SOLASTA HOME CARE
Where our clients come first…
WELCOME AND PHILOSOPHY
SOLASTA HOME CARE extends a warm welcome to you, our client, and to your family and friends. Your medical treatment, safety and happiness are most important to us. We will do our best to answer any questions you may have concerning your care.
Our philosophy is to provide quality services in the least restrictive environment (your home). Services must be consistent with the needs of our client while being cost effective.
We recognize that every human being has personal rights which must be respected and should not be violated. This booklet was designed to help you understand the Home Care process and explain your rights as a client.
We are committed to ensuring your rights and privileges as a home care client. Many aspects of our services and procedures may be new to you, so we have prepared this booklet to assist you in becoming more quickly acquainted with us. If you have additional questions, please do not hesitate to ask us.
The management and staff of SOLASTA HOME CARE
This SOLASTA Homecare LLC is in compliance with Title VI of the Civil Rights Act of 1964, with Section 504 of the Rehabilitation Act of 1973 and with the Age Discrimination Act of 1975, does not discriminate on the basis of race, color, sex, national origin, age or disability with regard to admission, access to treatment or employment. We will make every effort to comply with these and similar statutes.
SECTION Il. Agency Overview
This book contains general information regarding your rights and responsibilities as a client. There may be additions or changes to this book as necessary. Our complete policy and procedure manual regarding your care and treatment is available upon request for your viewing at the Agency offices at any time during normal business hours.
SOLASTA HOME CARE will accept a client based on the reasonable expectation that the needs can be met adequately in the client’s place of residence. The Agency will start providing Personal Assistance Services within 5 working days after acceptance of the client.
This Agency can provide a service or a combination of services in your home. Services appropriate to the needs of the individual will be planned, coordinated and made available under the direction of qualified staff and with the input of the client.
Home Care Services includes the following tasks:
Dressing may include:
Meal preparation may include:
Exercise, which is walking with the client
Assistance with Self-Administered Medications:
Clients should notify’ the office when you need to reschedule or discontinue any visits.
HOURS OF OPERATION
In life threatening situations, go to the hospital emergency room, or call the Emergency Medical Services number (911). Please refer to our On-Call Guidelines in Section VIl.
ADVERSE CONDITIONS: During inclement weather, we will make every effort to continue home care visits. However, the safety of our staff must be considered. When roads are too dangerous to travel, our staff will, if possible, contact you by phone to let you know that they are unable to make your visit that day.
We accept payment for services from Private Pay. Some. We will inform you, your family, caregiver or guardian of all charges and methods of payment before or upon admission.
Should any change be made in this policy regarding services or charges, you or your responsible party will be advised. If you have questions about charges or insurance billing, please call our office.
PER VISIT CHARGE RATES
___ (Will vary depending on terms and conditions in which services are provided)
You, our customers, are very important to us. Please ask questions if something is unclear regarding our services, the care you receive, or fail to receive. Please fill out the Client Satisfaction Survey with a selfZ addressed, stamped envelope located in the back of this booklet. Your answers help us to improve our services and ensure that we meet your needs and expectations.
INDIVIDUAL SERVICE PLAN
This agency involves key professionals and other staff members in developing your individualized plan of care. Your plan is based upon identified problems, needs and goals, services, timeframes, your environment and your personal wishes whenever possible. The plan is designed to increase your ability to care for yourself.
The Individual Service Plan is reviewed and updated as needed, based on your changing needs. We encourage you, your caregiver or your Designee to participate in the planning and revising of your plan of care. Information will be provided so that you, your caregiver or guardian can participate in developing your plan of care. You, your caregiver or guardian may have a copy of the plan of care, upon request.
We fully recognize your right to dignity and individuality, including privacy. We will notify you if an additional individual need to be present for your visit for reasons of safety, education or supervision.
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.
The client, client’s parent, family, spouse, significant other, or legal representative and the client’s attending physician (if applicable) will be given at least a five-day advance notice of a transfer to another agency or discharge, except in case of emergency. If you should be transferred or discharged to another organization, we will provide the information necessary for your continued care. All transfers or discharges will be documented in the client chart. When a discharge occurs, an assessment will be done and instructions provided for any needed ongoing care or treatment. We will coordinate your referral to available community resources as needed.
