid hospice services are divided into the following benefit periods. These periods are as follows:
         o First Benefit Period 90 Days
         o Second Benefit Period 90 Days
         o Unlimited number of subsequent 60-day periods

This election is continuous throughout the benefit period and that the patient can choose to cancel this benefit in writing at any time. Patient understands that if he/she cancels the benefit, he/she will forfeit any days remaining in the current benefit period. (For example, if the patient cancels the hospice benefit after the first 10 days, then he/she will give up the remaining 80 days of that benefit period).

The patient can choose not to continue hospice care at any time. To discontinue care, he/she must complete a revocation statement within 24 hours of my decision. He/she can obtain this hospice form from any Hospice employee.

The patient can choose to transfer to another hospice program one time during any of benefit periods. The patient must inform hospice of his/her wishes so that the arrangements for transfer can be made. Transferring to another hospice will lose no benefit days.

Metropolitan Hospice will be responsible for any hospitalization that is pre-authorized by hospice and is related to the terminal illness. Hospice must have a contract with the hospital for approval to be granted. The patient understands that in order for Medicare/Medicaid to pay for hospitalization at a hospital that Metropolitan Hospice is not contracted with, the patient must revoke hospice benefits.

Effective April 1, 2003 and thereafter, individuals that elect Medicaid hospice services and reside in a nursing facility will be required to pay towards the cost of care in the nursing facility. The amount required to pay to Metropolitan Hospice is referred to as the Patient Liability. The county Department of Family and Children Services (DFCS) will notify the patient of the amount of the patient liability.

Metropolitan Hospice has the authority to initiate legal action against any hospice patient or their responsible family member that refuses to pay the hospice agency a patient liability. In addition the provider can discharge a patient that refuses payment.

Back to top

Download our Notice of Privacy Practices in a PDF format.  You may need to download Adobe Acrobat Reader.