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ADMIN 09.2.1

NOTICE OF PATIENT RIGHTS AND RESPONSIBILITIES

As a patient of this agency, you have the right to:

1. Be informed of your rights in writing at the time of the initial evaluation visit in advance of care being furnished.
2. Exercise your patient rights as a patient of the home health agency; the patient’s legal representative may
exercise the patient’s rights when the patient has been adjudged to lack legal capacity.
3. Receive information in writing and in a manner that you understand from the home health agency regarding
your rights and responsibilities and transfer and discharge policies of the home health agency. The home health
agency may only transfer or discharge the patient from the home health agency if:
 The patient’s acuity requires another level of care;
 The home health agency will no longer receive payment for services;
 The physician and the home health agency agree that goals have been met;
 The patient refuses service, or elects to be transferred or discharged;
 Cause—disruptive, abusive, or uncooperative behavior by the patient (or other persons in the patient’s
home) to the extent that delivery of care to the patient or the ability of the home health agency to
operate is seriously impaired;
 The patient dies;
 The home health agency ceases to operate.
4. Be informed of the right to access auxiliary aids and language services, and instruction on how to access these
services.
5. Receive contact information for the home health agency administrator for the purpose of making complaints.
6. Be informed of rights regarding collection and reporting of OASIS information. These rights include:
 The right to be informed that OASIS information will be collected and for what purpose;
SAMPLE
 The right to have the information kept confidential and secure;
 The right to be informed that OASIS information will not be disclosed except for legitimate purposes
allowed by the Privacy Act;
 The right to refuse to answer questions;
 The right to see, review and request changes to your personal health information.
7. Be provided with a copy of the OASIS Privacy Notice at the time of the initial evaluation visit.
8. Have your property and person treated with respect.
9. Be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and
misappropriation of property.
10. Make complaints to the home health agency regarding treatment or care that is (or fails to be) furnished, and
the lack of respect for property and/or person by anyone who is furnishing services on behalf of the home
health agency.
11. Expect the home health agency to have a process for the investigation and resolution of patient complaints.
12. 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.