The five-day notification shall NOT be required in the following circumstances: Upon the client’s request;
As a matter of routine courtesy, every client will be addressed as Mr., Mrs., Miss, or Ms., as the case may be, until and unless you request that another name be used.
This agency requires that its employees provide client care within the ethical framework established. The agency affords clients, legally responsible parties, the right to participate in considerations of ethical issues regarding client care concerns. Ethical issues may be brought to the attention of any employee, who will then inform the appropriate agency personnel to arrange for conferencing as appropriate.
Agency employees may not possess, distribute and or use alcoholic beverages or controlled substances, including inhalants while on premises of property controlled by the Agency or while in the course of conducting company business or engaged in any company sponsored activity. Clients or visitors may not possess, distribute and or use alcoholic beverages or controlled substances, while on the premises of the property controlled by the Agency. Any employee who has knowledge of a person or persons violating this policy must report it to his/her supervisor immediately. Based on reasonable cause, the agency may conduct searches or inspections of an employee’s personal belongings and may be asked to take a drug test. Refusal to consent may result in termination.
The agency will investigate complaints made by a client or the client’s family or guardian or the client’s health care provider regarding services or care that is (or fails to be) furnished regarding the lack of respect for the client’s property by anyone furnishing services on behalf of the Agency. We will document the receipt of the complaint and initiate a complaint investigation within 10 calendar days of the agency’s receipt of the complaint; document all components of the investigation; and 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.
If you feel that our staff has failed to follow our policies or has in any way denied you your rights, please follow these steps without fear of discrimination or reprisal for filing a complaint, presenting a grievance or providing in good faith information relating to the Home Care services provided by the agency.
SECTION Ill. Your Rights & Responsibilities as a Home Care Client
As a Home Care provider, we have an obligation to protect your rights and explain these rights to you in a way you can understand before care begins and on an ongoing basis, as needed. Your family or your guardian may exercise these rights for you in the event that you are not competent or able to exercise them for yourself.
YOU HAVE THE RIGHT TO:
IMENI’ ADVANCE DIREC’TIVES – to be informed in writing of policies and procedures implementing Advance Directives, you will be informed if we cannot implement an advance directive based on conscience;
PRIVACY AND SECURITY: YOU HAVE THE RIGHT TO:
Our Notice of Privacy Practices describes your rights in detail.
FINANCIAL INFORMATION: YOU HAVE THE RIGHT TO:
QUALITY OF CARE: YOU HAVE THE RIGHT TO:
DEFINITIONS. In this chapter:
1.) Home Care services” means the provision of health service for pay or other consideration in a client’s residence regulated under Chapter 142, Health and Safety Code.
2.)”Alternate care” means services within an elderly individual’s own home, neighborhood, or community, including;
RIGHTS OF THE ELDERLY.
Rhode Island Department of Health,
Center for Facilities Regulation 3 Capitol Hill, Room 306
Providence, RI 02908
As part of the procedure for admission of a resident to a nursing facility a written contract shall be entered
into between the said resident or his next of kin or legal representative and the nursing facility and the following rules shall be observed in accordance with R.I. Gen. Laws Chapter 23-17.5 (Rights of Nursing Patients).
Each resident or responsible party shall be informed in writing, prior to, or at the time of admission and during stay, of services available and of related charges including all charges not covered either under federal and/or state programs by other third-party payers or by the nursing facility’s basic per diem rate.
If it is proposed that a resident be used in any human experimentation project, the resident shall first be thoroughly informed in writing of such proposal and shall be offered the right to refuse to participate in such project. A resident who, after being thoroughly informed, wishes to participate must execute a written statement of informed consent. The informed consent documentation shall be maintained on file in the nursing facility.
