Policy Manual sample

MDT Home Health Care Agency, Inc. (included in the Service Agreement) 10. Receive information about the scope of services that the Agency will provide and specific limitations on those services (included in the Service Agreement) 11. The patient's family or guardian may exercise the patient's rights when the patient has been judged incompetent, the following explanation is included in the Bill of Rights: “AS OUR CLIENT YOU HAVE THE RIGHT TO EXERCISE YOUR RIGHTS, AND/OR TO DESIGNATE A REPRESENTATIVE TO EXERCISE THEM FOR YOU” 12. The right to choose an attending physician (included in the Bill of Right form) 13. Be informed that OASIS information will not be disclosed except for legitimate purposes allowed by the Privacy Act (Included in the Admission Package, OASIS Privacy information) Our Agency and any staff acting on behalf of our HHA in accordance with a written contract must ensure the confidentiality of all patient identifiable information contained in the clinical record, including OASIS data (if applicable), and may not release patient identifiable OASIS information to the public. PATIENT’S RESPONSIBILITIES: Education about your responsibilities as a Patient, you have the following responsibilities: C Be under a physician's care (licensed in the state of Practice) while receiving the Home Health Agency Services. C Inform the Home Health Agency with a complete and accurate health history in order to plan and carry out care. C Inform Agency staff about any changes in your health status, condition or treatment. C Provide the Home Health Agency with all requested insurance and financial information/records. C Sign or have your legal representative sign the required consents and releases for insurance billing. C Allow the Home Health Agency to act on your behalf in filing appeals of denied payment of service by third - party payers and to cooperate to the fullest extent possible in such appeals. C Notify the Home Health Agency of any changes in treatment made by the physician. C Participate in your plan of care including, if appropriate, a pain management plan. C Ask your nurse/therapist what to expect regarding pain and pain management. Discuss pain relief options with your nurse/therapist. Provide your nurse/therapist with as comprehensive information as possible about your pain and any concerns you may have about pain medications and/or management. C Be available to The Home Health Agency Staff for home visits at reasonable times. C Notify the Home Health Agency If you are going to be unavailable for a visit. C Treat the Home Health Agency Personnel with respect and dignity without discrimination as to color, religion, sex or national or ethnic origin. C Accept the consequences for any refusal of treatment or choice of noncompliance. C Provide the Home Health Agency Personnel with a safe home environment in which your care can be provided. C Cooperate with your physician, The Home Health Agency Staff and other caregivers. C Inform the Agency if you are unable to understand or follow the Agency’s written instructions. C Make a family member or substitute available who will assume a primary caregiver role when Agency staff are not in your home. C Notify the Home Health Agency Of the existence of Advance Directives. C Advice the Home Health Agency Of any problem or dissatisfaction you may have with the care or services you are receiving and giving the agency the opportunity to resolve these issues. Home Health Agency Overall Plan and Budget E-6