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Patient Rights and Policies

Patient Rights

POLICY: Clients will be informed of their rights as a consumer of home care services. This includes the right to voice grievances and request changes without discrimination, reprisal, or unreasonable interruption of service.

 

PURPOSE: To consistently inform clients verbally and in writing, or by other means understood by the clients, of their right to make informed decisions regarding their care.

To protect and promote the exercise of clients’ rights.

To establish, operate, and maintain a grievance/complaint mechanism for use by the client/representative, which assures response and disposition and is in operation at a minimum during normal business hours.

 

SPECIAL INSTRUCTIONS

  1. A designated Registered Nurse/Therapist shall provide the client with the Written Notice of Consumer Rights and the Patient Rights and Responsibilities in writing in advance of furnishing care to the client or during the initial evaluation visit before treatment is initiated. In the event that the client is unable to make decisions, the Patient Rights and Responsibilities shall be given to the client’s legal guardian.

  2. If the patient is a minor the form shall be given to the minor’s parents/guardian. The reason the client is unable to acknowledge receipt of both the Written Notice of Consumer Rights and the Patient Rights and Responsibilities shall be documented.

  3. Client’s have the right to select a representative to assist them with care decisions and participate in care planning and implementation with the agency. The agency will ask the patient if they have such a selected representative. The representative will receive a copy of the client rights and responsibilities including discharge and transfer policies within four (4) business days of the initial evaluation visit. The agency will require a signature for receipt of this information, and signature confirmation will be maintained in client’s medical record.

  4. Clients/families/representatives will be informed of their right to privacy and confidentiality related to personal health care information data collection and transmission (OASIS).

  5. The rights will be provided verbally in the primary or preferred language of the individual, client or representative. If a patient cannot read the statement of rights and responsibilities, it is read and a copy given to the patient in a language the patient understands. As needed the verbal presentation may be provided prior to initiation of the second visit.  For a minor or a patient needing assistance in understanding these rights and responsibilities, both the patient and the parent, legal guardian, or other responsible person are fully informed of these rights and responsibilities.

  6. In situations in which the patient has been adjudged incompetent under state law by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed to act on the patient’s behalf.  If a state court has not adjudged a patient incompetent, any legal representative designated by the patient in accordance with state law may exercise the patient's rights to the extent allowed by state law.

  7. The agency provides information on Advance Directives. Written information will include both agency policies on Advance Directives, and applicable state information. This will be provided prior to care being provided.

  8. The client/caregiver shall be advised orally and in writing of their right to voice grievances and the method of contacting the agency if dissatisfied. This shall include information about the Home Health Agency Hotline (established by the state), including its hours of operation and that the purpose of the hotline is to receive questions or complaints about local home health agencies.

    Clients shall be informed of their right to voice a grievance without fear of retaliation from the provider (see complaint policy).

  9. The Agency may not request nor obtain from the client any waiver of any of the client’s rights.

  10. The Patient Rights and Responsibilities shall be redistributed to clients following any revisions or modifications.

  11. Documentation of the receipt of the Patient Rights and Responsibilities will be maintained in the clinical record.

  12. All complaints and status of investigation will be documented and maintained in a Confidential Administrative File.

  13. A summary of complaint reports will be presented to Professional Advisory Board and recommendations documented.

  14. When the client/caregiver have reviewed the Patient Rights and Responsibilities and their right to complain to the agency, they are also given the numbers and contact information for both the state specific Medicare Home Care.

 

EXPANDED RIGHTS AND RESPONSIBILTIIES

  1. Be fully informed in advance about service, care to be provided included the disciplines that furnish care and the frequency of visits as well as any modifications to the service care plan.

  2. Receive information about services provided under the Medicare Home Health benefit; for Medicare beneficiaries.

  3. Participate in the development and periodic revision of the Plan of Care, and be advised of any change in the plan of care before it is made.

  4. Be informed of the right to refuse in advance or during care or treatment after the consequences of refusing care or treatment are fully presented.

  5. Participate in, be informed about and consent to (i) completion of all assessments, (ii) care to be furnished based on the assessment(s), (iii) expected outcomes, including developing patient identified goals, (iv) disciplines that will furnish care and frequencies of visits, (v) anticipated risks and benefits, (v) factors that could affect treatment, (vi) changes in care to be furnished.

  6. Be informed, both verbally and in writing, of care being provided of the charges, including payment for service and care, including payment for service/care expected from third parties and any charges for which the patient will be responsible and i. The extent to which payment for HHA services may be expected from Medicare, Medicaid, or any other federally funded or federal aid program known to the HHA; (ii) The charges for services that may not be covered by Medicare, Medicaid, or any other federally-funded or federal aid program known to the HHA; (iii) The charges the individual may have to pay before care is initiated; and (iv) any changes in the information provided in accordance with 42 CFR 484.50(c)(7) of this section when they occur. The HHA must advise the patient and representative (if any), of these changes as soon as possible, in advance of the next home health visit.

  7. Receive all services in the plan of care.

  8. Receive written notice in advance of furi if the agency believes services may not be covered by the patient’s payer, and in advance of the agency reducing or terminating care.

  9. Have one’s property and person treated with respect, consideration and recognition of patient dignity and individuality.

  10. Be able to identify visiting staff members through proper photo identification.

  11. Be free from mistreatment, neglect or verbal, mental, sexual and physical abuse including injuries of unknown source and misappropriation of patient property.

  12. Voice grievances/complaints regarding treatment or care, lack of respect of property or recommend changes in policy, staff or service/care without restraint, interference, coercion, discrimination or reprisal.

  13. Have grievances/complaints regarding treatment or care that is or fails to be furnished or lack of respect of property investigated.