Restraining devices are generally prohibited. A controlling device to be used for the protection of the resident may be utilized only as ordered in writing and signed by a physician, physician assistant, or advanced practice registered nurse. The length of time, the purpose and the kind of restraint shall be specified in the physician’s, physician assistants, or advanced practice registered nurse’s order.
periods for which the restraint has been determined to serve the purpose defined in S I .15.5(K)(2) of this Part. This does not allow the use of restraints for convenience sake.
Posted reasonable visiting hours must be maintained in each nursing facility, with a minimum of four (4) hours daily. The nursing facility must provide immediate access to residents by properly identified appropriate government personnel, family members, physicians, and relatives. However, the resident reserves the right to refuse visitation by any of the aforementioned.
Laws Chapters 5-29 or 5-37 and all health care facilities, as defined in R.I. Gen. Laws S 23-17-2(5) shall be required to note in their residents’ permanent medical records, the name of individual(s) not legally related by blood or marriage to the resident, who the resident wishes to be considered as immediate family member(s), for the purpose of granting extended visitation rights to said individual(s), so said individual(s) may visit the resident while he or she is receiving inpatient health care services in a nursing facility.
The right to privacy and confidentiality relates to the public dissemination of specific information contained within resident records and to the identification of specific individuals but does not abrogate the responsibility of the licensing agency to review all resident records.
A resident shall be transferred or discharged only for medical reasons, or for his welfare or that of other residents or for nonpayment of his stay.
(l ) The provisions of the medical assistance program state plan regarding the period (if any) during which the resident will be permitted under the state plan to return and resume residence in the nursing facility; and
(2 The policies of the nursing facility regarding such a period, which policies must be consistent with S I .1 5.5(S)(3)(b) of this Part;
(l) Who is transferred from the nursing facility for hospitalization or therapeutic leave; and
A resident shall have the right to live in a tobacco smoke-free environment. It shall be prohibited for any person other than a nursing facility resident to smoke in a nursing facility.
Nursing facility residents who smoke may do so only in private or semiprivate rooms where both residents smoke, or rooms designated by the administration of the nursing facility.
right to receive information concerning hospice care, including the benefits of hospice care, the cost, and how to enroll in hospice care.
Heat relief: Pursuant to R.I. Gen. Laws S 23-17.5-27, any nursing facility which does not provide air conditioning in every patient room shall provide an air-conditioned room or rooms in a residential section(s) of the facility to provide relief to patients when the outdoor temperature exceeds eighty (80) degrees Fahrenheit.
Adjudicated incompetent in accordance with state law; or
A summary of the major provisions of the Rights of Residents as set forth in this Part;
Rhode Island Department of Health, Three Capitol Hill, Providence, R.I. 02908 (Telephone Number: 401-222-2566), the agency which will accept complaints or notice of violations of the provisions of this Part;
I . 15.5 Resident and Family Notification
Notify the resident, or his or her legal representative, the resident’s family representative, the resident’s attending physicians of record and the nursing facility’s medical director, if that resident has been found to be in immediate jeopardy (IJ) to health and safety and/or substandard quality of care.
(10) days following the citation.
1.15.6 Family Councils
How the nursing facility facilitates resident choice and resident directed activities; and
YOU HAVE THE RESPONSIBILITY TO:
PROVIDE COMPLETE AND ACCURATE INFORMATION to the best of your knowledge about your present and past illnesses, hospitalizations, pain, medications, allergies, and other matters relating to your health;
NOTIFY US OF CHANGES IN YOUR CONDITION – to notify us of perceived risks, changes in your condition.
FOLLOW THE INDIVIDUAL SERVICE PLAN and instructions and accept responsibility for the outcomes if you do not follow the care, treatment or service plan;
ASK QUESTIONS when you do not understand about your care, treatment and service or other instructions about what you are expected to do. If you have concerns about your care or cannot comply with the plan, let us know;
REPORT PAIN – discuss pain, pain relief options and your questions, worries and concerns about pain medication with staff or appropriate medical personnel;
NOTIFY US OF SCHEDULE CHANGES – to tell us if your visit schedule needs to be changed due to medical appointment, family emergencies, etc.;
NOTIFY US OF INSURANCE CHANGES – to tell us if your Medicaid or other insurance coverage changes.
