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DONT UPSET PATIENT EVER.
As a home care provider, we have an obligation to protect the rights of our patients and explain these rights to you before treatment begins. Let them know that their family or your designee may exercise these rights for you in the event that you are not competent or able to exercise them for yourself.
Please let them know that as a patient they have the right to:
Competent, individualized health care without regard to race, color, creed, sex, age, national origin, handicap, ethical/political beliefs, ancestry, religion or sexual orientation or whether or not an advance directive has been executed.
Receive appropriate care without discrimination in accordance with physician orders.
Exercise your rights as a patient of this agency or, if appropriate, the patient representative with legal authority to make health care decisions has the right to exercise your rights at any time.
Be treated with consideration, respect, and full recognition of the patient’s human dignity and individuality, including privacy in treatment and care for personal needs.
Receive treatment, care, and services that are adequate, appropriate, and in compliance with relevant State, local, and federal laws and regulations.
Participate, either yourself or your designated representative, in the consideration of ethical issues that arise in your care.
Have your property and person be treated with respect.
Be free from mental, verbal, sexual and physical abuse, neglect, involuntary seclusion and exploitations including humiliation, intimidation or punishment including injuries of unknown source, neglect and misappropriation of property by anyone
Be admitted for service only if the agency has the ability to provide safe, professional care at the level of intensity needed.
Expect all personnel caring for you will be current in knowledge, duly licensed or certified as applicable and have completed a training –program or competency evaluation regarding his/her respective areas of employment.
Participate in, be informed about, and consent or refuse care in advance of and during treatment, where appropriate, with respect to
Completion of all assessments;
The care to be furnished, based on the comprehensive assessment;
Establishing and revising the plan of care;
The disciplines that will furnish the care;
The frequency of visits;
Expected outcomes of care, including patient-identified goals, and anticipated risks and benefits;
Any factors that could impact treatment effectiveness; and
Any changes in the care to be furnished.
A plan of care which shall include the frequency of visits, expected outcomes of care, including patient-identified goals, and anticipated risks and benefits, any factors that could impact treatment effectiveness and any changes in the care to be furnished.
Know when and how each service will be provided and coordinated, the agency ownership, name and functions of any person and affiliated agency personnel providing care and services.
Choose care providers, to communicate with those providers and to reasonable continuity of care.
Be fully informed, orally and in writing, at the time of admission and in advance of care provided, a statement of services available by the agency, care and treatment provided by the agency and related charges. This must include those items and services for which you may be responsible for reimbursement. The agency will advise you of changes orally and in writing as soon as possible, in advance of the next home health visit.
Be informed of any financial benefits.
Be advised, orally and in writing, of the extent to which payment for services may be expected from Medicare, Medicaid, or any other federally funded or federal aid program known to the organization.
Be informed about the nature and/or purpose of any technical procedure that will be performed including information about both the potential benefits and burdens to him/her, as well as who will perform the procedure.
Be taught and have your family members taught the treatment plan, so that you can, to the extent possible, assist yourself and your family or other designated party can also understand and assist you.
Request information regarding the diagnosis, prognosis and treatments including alternatives to care risk(s) involved. This information will be given in a language or format so that you and your family members can readily interpret and understand so that informed consent may be given.
Refuse treatment after the possible consequences of refusing treatment have been fully explained.
The agency shall allow a patient, or patient representative with legal authority to make health care decisions, to accept or reject, at the patient’s or patient representative’s discretion without fear of retaliation from the agency, any employee, independent contractor, or contractual employee that is referred by the agency.
To refuse any portion of planned treatment or other portions of the treatment plan, except where medical contraindications to partial treatment exist.
An individual who is not certified to help with activities of daily living and treatments of a routine nature if the patient signs a waiver of skilled services detailing the potential risks and benefits of waiver.
Have a confidential patient record and access to or release of patient information and records in accordance with Health Insurance Portability and Accountability Act (HIPAA) law and regulation (45 CFR parts 160 and 164).
Review all of your health records during normal business hours.
