HIGH PEAKS HOSPICE
CLINICAL POLICIES AND PROCEDURES
As of April 4, 2019
These policies are listed in alphabetical order regardless of policy number; revision date is indicated after the title. Forms are listed under the policy to which they pertain.
Admission Criteria CP-202 (Updated 09/01/18) (See Inpatient Care CP276 and Skilled Nursing Facility Care CP277 for more information).
Advance Directives CP-204 (Updated 09/01/18) (Also See "Do Not Resuscitate, CP221")
Brochure: Planning Your Health Care in Advance (NYSOAG)2016 (27 Pages)
Information: Patient Self-Determination Information (Rev 07/18)
Adverse Events CP230 (Upd 09/01/18) For Medication Incidents see "Medication Errors CP239"
Form - Authorization for Release of Health Information and Confidential HIV Related Information (DOH2557, R2/11) go to NYS DOH Website for this form
Form - Redisclosure of HIV Information (Rev 07/18)
Form - Hospice Aide Activity Sheet (Rev 07/18)
Form - Hospice Aide Extended Service Checklist (Rev 04/19)
Form - Hospice Aide Orientation/Supervision Summary (Rev 07/18)
Form - Hospice Aide Orientation to Hospice Care (Rev 07/18)
Form - IDT Meeting (Rev 04/19)
Nursing Home Care CP277 is now under "SKilled Nursing Facility Care"
Instructions: ABN of Non Coverage CMS-R-131
Information - Informed Consent Policy by Arent Fox
Skilled Nursing Facility Care CP277 (Updated 09/01/18) was "Nursing Home Care"
Suspected Abuse and/or Neglect CP-266 (Updated 09/01/18)
Form - Report of Suspected Child Abuse (NYS OCFSForm 09/16) Fill in form on NYS OCFS website