Patient Rights & Responsibilities

As a HOSPICE OF THE VALLEYS patient, you have the right to:

1. Be informed of your rights in a manner which you understand.
2. Make informed decisions regarding proposed and ongoing care and services.
3. Choose whether or not to participate in research, investigational or experimental studies, or clinical trials.
4. Have your communication needs met.
5. Have complaints/grievances heard, reviewed, and if possible, resolved.
6. Confidentiality of protected health information, privacy and security mandated by Federal law and outlined in hospice’s Notice of Privacy Practices.
7. Be fully informed of your rights in a manner which you understand, as evidenced by your written acknowledgement or by that of your appointed representative, of these rights and of all rules and regulations governing patient conduct, prior to or at time of admission.
8. Be involved in the care planning process.
9. Be fully informed by a physician of your medical condition, unless medically contraindicated, and to be afforded the opportunity to participate in your medical treatment.
10. Formulate advance directives.
11. Have an appropriate assessment and management of your pain.
12. Keep and use personal clothing and possessions.
13. To have property and person treated with respect, free of mistreatment, neglect, or verbal, mental, sexual and physical abuse, including injuries of an unknown source.
14. An environment that preserves dignity and contributes to a positive self-image. In the interest of safety for the patient, family and staff if in the event of a pandemic or other emergency, visitors may be limited during hospice staff visits.
15. Be fully informed, prior to or at time of admission, of services available through HOSPICE OF THE VALLEYS, and related charges, including services not covered under Titles XVIII or XIX of the Social Security Act.
16. Refuse treatment to the extent permitted by law and to be informed of the medical consequences of such refusal.
17. Be advised of what hospice services are to be rendered and by what discipline, e.g., registered nurse, counselor, chaplain, etc.
18. To choose his/her attending physician.
19. Be advised in advance of any change in treatment, care or services.
20. Be assured confidential treatment of personal and clinical records and to approve or refuse their release to any individual outside the hospice, except in the case of transfer to another health facility, or as required by law or third-party payment contract.

21. Be treated with consideration, respect, and full recognition of dignity and individuality, including privacy in treatment and in care for personal needs.
22. Not be subjected to discrimination, exploitation, verbal, physical or sexual abuse of any kind, and not be subjected to reprisal for exercising his/her rights.
23. Be informed by the licensee of the provisions of the law regarding complaints and procedures for registering complaints confidentially, including, but not limited to, the address and telephone number of the local District office of the Department of Health Services and Community Health Accreditation Partner (CHAP).
24. Be informed of the provisions of the law pertaining to advanced directives, including but not limited to living wills, power of attorney for health care, withdrawal or withholding of treatment and/or life support.
25. Be assured the personnel who provide care are qualified through education and experience to carry out the services for which they are responsible.
26. Right to services provided without regard to race, religion, age, gender, sexual orientation, disability (mental or physical), communicable disease, or place of national origin.
27. Request health information in a format of their choosing. Currently Hospice of the Valleys offers paper documentation via in person delivery, mail, encrypted email, fax or DocuSign.

Patient and Caregiver Responsibilities
As a HOSPICE OF THE VALLEYS patient, you and your caregivers have the responsibility to:

1. Treat hospice personnel with respect and consideration in word and deed. Hospice of the Valleys will not tolerate any verbal or physical abuse of staff members.
2. Provide a safe home environment in which care can be given. If the patient’s or staff’s welfare or safety is threatened, service may be terminated.
3. Immediately inform hospice staff of any suspected COVID-19 (or other infectious diseases) symptoms of the patient/family including, but not limited to: fever, shortness of breath, or chest pain.
4. Any weapon/firearm and ammunition will be placed out of sight in a secure area.
5. Keep pets secured away from Hospice staff for safety and to avoid contamination of equipment/bags.
6. Obtain consent from your hospice staff or caregiver before audio or video recording
them. Under California law, both parties (the patient and the staff or caregiver) must consent prior to being recorded.
7. Remain under a doctor’s care while receiving hospice services.
8. Inform the hospice of advance directives or any changes in advance directives, and provide the hospice with a copy.
9. Cooperate with your primary doctor, hospice staff and caregivers by providing information, following instructions and asking questions.

10. Notify the hospice of address or telephone number changes or when you are unable to keep appointments.
11. Obtain medications, supplies and equipment ordered by your physician if they cannot be obtained or supplied by the hospice.
12. Sign the required consents and releases for insurance billing, and provide insurance and financial records as requested.
13. Accept the consequences for any refusal of treatment or choice of non-compliance.
14. Advise the agency of any problem or dissatisfaction with our care, without being subject to discrimination or reprisal. The Hospice shall investigate all grievances; document the existence of the complaint and findings. Findings will be communicated to the patient/family.

(Revised 1/24/22)


If you have any questions or concerns regarding the services you have received from HOSPICE OF THE VALLEYS or the implementation of your Advanced Directives contact:

Hospice of the Valleys Main phone number:   951-200-7800.                      Alternative number: 877-889-0325

The Following Resources Are Available to You:

Community Health Accreditation Partner (CHAP) 24-hour Hotline, toll-free that you may contact at any time for complaints: 800-656-9656
Department of Public Health Service operates a 24-hour, toll-free hotline that you may contact at any time for complaints:

Department of Health Services:  888-354-9203

In Riverside District:  909-388-7170

The Department of Public Health Service office hours are M-F, 8 am – 5 pm except holidays. You may write to them at the following address:

Department of Health Services, 625 E. Carnegie Drive, Suite 280 San Bernardino, CA 92408

Information blocking complaints can be submitted through the Office of the National Coordination for Health Information Technology. create%2F67

Notice to Consumers:

Medical doctors are licensed and regulated by the Medical Board of California.


(Revised 1/24/22)