Assistance in the locating appropriate community resources before you run out of funds. However, in keeping with proper fiscal responsibility, uncompensated care may not be provided.
Be informed of patient rights regarding the collection and reporting of OASIS information.
Be informed that OASIS information will not be disclosed except for legitimate purposes allowed by the Privacy Act.
Be informed of anticipated outcomes of care/services and of any barriers in outcome achievement.
Privacy including confidentiality of all record communications, personal information and to transfer to a health care facility, as required by law or third-party contracts. You shall be informed of the policy and procedure regarding disclosure of your clinical records.
Receive the care necessary to assist you in attaining optimal levels of health, and if necessary, cope with death. To know that a patient / patient does not receive experimental treatment or participate in research unless he / she gives documented voluntary informed consent.
Provide information to a patient about advance directives and the right to have an advance directive and this agency request information regarding the patient’s advance directives to determine whether the advance directive information has an impact on care provided.
Be informed in writing of policies and procedures for implementing advance directives, including any limitations if the provider cannot implement an advance directive on the basis of such limitations as living wills or the designation of a surrogate decision-maker, are respected to the extent provided by law.
Know that Do – Not – Resuscitate orders shall not constitute a directive to withhold or withdraw medical treatment other than CPR. Withdrawal of life sustaining treatment is done only after the physician has ordered it and the family / significant other is notified.
Be informed of the procedures for submitting patient complaints with respect to patient care, that is, or fails to be furnished or regarding the lack of respect for property by anyone who is furnishing services on behalf of the agency with suggested changes in services without coercion, discrimination, reprisal or unreasonable interruption of services.
Choose a health care provider, including choosing an attending physician
The consumer or authorized representative has the right to be informed of the consumer’s rights through an effective means of communication.
The patient has the right to be informed about the individuals providing his or her care the patient has the right to be informed of the full name, licensure status, staff position and employer of all persons with whom the consumer has contact and who is supplying, staffing or supervising care or services. The patient has the right to be served by agency staff that is properly trained and competent to perform their duties. Be able to identify visiting staff through proper agency generated photo identification.
The telephone number where a patient or the patient representative can contact the agency 24 hours a day, 7 days a week regarding care is 833-286-7466.
This agency shall disclose of any sub contractual relationship with any individual or agency to be assigned or referred to provide care to the patient.
Live free from involuntary confinement, and to be free from physical or chemical restraints.
Be provided with updates and state amendments on individual rights to make decisions concerning medical care within 90 days from the effective date of changes to state law.
Receive information about the care/services covered under the Medicare Home Health Benefit.
A patient has the right to receive information about the scope of services that the organization will provide and specific limitations on those services.
Be informed of the agencies transfer and discharge policies.
The agency Administrator name is: Eddin Ansari
Provide verbal notice of the patient's rights and responsibilities in the individual's primary or preferred language and in a manner the individual understands, free of charge, with the use of a competent interpreter, if necessary, no later than the completion of the second visit from a skilled professional.
Provide written notice of the patient's rights and responsibilities and this agency’s transfer and discharge policies to a patient-selected representative within 4 business days of the initial evaluation visit
Be informed of the procedure for submitting a written complaint / grievance to the home health agency. All complaints / grievances may be given to any agency member. If not satisfied with the response or any step-in chain of command, continue to the next person. Contact, UMS Homecare and speak to the following:
Case Manager
Clinical Manager
Administrator
Receive a prompt response, through an established complaint or grievance procedure, to any complaints, suggestions, or grievances the participant may have. Administrator or designee documents and investigates the grievance/complaint within 10 calendar days of receipt of the complaint. The Administrator or designee must complete the investigation and documentation within 30 calendar days after the Agency receives the complaint unless the Agency has and documents reasonable cause for delay. You may appeal the administrator findings to the Governing Board by submitting a written complaint to:
Attention Governing Body
UMS Homecare
85 Main Street, Suite 101,
Hackensack, NJ 07601
Voice and report grievances or complaints regarding treatment or care that are (or fail to be) delivered, the lack of respect for property and/or person, or the violation of any rights to the organization, CHAP, and state or local agencies.
