HOME HEALTH
Patient Responsibilities

As a patient, I also understand I have a responsibility to:

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1. Provide accurate and complete information to the Agency regarding my medical history and current condition, any payers which may cover my care, financial information and to promptly inform the Agency of changes in this information.

2. Agree to accept caregivers regardless of age, race, color, national origin, religion, sex, disability, being a qualified disabled veteran, being a qualified veteran of the Vietnam era, or any other category protected by law.

3. Select a physician; remain under medical supervision and to notify the Agency of changes in my physician, medication, treatment, or symptoms (when medical supervision is required).

4. Maintain an adequate and safe environment for homecare.

5. Protect my valuables by storing them carefully in an appropriate manner.

6. Participate in planning, evaluating and revising my care plans to the degree that I am able to do so.

7. Adhere to the plan of care, which I participated in developing.

8. Ask the Agency's personnel what to expect regarding pain and pain management, discuss pain relief options with them, work with them to develop a pain management plan, ask for pain relief when pain begins, help the Agency's personnel assess your pain, tell them if your pain is not relieved, and tell them about any worries you have about taking pain medications.

9. Arrange for supplies, equipment, medications, and other services which the Agency can not provide which are necessary for provision of care and my safety.

10. Notify the Agency prior to the scheduled visit if l will not be available, do not want service, or wish to discontinue with the Agency.

11. Treat the Agency's staff with respect, courtesy, and consideration.

12. Pay for services as agreed in my Home Care Consent.

13. Accept the consequences for any refusal of treatment or choice of noncompliance, including changes in reimbursement eligibility.

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