Hospice 101 Acknowledgement
Thank you for the privilege of working together to serve your residents and their families at end of life. As part of our contractual relationship, we are pleased to provide you with hospice orientation materials to train your facility staff on end-of-life care. The intention of this material is also to ensure regulatory compliance for your facility staff and our hospice in accordance with Conditions of Participation (COP) from CMS.
Upon signing this page, you will receive the instructional materials to be used for your staff’s orientation purposes. We are pleased to offer multiple options for this training. These sessions can be conducted by your training staff or by choosing one of the options for a member or our Hospice & Community Care Team to provide the education. More information will be provided with the instructional materials upon completion of the form. Please contact Karen Stauffer at (717) 490-4074 with questions or for additional details.
- Hospice 101 Presentation (Alternate PDF)
- Mission, Vision, and Values Statement
- Long Term Care Facility Agreement
- Notice of Privacy Practices
- Notice of Nondiscrimination in Health Programs and Activities
- Election of Hospice Medicare Benefit Informed Consent
- Fax Cover Sheet Nursing Home Billing Arrangements
- Care Facility Contacts
- Volunteer Nursing Facility Resident Visit Form
- Corporate Compliance Plan