Be informed of your state’s home health agency hotline and the agencies contact information make suggestions or complaints, or present grievances on behalf of the patient to the agency, government agencies, or other persons without the threat or fear of retaliation.
For New Jersey:
New Jersey Division of Consumer Affairs Complaints
Consumer Service Center
(973) 504-6200
1-800-242-5846
___________________________________________________________________________________________________
Home Care Accreditation Agencies
Commission on Accreditation for Home Care (CAHC)
(201) 880-9135
Email: info@cahnj.org
___________________________________________________________________________________________________
UMS Homecare
85 Main Street, Suite 101, Hackensack, NJ 07601
833-286-7466
Email: Compliance@umshomecare.com
___________________________________________________________________________________________________
For Michigan:
Michigan Department of Licensing and Regulatory Affairs
Bureau of Community & Health Systems - Federal Certification
611 W. Ottawa Street
PO Box 30664
Lansing, MI 48909
Phone: 517-284-8953
FAX: 517-241-3354
__________________________________________________________________________________________________________
CHAP
2300 Clarendon Blvd, Suite 405
Arlington, VA 22201
202.862.3413
__________________________________________________________________________________________________________
Be advised of the names, addresses, and telephone numbers of the following Federally funded and state-funded entities that serve the area where the patient resides:
For New Jersey:
Adult Protective Services
To report abuse or neglect
(609) 588-6501
or 1-800-792-8820
List of County APS Offices:
www.state.nj.us/humanservices/doas/home/adultpsp.html
____________________________________________________________________________________________________________
N.J. Senior Fraud Hotline
1-877-746-7850
www.njconsumeraffairs.gov/fraud
____________________________________________________________________________________________________________
Division of Aging Services
New Jersey Department of Human Services
P.O. Box 715
Trenton, NJ 08625-0715
1-877-222-3737
https://www.nj.gov/humanservices/doas/contact/
__________________________________________________________________________________________________
Receive all services outlined in the plan of care.
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.
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.
The charges the individual may have to pay before care is initiated.
Any changes in the information provided in accordance with 42 CFR 484.50(c)(7) 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. The HHA must comply with the patient notice requirements at 42 CFR 411.408(d)(2) and 42 CFR 411.408(f)
Receive proper written notice, in advance of a specific service being furnished, if the HHA believes that the service may be non-covered care; or in advance of the HHA reducing or terminating on-going care. The HHA must also comply with the requirements of 42 CFR 405.1200 through 405.1204.
Be informed of the right to access auxiliary aids and language services and how to access these services. Information must be provided to patients in plain language and in a manner that is accessible and timely to:
a. Persons with disabilities, including accessible Web sites and the provision of auxiliary aids and services at no cost to the individual in accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.
b. Persons with limited English proficiency through the provision of language services at no cost to the individual, including oral interpretation and written translations.
Patients' Responsibilities:
To ask questions of the staff about anything they do not understand concerning their treatment or services provided.
To provide complete and accurate information concerning their present health, medication, allergies, etc.
To inform staff of their health history, including past hospitalization, illnesses, injuries.
To involve themselves and/or Caregiver, as needed and as able, in developing, carrying out, and modifying their home care service plan.
To review the Agency’s information on maintaining a safe and accessible home environment in their residence.
To request additional assistance or information on any phase of their health care plan they do not fully understand.
To inform the staff when a health condition or medication change has occurred.
To notify the Agency when they will not be home for a scheduled home care visit.
To notify the Agency prior to changing their place of residence or telephone.
To notify the Agency when encountering any problem with equipment or services.
To notify the Agency if they are to be hospitalized or if a physician modifies or ceases their home care prescription.
To make a conscious effort to comply with all aspects of the plan of care.
To notify the Agency when payment source changes.
To notify the Agency of any changes in or the execution of any advanced directives.
To inform staff of their health history, including past hospitalization, illnesses.