PROMPTLY MEET YOUR FINANCIAL OBLIGATIONS and responsibilities agreed upon with the agency;
INFORM US OF CHANGES IN ADVANCE DIRECTIVES – to inform us of the existence of, and any changes made to advance directives;
ADVISE US OF PROBLEMS – to tell us of any problems or dissatisfaction with the services provided;
PROVIDE A SAFE ENVIRONMENT – to provide a safe and cooperative environment for care to be provided (such as keeping pets confined, not smoking or putting weapons away during your care);
SHOW RESPECT & CONSIDERATION – for agency staff and equipment; and
CARRY OUT YOUR RESPONSIBILITIES – to carry out mutually agreed responsibilities.
NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
“THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE
USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY,”
Our Agency is required by law to maintain the privacy of protected health information and to provide you adequate notice of your rights and our legal duties and privacy practices with respect to the uses and disclosures of protected health information. [45 CFR 165.520] We will use or disclose protected health information in a manner that is consistent with this notice.
The agency maintains a record (paper/electronic file) of the information we receive and collect about you and of the care we provide to you. This record includes physicians’ orders, assessments, medication lists, clinical progress notes and billing information.
As required by law, the agency maintains policies and procedures about our work practices, including how we provide, and coordinate care provided to our clients. These policies and procedures include how we create, maintain and protect medical records; access to medical records and information about our clients; how we maintain the confidentiality of all information related to our clients; security of the building and electronic files; and how we educated staff on privacy of client information.
As our client, information about you must be used and disclosed to other parties for purposes of treatment, payment and health care operations. Examples of information that must be disclosed:
The following uses and disclosures do not require your consent, and include, but are not limited to, a release of information contained in financial records and/or medical records, including information and treatment records and/or laboratory test results, medical history, treatment progress and/or any other related information to:
We are permitted to use or disclose information about you without consent or authorization in the following circumstances;
1 1. For certain research purposes under very select circumstances. We may use your health information far research. Before we disclose any of your health information for such research purposes, the project will be subject to an extensive approval process. We will usually request your written authorization before granting access to your individually identifiable health information;
14.For Workers’ Compensation purposes: Workers’ compensation or similar programs provide benefits for work related injuries or illness.
We are permitted to use or disclose information about you without consent or authorization provided you are informed in advance and given the opportunity to agree to or prohibit or restrict the disclosure in the following circumstances:
l . Use of a directory (includes name, location, condition described in general terms) of individuals served by our Agency; and
Other uses and disclosures will be made only with your written authorization. That authorization may be revoked, in writing, at any time, except in limited situations,
YOUR RIGHTS • You have the right, subject to certain conditions, to:
I ()88 [42 USC NS 263a and 45 CFR 493 (a)(2)]. If you request a copy of your health information, we will charge a reasonable fee for copying.
COMPLAINTS – If you believe that your privacy rights have been violated, you may complain to the Agency or to the Secretary of the (. J.S. l.) QC Health and Services. There will be no retaliation against you filing a com-plaint. The complaint should be filed in writing and should state the specific incident(s) in terms of subject, date and other relevant matters. A complaint to the Secretary must be filed in writing within 180 days of when the act or omission complained of occurred, and must describe the acts or omissions believed to be in violation.
Rhode Island Department of Health
End of Life Decisions / Advanced Directives
Discussions of end of life issues are difficult. These talks can, however, help patients make sure that they will be treated as they wish. Rhode Islanders have the right to control decisions related to their medical care and to authorize others to make medical decisions for them if they become unable to do so themselves. These decisions, when put into writing are known as “advanced directives”. There are several ways you can make your wishes knovvn depending on your health condition. All of these tools are voluntary and can be modified by you upon your request. People considering end of life issues may want to consult with their doctor to understand the medical procedures, their side effects, benefits, and limitations; a lawyer to understand the legal issues; and their loved ones for support.
