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YOU HAVE THE
RIGHT TO:
1. Receive a timely response to your request for nursing
services.
2. Be given information regarding policies, charges for
services, and information and assistance for third party
reimbursement.
3. Have your care and services coordinated with other health
care providers involved in your care.
4. Be given appropriate and professional quality health care
without discrimination against your race, color, sex, religion,
creed, sexual preference, diagnosis, or age.
5. Be treated with courtesy and respect by all who provide care
to you.
6. Be free from physical and mental abuse or neglect.
7. Be given proper identification by name and title to everyone
who provides care to you.
8. Be informed of and give consent for any procedures.
9. Be given, upon request, information regarding your
diagnosis, treatment, alternatives and risks in a language you
are able to understand.
10. A care plan which will be developed to meet your individual
needs. You and your family may participate in the development
of a care plan.
11. Be assured of private and confidential treatment.
12. Review your clinical record.
13. Be given information regarding discharge, transfer, or
termination of service.
14. Request changes or make complaints regarding services.
15. Control decisions about accepting or refusing any medical
care including life sustaining treatment under the provisions of
the Patient Self Determination Act.
16. Expect that Emerald will abide by the provisions of your
Advance Directive.
17. Voice any complaints regarding services provided by any
Emerald Health Care Services, Inc. employee. Complaints
regarding personnel should be directed to the Nursing or Home
Health Aide Director. All complaints will be investigated and
the patient will be advised of the disposition of said
complaint. Complaints regarding any office staff member may be
directed to the President or Vice-president. All complaints
will be investigated and the patient will be notified of any
actions taken.
18. Pain Control. Emerald will support you by providing
information and by assessing and assisting in your pain control
plan.
19. Emerald will respect your cultural, psychological, spiritual
beliefs and will respect your right to personal dignity.
20. Emerald supports your right to pastoral and spiritual
services.
YOU HAVE THE RESPONSIBILITY TO:
1. Release Emerald Health Care Services, Inc. and/or
any employees of Emerald Health Care Services, Inc. from all
liability in the event of a personal injury incurred by you
regardless of cause when you are not under the direct care of an
Emerald Health Care Services, Inc. employee.
2. Give accurate health information regarding past treatment,
illnesses, hospitalizations, and allergies.
3. Inform Emerald at least three hours in advance if, for any
reason, you must cancel services.
4. Participate in the development and update of your care plan.
5. Adhere to the care plan.
6. Assist in developing and maintaining a safe environment.
7. Request further information concerning anything you do not
understand.
8. Give information regarding concerns and problems to
Emerald's nursing or home health aide director.
9. Provide Emerald with a copy of your Advance Directive if you
have one.
If you have appointed a proxy or health care representative you
will provide Emerald with the proxy's name and phone number.
10. Notify Emerald immediately if you rescind or revise your
Advance Directive.
11. Provide powder free latex disposable gloves, liquid soap,
and paper towels for personal care.
12. Secure animals during staff visits.
13. Permit and provide access to the home and to the patient
for visits.
14. Agree that Emerald has the right to discharge or terminate
services under the following conditions:
a. The physician does not order service.
b. The client’s physical condition changes and EHC
can no longer provide appropriate care.
c. Client’s emotional needs change and EHC can no
longer provide appropriate care.
d. The client request inappropriate level of care.
e. The client moves out of our service area.
f. The home care setting is unsafe for either the
client or the EHC employee.
g. Non-payment.
15. Identify an able adult with knowledge of client care who
will provide care in the absence of nurse or aide.
16. Sign the time card daily. Your signature is verification
of the accuracy of the hours (time started and finished). NEVER
sign for hours which are not accurate, as this could cause
fraudulent billing, a serious event. Please call our office if
you are ever asked to sign a card for hours which are not
accurate.
17. Keep any medication which is to be administered by an
Emerald nurse in its original labeled container or bottle.
18. I further agree to inform Emerald Health Care Services,
Inc. of any services received from any other agency so that
coordination of services can be maximized and duplication
avoided. |
