Page 10 - Home Health Marketing

If you are an Original Medicare (fee for service) beneficiary and your plan of
care changes, including a decrease in the frequency of home health visits or
a discontinuation of services during your episode of care, you or your
authorized representative will be issued and asked to sign and date a Home
Health Change of Care Notice (HHCCN).

We fully recognize your right to dignity and individuality, including privacy in
your treatment and in the care of your personal needs. We will notify you if
an additional individual needs to be present for your visit for reasons of
safety, education or supervision.

We do not participate in any experimental research connected with patient care
except under the direction of your physician and with your written consent.

There must be a willing, able and available caregiver to be responsible for
your care between agency visits. This person can be you, a family member, a
friend or a paid caregiver.

MEDICAL RECORDS

Your medical record is maintained by our staff to document physician orders,
assessments, progress notes and treatments. Your records are kept strictly
confidential by our staff and are protected against loss, destruction,
tampering or unauthorized use. Our Notice of Privacy Practices describes how
your protected health information may be used by us or disclosed to others,
as well as how you may have access to this information.
STATE SPECIFIC INFO
DISCHARGE, TRANSFER AND REFERRAL POLICY WILL BE ADDED HERE
(IF APPLICABLE)
We may only discharge or transfer you from this agency if:
 It is necessary for your welfare, and your physician who is responsible for
your home health plan of care and our agency agree that we can no longer
meet your needs based on your acuity level. We must arrange a safe and
appropriate transfer to another care provider when your needs exceed our
agency’s capabilities;
 You or your payer will no longer pay for the home health services;
 Your physician who is responsible for your home health plan of care and
our agency agree that the measurable outcomes and goals of your plan of
care have been achieved and you no longer need home health services;
 You refuse services or elect to be transferred or discharged;
 Our agency closes;
 Our agency determines, based on our policy, that your behavior or the
behavior of other persons in your home is disruptive, abusive or uncooperative
to the extent that delivery of your care or the ability of our agency to effectively
operate is seriously impaired. Prior to discharging for cause, our agency must:
o Advise you, your representative, if any, your physician(s) issuing orders
for your home health plan of care, your primary care practitioner or any
other health care professional who will be responsible for providing care
and services to you after discharge from our agency that a discharge for
cause is being considered;

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