What you may do to ensure that your decisions are followed
Draft a Living Will
The Rights of the Terminally Ill Act allows individuals to instruct their physicians to withhold or withdraw life-sustaining procedures in the event of a terminal condition. If you wish to establish a Living Will, you may use the form in the statute or you may create your own form if it meets the requirements of the Act.
Establish a Durable Power of Attorney for Health Care
Rhode Island law allows an individual to authorize another person to make decisions affecting their healthcare if they become unable to do so. You do not have to have a terminal condition to activate the Durable Power of Attorney for Health Care. If you wish to name an agent for these purposes, you may use this form that conforms to the legal requirements. Under Rhode Island law, all durable power of attorney forms are presumed valid, and physicians, health care providers, and emergency medical services personnel may rely on them, unless otherwise notified. If you already have a durable power of attorney form in place, there is no need to change it.
Set Medical Orders for Life-Sustaining Treatment
If you have a terminal illness, your doctor can help you decide what level of medical intervention you would like. Your doctor can take your wishes and put them into Medical Orders for Life Sustaining Treatment that they will become part of your medical files. If you transfer to another medical facility your wishes will be brought with you.
Consider Organ Donation
The Office of State Medical Examiners supports the donation of organs and tissue. Organ donation can help families through the grieving process and give others a second chance at LIFE requirements, [45 CFR 160.306] For further information regarding filing a complaint, contact;
Adults have the fundamental right to control the decisions relating to their health care. You have the right to make medical and other health care decisions for yourself so long as you can give informed consent for those decisions. No treat-ment may be given to you over your objection at the time of treatment. You may decide whether you want life sustaining procedures withheld or withdrawn in instances of a terminal condition.
What is a Durable Power of Attorney -for Health Care?
This Durable Power of Attorney for Health Care lets you appoint someone to make health care decisions for you when you cannot actively participate in health care decision making. -The person you appoint to make health care decisions you when you cannot actively participate in health care decision making is called your agent. The agent must act consistent with your desires as stated in this document or otherwise known. Your agent must act in your best interest. Your agent stands in your place and can make any health care decision that you have the right to make,
You should read this Durable Power of Attorney tor Health Care carefully.
Follow the witnessing section as required. To have your wishes honored, this Durable Power of Attorney for Health care must be valid.
You must be at least eighteen (18) years old.
You must be a Rhode Island resident. You should follow the instructions on this Durable Power of Attorney for Health Care. You must voluntarily sign this Durable Power of Attorney for Health
You must have this Durable Power of Attorney for Health Care witnessed properly.
No special form must he used but if you use this form it will be recognized by health care providers.
Make copies of your Durable Power of Attorney for Health Care for your agent, alternative agent, physicians, hospital, and family.
Do not put your Durable Power of Attorney for Health Care in a safe deposit box.
Although you are not required to update your Durable Power of’ Attorney for Health Care; you may want to review it periodically.
A copy of any of the forms required to initiate the advance directives mentioned are available to you upon request.
Home accidents are a major cause of injury and death, especially for those over 60. As people grow older, they may be less agile, and their bones tend to break more easily. A simple fall can result in a disabling injury. All clients need to take special precautions to ensure a safe living environment.
Most accidents in the home can be prevented by the elimination of hazards. Use the attached checklists to determine the safety level of your home. Check each statement that applies to your home or to your habits in your home. Then review the unchecked boxes to determine what else you can do to make your home a safer place to live.
Electrical appliances (radio, TV, heater) are kept away from the bathtub or shower area.
HAZARDOUS ITEMS AND POISONS
FIRE SAFETY PRECAUTIONS
All family members and caregivers are familiar with emergency 911 procedures. Fire department is notified if a disabled person is in the home.
If your exit is through the ground floor window, it opens easily.
In case of a power outage, if you require assistance and our agency phone lines are down, do the following:
EMERGENCY PREPAREDNESS INFORMATION
In the unlikely event of a disaster (hurricane, tornado or flood), every possible effort will be made to assure that your medical needs are met.
In the event of inclement weather, we will follow these guidelines regarding travel during the hurricane season. Every effort will be made to make sure you receive the care you need. The safety of our staff however, as they try to make visits it must be considered. When roads are too bad to travel, our staff will, if possible, contact you by phone to let you know that they are unable to make your visit that day.
