Hospice Contract Templates are editable templates with prompts to customize with your agency's specific information. Order individual templates or the entire package, discounted as a set.
Hospice Contract Template Package is a set of all five and includes:
- Hospice DME Contract Template
- Hospice Pharmacy Services Contract Template
- Hospice Professional Services Contract Template
- Hospice SNF Contract Template
- Hospital Inpatient and Respite Services Contract Template
Hospice Contract Template Package includes five hospice contract templates. The templates are completely editable and include prompts for your agency to fill in the blanks to enter your agency's specific information. Ordering the package saves $301 off the price of ordering all five individually. This set of five is available via an email link once the order is processed (typically about 24 business hours.
Individual Hospice Contract Templates: Select from the following 5 Templates:
Hospice DME Contract Template
The Hospice Durable Medical Equipment Contract Template is focused toward hospices that contract with DME companies to provide medical equipment. This template is completely editable and includes prompts for your agency to fill in the blanks to enter your agency's specific information. Items covered include:
- A statement of principles
- Definitions
- Responsibilities of supplier
- Patient education
- Equipment maintenance
- Responsibilities of the hospice
- Compensation
- Term and termination
- General provisions, etc.
Hospice Pharmacy Services Contract Template
The Hospice Pharmacy Services Contract Template is focused toward hospices that contract with pharmacies with licensed pharmacists to provide pharmacy services. This template is completely editable and includes prompts for your agency to fill in the blanks to enter your agency's specific information. Items covered include:
- A statement of principles
- Definitions
- Responsibilities of pharmacy
- Responsibilities of the hospice
- Compensation
- Term and termination
- General provisions, etc.
Hospice Professional Services Contract Template
The Hospice Professional Services Contract Template is meant for hospices that contract with a Medical Director, Nurse Practitioner, or other professional to provide service. This template is completely editable and includes prompts for your agency to fill in the blanks to enter your agency's specific information.
*This contract is included in TCG's Hospice Policy & Procedure manuals.* Items covered include:
- A statement of principles
- Definitions
- Responsibilities of pharmacy
- Responsibilities of the hospice
- Compensation
- Term and termination
- General provisions, etc.
Hospice SNF Contract Template
The Hospice SNF Contract Template is meant for hospices that contract with nursing homes to provide hospice care to nursing home residents. This template is completely editable and includes prompts for your agency to fill in the blanks to enter your agency's specific information. Items covered include:
- Definitions
- Responsibilities of the hospice
- Responsibilities of the nursing home
- Services to be performed cooperatively by hospice and the nursing home
- Records and maintenance of records
- Financial responsibility
- Term and termination
- General provisions
- Admission criteria, etc.
Hospice Inpatient and Respite Services Contract Template
The Hospice Inpatient and Respite Services Contract Template is for hospices that partner with a hospital to make inpatient facilities and services available to hospice patients for symptom management, pain control, and respite care. This template is completely editable and includes prompts for your agency to fill-in the blanks to enter your agency's specific information. Items covered include:
- A statement of principles
- Definitions, responsibilities of the hospital
- Responsibilities of the hospice
- Qualifications
- Compensation and billing
- Term and termination
- General provisions
- Compensation, etc.
