Patient Bill Of Rights
AS A HOME CARE PATIENT YOU HAVE THE RIGHT TO:
- Receive a copy and explanation of the Bill of Rights upon admission and subsequent revision of the Bill of Rights; be informed of your right as an adult to self-determination regarding health care treatment and to designate another adult to make those decisions should you become incapacitated.
- Receive appropriate and professional home care services without discrimination as to age, sex, race, religion, national origin, sexual orientation, diagnosis, HIV status or handicap.
- Be treated with consideration, respect, dignity, individuality and be free from mental and physical abuse and/or neglect by staff.
- Have your property treated with respect.
- Choose your home care provider and receive information about how and when services will be provided, the name and function of any person or affiliated Agency providing care services.
- Receive a timely response from the Agency following a request for home care services.
- Receive a list of Agency services, what it can and can not do, and receive information orally and in writing about the expected payment coverage from any third party payers and what cost you will be responsible for, and of any changes in payment coverage as soon as possible after they occur but within 30 days of the Agency learning of the change;
- Be informed of all treatments and /or products to be provided by the Agency (in terms you can reasonably be expected to understand) and your anticipated financial responsibilities in advance of a service;
- Participate in the development and revision of your plan of care to meet your unique health care needs and receive an assessment and update of your status; and participate in the development of your discharge or transfer plan;
- Refuse services, medication and treatment, to the extent permitted by law, after being fully informed of and understanding the consequences of such a decision;
- Review and/or receive a copy of your clinical record upon your written request.
- Privacy and confidentiality of your patient record including the right to refuse release of the clinical record except as required by law or third party payment contract or when transferred to a health facility;
- To have their pain managed at home to the extent possible as determined by the patient's beliefs and desires, cause and treatment alternatives available.
- Recommend changes to Agency staff regarding policies or services or make a complaint to the Agency Administrator at 718-499-6066 and/or the New York State Department of Health at 212-417-4921 or others of your choice, without fear of interference, coercion, discrimination or reprisal; and
- To file a complaint about the care, services provided or not provided, or lack of respect for your property by anyone furnishing services by or on behalf of the Agency, and expect that it will be investigated, you may file a complaint orally or in writing, to do so you should:
- If possible, discuss your complaint with the staff member involved/caring for you,
- If you are not satisfied or do not feel you can discuss the situation with them, send it to or call the Nursing Supervisor at 718-499-6066 to discuss it.
- If you are dissatisfied with the response, you may appeal by writing or calling the Agency Administrator at 718-499-6066 to explore it further. You will receive a response in writing within 15 days of receipt of the complaint.
- If dissatisfied, you may appeal in writing to the Board of Directors of the Agency at the above address, specify your complaint and request a resolution. You will receive a response within 30 days of receipt of the complaint.
- If the response is unsatisfactory, you may appeal to the New York State Department of Health at:
Home Health Care Service Program Director
NEW YORK STATE DEPARTMENT OF HEALTH
METROPOLITIAN AREA REGIONAL OFFICE
90 CHURCH STREET, 13™ FLOOR
NEW YORK, NY 10007
HOTLINE # 1-800-628-5972 OR 1-212-290-4100
AS A HOME CARE PATIENT, YOU HA VE THE RESPONSIBILITY TO:
- Provide complete and accurate health information concerning past illnesses, hospitalization, medications, allergies and other pertinent items and, if necessary, financial information;
- Assist in developing and maintaining a safe environment for yourself, caregiver and Agency staff;
- Cancel scheduled visits in advance if you are unable to receive the staff member;
- Participate in the development and update of the care plan, adhere to the plan of care and transfer/discharge plan;
- Request additional information or clarification as needed;
- Discuss concerns and problems with Agency staff as they arise;
- Adhere to agreed upon financial arrangements;
- Review and sign the Bill of Rights to signify understanding and acceptance of the service relationship, keep a copy of the Bill of Rights;
- Notify the Agency if you receive care from another source;
- Secure medical care initially and at intervals as requested by staff and
- Refrain from discriminating against staff members.
All rights and responsibilities specified as they pertain to a patient adjudicated incompetent in accordance in state law devolve to the appointed committee authorized to act on behalf of the patient.
The Patient, Family and Agency have Mutual Responsibilities to ensure that the Best Home care is provided and correctly used.
This statement of rights and responsibilities is for the purpose of your education and to establish and maintain proper understanding and expectations about the care to be provided to you.