Natural disasters shall be defined and determined by the guidelines set forth by the National Weather Service and/or governing state. Most Home Care services are not life-supporting and can therefore be suspended for brief periods of time without placing the client at great risk.
The agency shall maintain a written plan which outlines, controls and directs protective measures to be taken in the event of a natural disaster, emergency, or unforeseen interruption in agency services.
All clients, upon admission will be oriented to the disaster plan. Clients will be knowledgeable of disaster needs, including the need to evacuate, survival needs and special needs.
Clients will be given safety information to help them during disasters, emergency preparedness and unforeseen circumstances. This information is provided as a helpful reminder and in no way, makes the agency responsible for client safety during a disaster or emergency.
Floods are the most common and widespread of all-natural hazards. Some floods can develop over a period of days, but flash floods can result in raging waters in just a few minutes. Be aware of flood hazards, especially if you live in a low-lying area, near water or downstream from a dam.
Assemble a disaster supplies kit. Include a battery-operated radio, flashlights and extra batteries, first aid supplies, sleeping supplies and clothing. Keep a stock of food and extra drinking water.
If local authorities issue a flood watch, prepare to evacuate:
Tornadoes are nature’s most violent storms. When a tornado has been sighted, go to your shelter immediately. Stay away from windows, doors and outside walls. In a house or small building: Go to the basement or storm cellar. If there is no basement, go to an interior room on the lower level (closets, interior hallways). Get under a sturdy table, hold on and protect your head. Stay there until the danger has passed.
If the client is bed bound, move the client’s bed as far away from windows as possible. Cover the client with heavy blankets or pillows being sure to protect the head and face. Then go to a safe area. In a school, nursing home, hospital, factory or shopping center: Go to pre-designated shelter areas. Interior hallways on the lowest floor are usually safest. Stay away from windows and open spaces. In a high-rise building: Go to a small, interior room or hallway on the lowest floor possible. In a vehicle, trailer or mobile home: Get out immediately and go to a more substantial structure. If there is no shelter nearby, lie flat in the nearest ditch, ravine or culvert with your hands shielding your head. In a car, get out and take shelter in a nearby building. Do not attempt to out-drive a tornado. They are erratic and move swiftly.
Inside a home, avoid bathtubs, water faucets and sinks because metal pipes can conduct electricity. Stay away from windows. Avoid using the telephone, except for emergencies. If outside, do not stand underneath a natural lightning rod, such as a tall, isolated tree in an open area. Get away from anything metal, including tractors, farm equipment, bicycles, etc.
Heavy snowfall and extreme cold can immobilize an entire region. Even areas which normally experience mild winters can be hit with a major snow storm or extreme cold. The results can range from isolation due to blocked roads and downed power lines to the havoc of cars and trucks sliding on icy highways.
Gather emergency supplies:
Dress for the season:
A licensed nurse is on call at our agency at all times and is available after regular office hours. If you have a change in condition, please contact the office during regular office hours if possible so we can determine if a visit needs to be made and communicate with your physician if necessary. However, we are available after regular office hours for urgent conditions only.
As part of the admission process, we ask for your consent to treat you, release information relative to your care, and allow us to collect payments directly from your insurer. You or your legal representative must sign this consent before we can admit you.
CONSENT FOR SERVICES –
We require your permission before we can assist you. The services that we provide will be carried out by qualified home care staff. Without you or your representative’s consent, we cannot assist you. You may refuse services at any time. If you decide to refuse services, we may ask you for a written statement releasing us from all responsibility resulting from such action.
RELEASE OF INFORMATION –
Your client record is strictly confidential and protected by Federal law.
AUTHORIZATION FOR PAYMENT –
We will directly bill you for the services which we provide to you, as discussed.
You must tell us if you have a living will or a durable power of attorney for Health care so that we will obtain a copy to allow us to follow your directives. We will provide you care whether or not you have executed either of these documents but having an advance directive will have an impact on the type of care provided during Emergency situations.