About this course
This course teaches hospice aides, nurses, social workers, and office staff the patient rights in 42 CFR 418.52 and the self-determination framework that surrounds them. Part one covers the rights themselves: that they are a Condition of Participation rather than agency policy, that notice must be given verbally and in writing in a language the patient understands before care begins, and what each of the eight rights in 418.52(c) looks like in a real house on a real shift, including the right to effective pain and symptom control, involvement in the plan of care, choice of attending physician, and a confidential clinical record. Part two covers exercising those rights: the deliberately broad CMS definition of a grievance, freedom from discrimination and reprisal, who may act as a representative and how to verify the scope of their authority, the substituted judgment and best interest standards, and informed consent and the right to refuse care or treatment. Part three covers the Patient Self-Determination Act and its implementation at 42 CFR 489.102, living wills, and healthcare proxies. Part four draws the distinction the course exists for: POLST and MOLST forms are portable medical orders that emergency responders can act on, while advance directives are legal documents that they cannot, and a DNR order addresses attempted resuscitation and nothing else. Part five rehearses the hard moments: family disagreement, requests to ignore or remove a directive, and what a staff member actually does on finding a patient unresponsive. Part six covers revocation of the hospice election under 418.28 and how it differs from both discharge and revoking a DNR. Suitable for new-hire orientation, annual mandatory training, and state patient-rights training requirements.