PATIENT'S BILL OF RIGHTS AND RESPONSIBILITIES
Every patient
has the right to:
1. Be given written information about their rights for receiving home
care services at the time of admission, as evidenced by written documentation
in the home care record.
2. Be treated with consideration, courtesy and respect by all HRTE personnel.
3. Be given the necessary information so that they can make informed decisions
about their individual services.
4. Choose a preferred day/time for service of equipment and contribute
to equipment set-up.
5. Refuse treatment within the confines of the law after being fully informed
of and understanding the consequences of such action.
6. Be educated of the function, safe and proper use and maintenance of
all equipment provided by HRTE.
7. Receive a timely response from HRTE regarding their request for home
care equipment.
8. Receive privacy and confidentiality of medical records as required
by law. 9. Voice grievance with and/or suggest a change in home care services.
10. Be informed of HRTE's policies, procedures and charges.
11. Be given appropriate and professional quality home care without discrimination
against race, color, sex, national origin or age.
Every client has
the responsibility to:
1. Request further information concerning anything not fully understood.
2. Assist in developing and maintaining a safe environment.
3. Contact HRTE whenever you have an equipment problem or no longer need
the equipment.
4. Keep all medical equipment where installed (except portable equipment).
5. Use the equipment only in the appropriate prescribed manner.
6. Maintain ordinary care (keeping clean, etc.) of all rented equipment.
7. Give accurate and complete health information concerning your past
illnesses, hospitalizations, medications, etc.
8. Contact HRTE whenever you are hospitalized or change residence.
PERMISSION FOR DISCLOSURE AND USE OF INFORMATION
I consent to the release of my HRTE records to be reviewed by authorized representatives of Medicare/Medicaid, Medicare intermediary, and/or my private insurance company(ies) for use in determining my home health benefits. Specifically, I authorize and request HRTE to allow the individual/agency requesting to review my clinical records to examine my personal and medical records now held by HRTE and to make machine or photographic copies of said records. I understand that I have the legal right to refuse the release of the personal and medical records now held by HRTE and that I am waiving this legal right by this consent. This consent shall be valid for whatever period of time is reasonably necessary for the individual/agency requesting to review my clinical records to fulfill the above described purpose(s). Such period shall not exceed two (2) years from the date of signature on the delivery ticket, or until I revoke this consent in writing. Such revocation of this consent shall have a prospective effect only. I further authorize HRTE and the Joint Commission for the Accreditation of Health Care Organizations (JCAHO) to periodically examine by records for the purpose of quality assurance compliance and JCAHO requirements.