Agency's Responsibilities:
Before the care is initiated, the agency must inform a patient orally and in writing of the following:
The extent to which payment may be expected from third party payers;
The charges for services that will not be covered by third party payers;
Services to be billed to third party payers;
The method of billing and payment for services;
The charges that the patient may have to pay;
A schedule of fees and charges for services;
The nature and frequency of services to be delivered and the purpose of the service;
Any anticipated effects of treatment, as applicable;
The agency must inform a patient orally and in writing of any changes in these charges as soon as possible, but no later than five (5) days from the date the home health agency provider becomes aware of the change;
If an agency is implementing a scheduled rate increase to all patients, the agency shall provide a written notice to each affected consumer at least 30 days before implementation;
The requirements of notice for cancellation or reduction in services by the organization and the patient;
The refund policies of the organization; and
The agency shall not assume power of attorney or guardianship over a consumer utilizing the services of the agency, require a consumer to endorse checks over to the agency or require a consumer to execute or assign a loan, advance, financial interest, mortgage or other property in exchange for future services.
COMPLAINTS & GRIEVANCES
The patient may report a complaint or grievance at any time without reprisal or disruption of services.
Any staff member may receive a complaint or grievance about services or care that is or is not furnished or about the lack of respect for the consumer's person or property by anyone furnishing services on behalf of the agency.
Complaints and Grievances Procedure:
1. Patient or patient representative reports a complaint/grievance to any staff member.
2. Staff members receiving complaints or grievances report them to the Administrator or designee.
3. Administrator or designee documents the complaint and investigates the grievance/complaint within 10 calendar days of receipt of the complaint. The Administrator or designee must complete the investigation and documentation within 30 calendar days after the Agency receives the complaint unless the Agency has and documents reasonable cause for delay.
4. If the Administrator or designee is unable to resolve the complaint/grievance, the Governing Body is notified and takes action toward resolution.
5. Notify the patient when appropriate action has been taken or that the problem has been resolved.
6. Document the action taken and resolution on the Complaint Form.
7. You may appeal the administrator findings to the Governing Body by submitting a written complaint to:
Attention Governing Body
UMS Homecare
85 Main Street, Suite 101,
Hackensack, NJ 07601
The patient may contact at any time without reprisal or disruption in services the:
New Jersey Division of Consumer Affairs Complaints
Consumer Service Center
(973) 504-6200
1-800-242-5846
_____________________________________________________________________________________________
Home Care Accreditation Agencies
Commission on Accreditationfor Home Care (CAHC)
(201) 880-9135
Email: info@cahnj.org
_____________________________________________________________________________________________
UMS Homecare
85 Main Street, Suite 101, Hackensack, NJ 07601
833-286-7466
Email: Compliance@umshomecare.com
Public Disclosure
The following information, if known, shall be disclosed to members of the public upon request whether written or verbal. Some information is located the entrance area on display. Other information is located in the P&P manual which is located in the resource center. If you are unable to find a piece of public disclosure information, please contact the administrator.
License Number
Name of Licensed Agency Owner (including the corporation name and corporate officers), Administrator and Clinical Manager
Address of Record
Patient Rights (Must display in a conspicuous place at the entrance to the agency)
Date Original License Issued
License Expiration Date
Current License Status
Accreditation Status and Programs or Services that is applicable.
Mission Statement, Goals, Philosophy
Official findings of deficiencies based on survey reports by the licensing agency.
Plan of correction between the provider and the licensing agency.
Comments furnished by the provider to the licensing agency.
Quality Reports are available with truthful and accurate descriptions.
Information related to safety and quality
Conditions for acceptance or termination of services.
Services Offered
Hours of Operation, including on call availability
Service Limitations
Referral Procedures and contact information
Patient responsibility for care/service and/or products before or at time of delivery
Fee Schedule
If the information on the license is officially amended during the licensure period, a notice must be posted beside the license to provide public notice of the change.
This document provides an overview of available important information, not a limitation on documents otherwise available. All documents must accurately represent the agency and its services offered.
Attachments:
Brochure
A Consumer’s Guide to Homemaker-Home Health Aides
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