  14. Choose a health care provider including an attending physician.

  15. Confidentiality and privacy of all information contained in the patient record and of protected health information.

  16. Be advised on agency’s policies and procedures regarding the disclosure of clinical records.

  17. Receive appropriate care without discrimination in accordance with physician orders.

  18. Be informed of any financial benefits to the agency when referred to an organization.

  19. Be fully informed of one’s responsibilities.

  20. Receive information about the scope of services that the organization will provide and specific limitations on those services.

  21. Be informed of patient rights under state law to formulate advance directives.

  22. Be informed of anticipated outcomes of care and of any barriers in outcome achievement

  23. Be informed of that OASIS information collected will not be disclosed except for legitimate purposes allowed by the Privacy Act.

  24. The right to be advised orally and in writing, before care is initiated, of the extent that payment for the agency services may be expected from Medicare or other sources, and the extent of that payment; furthermore, to receive written notice if the agency believes a service is non-covered.

  25.  Be informed of organizational ownership and control.

  26. Be informed of the names and addresses of federally and state funded entities that serve the area in which the client resides.

  27. Be informed of the right to access and how to access auxillary aids.

 

If you believe your rights have been violated you may contact the agency directly:

24/7 AvaRe Healthcare

Tatyana Akhmetova, Administrator

8055 E. Tufts Ave., Ste. 250 Denver, CO 80237

Contact

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123-456-7890 

ADMISSION POLICY

POLICY: Clients are accepted for treatment in the home on the basis of reasonable criteria and under the expectation that the client’s medical, nursing, and social needs can be met adequately by Agency in the client’s place of residence. Agency shall make available and provide services to all persons without regard to race, color, creed, sex, national origin, handicap, sexual orientation, age, marital status, status with regard to public assistance or veteran status, in compliance with 45CFR parts 80, 84, 91, and other agency guidelines. All services are available without distinction to all program participants, regardless of diagnosis. Agency shall not deny admission to people with a contagious disease, including, but not limited to HIV, MRSA, and Hepatitis. All persons and organizations that either refer persons for services or recommend the agency’s services shall also be advised of same. The person designated to coordinate the agency’s compliance with Section 504 of the Rehabilitation Act of 1973 (nondiscrimination against the handicapped) is Tatyana Akhmetova who can be reached at 303-247-1111

 

PURPOSE: To provide guidelines for accepting clients for home health care services to be provided in the client’s place of residence that are clear to the home care staff, the medical and lay community, and that abide by state/federal guidelines. To comply with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, The Age Discrimination Act of 1975, all the requirements imposed by, or pursuant to, the regulations of the Department of Health and Human Services (45CFR Parts 80, 84, and 91) issued pursuant to these statutes and other agency guidelines.

 

SPECIAL INSTRUCTIONS: Criteria for Client Admission: A direct request for service shall be made to the agency. It may be generated by a client, physician, caregiver, health facility representative or community member. The client must live in the geographic area served by the Agency. Services for a client receiving Skilled Nursing, Therapy, Medical Social Services or Home Health Aide services must follow a written Plan of Care established and periodically reviewed by a doctor of medicine, osteopathy, or podiatric medicine. The written Plan of Care shall be reviewed at least every 60 days by that physician or their designee. There must be a reasonable expectation that the client’s medical, nursing, social, or rehabilitation needs can be adequately met in the client’s home. Reasonable expectation shall consider: Whether the agency’s personnel and resources are adequate and suitable for providing the services the client requires. The attitudes of client/caregiver toward care at home. The benefits of care at home as compared to care in a hospital, extended care facility or alternate setting. Whether the physical facilities in the client’s home are adequate for giving the client proper care. There is indication that the delivery, monitoring and coordination of home health care services will enable the client to remain within the home environment. When determined necessary based on the client’s condition, a competent caregiver and/or family member may assume responsibility for client care with intermittent services provided by the agency. Medicare beneficiaries must meet the qualifying criteria identified in the Conditions of Participation for the agency to receive payment for services from Medicare (Policy C-122). The client must be entitled to receive covered home health services under the Health Insurance for the Aged Act, Title XVIII and/or Title XIX of the Social Security Act (Medicare and Medicaid), or have other funding sources, i.e., private insurance, HMO, or ability to self pay. Agency services must be appropriate and available to meet the specific needs and requests of the client and caregiver.

 

MEDICARE QUALIFYING CRITERIA FOR BENEFICIARY REIMBURSEMENT POLICY: To accept a client for care under Medicare reimbursement, the client must meet qualifying criteria as outlined in the current CMS Internet Only Manuals 100-2, Chapter 7 (CMS Home Health Agency Manual and in the CFR 42 S93 Section 409.42). PURPOSE To provide written guidelines for determining whether clients qualify for Medicare reimbursement of home health services.

 

SPECIAL INSTRUCTIONS: The client must be confined to the home or place of residence that is not a hospital or skilled nursing facility (Homebound.) The client may leave their home for medical appointments and treatments without compromising home bound status. Attendance at adult day care does not preclude the client from receiving Medicare home health services, if indicated. The client must be under the care of a physician who establishes and reviews the Plan of Care. The client must need at least one of the following skilled services as certified by the physician: Intermittent skilled nursing. Physical therapy. Speech Language Pathology. Continuing Occupational therapy if the prior need for skilled nursing, physical therapy, or speech therapy had been established in the current or prior certification period. The services required or anticipated coverage needed must meet part-time or intermittent criteria. The services must be reasonable and necessary as determined by client condition, diagnosis, available caregivers and documentation must also reflect that services meet this criteria. Physician orders must be present and signed specifying the medical treatments to be furnished, type, frequency, and duration of services to be provided by discipline(s). Orders must be reviewed by the physician at least every sixty (60) days. Services must be furnished by a Medicare-certified agency. The client must be eligible for Medicare.