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PRINTED: DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES(X1) PROVIDER/SUPPLIER/LIGAND PLAN OF CORRECTIONIDENTIFICATION NUMBER:15155906/29/2016FORM
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Begin by reading the instructions thoroughly. Ensure you have all the necessary documents and information.
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Start by providing your personal information, including your full name, address, contact details, and date of birth.
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Next, provide your medical history, including any existing conditions, medications you are currently taking, and previous treatments.
05
Provide the contact details of your primary healthcare provider and any other healthcare professionals involved in your care.
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Specify your preferences for hospice care, including the location (home or facility), the desired level of involvement from family members, and any specific religious or cultural considerations.
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Review the completed form for any errors or missing information before submitting it to the Dekalb Health Hospice.

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Dekalb Health Hospice is designed for individuals who require end-of-life care and support. This includes individuals with terminal illnesses or life-limiting conditions that no longer respond to curative treatments. Patients who have a prognosis of six months or less to live, as determined by a doctor, may benefit from Dekalb Health Hospice services. It is essential for individuals who wish to spend their final days in the comfort of their own home or prefer personalized care in a hospice facility. Dekalb Health Hospice aims to provide physical, emotional, and spiritual support to both the patient and their families during this difficult time.
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Dekalb Health Hospice provides care and support for terminally ill patients and their families.
Healthcare providers and facilities responsible for the care of terminally ill patients are required to file Dekalb Health Hospice.
To fill out Dekalb Health Hospice, complete the required forms with patient information and care details.
The purpose of Dekalb Health Hospice is to provide compassionate care for terminally ill patients and support for their families.
Information such as patient demographics, medical history, treatment plans, and end-of-life care preferences must be reported on Dekalb Health Hospice.
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