MICHIGAN ASSOCIATION FOR HOME CARE
Statement of Patient Rights and Responsibilities
The home health agency must protect and promote the rights of each patient under its care. (Care includes all treatments and services). These rights may be exercised by the patient or the patient’s legal representative when the patient has been judged incompetent.
THE PATIENT HAS THE RIGHT:
1. To be fully informed verbally and in writing (in advance of coming under the care of the agency) of their rights and obligations under any regulatory body or third party payor.
2. To exercise their rights as a patient of the home health agency. In the event that the patient is legally judged incompetent, the patient’s legal representative may exercise these rights.
3. To be informed of the names and professional titles of the staff that will provide care and the proposed frequency of visits.
4. To be informed verbally and in writing in advance about:
A. The care and treatment to be furnished or any changes in the care and treatment to be furnished.
. Expected outcomes, barriers to treatment and consequences of treatment options.
. Their right to participate in planning care or changes in care.
. Community resources available to meet care needs.
5. To be fully informed of outcomes, including unanticipated outcomes, of services provided.
6. To make informed decisions concerning medical care, including the right to accept or refuse treatment and the right to formulate an advance directive (known in Michigan as Durable Power of Attorney for Health Care).
7. To be informed of the agency’s policy of patient Advance Directives including a description of an individual’s rights under State law (whether statutory or as recognized by the courts of the State) and how such rights are implemented by the agency.
8. To be assured that the home health agency will not condition the provision of care or otherwise discriminate against an individual based on personal, cultural or ethnic preference or whether or not the individual has executed an Advance Directive.
9. To have pain assessed and resolved to the best of agency’s abilities.
10. To voice grievances without discrimination or reprisal with respect to treatment or care that is (or fails to be) furnished or regarding the lack of respect for personal property by anyone providing services on behalf of the home health agency. The agency will investigate grievances made by a patient or patient’s guardian and document both the existence of the complaint and the resolution of the complaint. (To lodge complaints with UNS Home Health Agency, Inc. call 1-888-882-5005 or mail the complaint / concern form to UNS Home Health Agency, Inc., 2925 Portage Street, Kalamazoo, MI 49001). Contact name: Susan Molenaar, RN, BSN, Executive Director, office hours 8:00am-5:00pm Monday through Friday. Administrative staff is available after hours by calling regular office phone number and requesting administrator on-call.
11. To be treated with dignity, courtesy and respect, and protected from all forms of abuse, neglect, and exploitation.
12. To have their property treated with respect.
13. To provide privacy during care and security in all interactions with agency staff.
14. To participate in decisions regarding initiating withholding, or withdrawing, life-sustaining care.
15. To be informed of the home health agency’s policy regarding resuscitation of patients, and the implications of a valid “Do Not Resuscitate” (DNR) order that is in effect and available in the medical record.
16. To refuse to participate in experimental treatment or research. To receive competent, professional care.
17. To be referred to another provider organization promptly if the home health agency is unable to meet the patient’s needs or if the patient is not satisfied with the care he/she is receiving.
18. To be involved in seeking resolution to ethical issues in the patient’s care or services within the framework established by the home health agency.
19. To be fully informed verbally and in writing prior to having services initiated, in a language or form understandable to the patient, of the following:
A. All information related to care and treatment in order to make informed decisions.
B. All items, services, products, and equipment provided (directly or under arrangements with the agency) for which payment may be made under Medicare or any other insurance.
. The specific charges for items and services furnished by (or under arrangement with) the agency which are not covered under Medicare or other insurance which the patient will be required to pay.
. Any changes in the charges for items and services for which the patient may be required to pay.
. Disclosure information regarding any beneficial relationships the organization has that may result in profit for the referring organization.
. Billing and payment procedures and any changes in the information provided on admission as they occur within 30 days from the date that the organization is made aware of the change.
20. To be advised of the availability of the toll-free State Home Health Agency hotline. 1-800-882-6006 is available to receive complaints if not resolved by UNS Home Health Agency, Inc., questions or compliments about local home health agencies, or to lodge complaints concerning the advance directive requirements. A representative of Michigan Department of Community Health will answer the hotline during hours of 8:00am – 5:00pm, or will return your message. Your message will be recorded during other hours. Also, see Community Health Accreditation Program (CHAP) hotline phone number 1-800-656-9656, available during the hours of 8:00am – 6:00pm.
21. To expect the home health agency to maintain confidentiality regarding the patients care in accordance with professional and legal mandates.
22. To be informed of the agency’s policy and procedures regarding access and disclosure of clinical records.
THE PATIENT’S RESPONSIBILITIES ARE:
1. To provide an accurate history.
2. To engage a physician and remain under medical supervision.
3. To participate in the established plan of care in partnership with your staff.
4. To communicate changes in the plan of care to agency staff.
5. To treat agency personnel with dignity, courtesy, and respect.
6. To notify the agency in advance if you wish to cancel service(s) and/or prescribed treatments.
7. To notify the agency in advance if unavailable for scheduled visit.
8. To supply medications, equipment, or supplies that the agency in unable to provide.
9. To inform the health care provider of complications or side effects of prescribed treatment.
10. To provide accurate insurance and/or financial information.
11. To notify the agency of any changes in the physician or insurance coverage.
12. To notify the agency of/or change to the Durable Power of Attorney for health care or DNR statusand provide a copy of the same if requested.
13. To provide a safe environment for staff and to secure animals and/or weapons. (Actions that endanger the patient or staff’s safety may be cause for termination of service.)
14. To identify an alternative plan and/or caregiver in the event of an emergency or a natural disaster.
15. To accurately report symptoms, follow your medical plan, ask questions, and share concerns regarding your condition and treatment.
10/08, rev. 1/14 ajb