Patient/Client Rights and Responsibilities – Advance Directives/DNR Patient/Client and Agency Responsibilities

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Patient/Client Rights

The Law provides certain rights to all home health patients/clients. These include the right to:

  1. Have his or her property and person treated with respect;
  1. Be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect, and misappropriation of property;
  2. Make complaints to the 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 Agency;
  3. 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/client-identified goals, and anticipated risks and benefits
    • Any factors that could impact treatment effectiveness, and
    • Any changes in the care to be furnished.

5. Receive all services outlined in the plan of care.

6. Have a confidential clinical record. Access to or release of patient/client information and clinical records is permitted in accordance with 45 CFR parts 160 and 164 {relating to the HIPAA Privacy Rule}

7. Receive written information regarding advance directives prior to care being provided;

  1. Be advised of:
  • The extent to which payment for Agency services may be expected from Medicare, Medicaid, or any other federally-funded or federal aid program known to the Agency,
  • The charges for services that may not be covered by Medicare, Medicaid, or any other federally-funded or federal aid program known to the Agency,
  • The charges the individual may have to pay before care is initiated; and
  • Any changes in the information provided related to charges, when they occur. The Agency must advise the patient/client and representative (if any), of these changes as soon as possible, in advance of the next home health visit. The Agency must comply with the patient/client notice requirements at 42 CFR 411.408(d)(2) and 42 CFR 411.408(f) {relating to the Advance Beneficiary Notice}.
  1. Receive proper written notice, in advance of a specific service being furnished, if the Agency believes that the service may be non-covered care; or in advance of the Agency reducing or terminating on-going care. The Agency must also comply with the requirements of 42 CFR 405.1200 through 405.1204 {relating to the Notice of Medicare Non-Coverage}.
  1. Be advised of the state toll free home health telephone hot line, its contact information, its hours of operation, and that its purpose is to receive complaints or questions about local Agencies.
  1. Be advised of the names, addresses, and telephone numbers of the following Federally-funded and state-funded entities that serve the area where the patient/client resides:

a. Agency on Aging

b. Center for Independent Living

c. Protection and Advocacy Agency

d. Aging and Disability Resource Center; and

e. Quality Improvement Organization.

  1. Be free from any discrimination or reprisal for exercising his or her rights or for voicing grievances to the Agency or an outside entity.
  1. Be informed of the right to access auxiliary aids and language services and how to access these services.
  1. The patient/client and representative (if any), have the right to be informed of the Agency’s policies for transfer and discharge.
  1. To be informed that OASIS information will be collected and the purpose of the collection:
  • To have the information kept confidential
  • To be informed that OASIS information will not be disclosed except for legitimate purposes allowed by Federal Privacy Acts
  • To refuse to answer questions
  • To see, review, and request changes on the assessment.
  1. If a patient/client has been adjudged to lack legal capacity to make health care decisions as established by state law by a court of proper jurisdiction, the rights of the patient/client may be exercised by the person appointed by the state court to act on the patient’s/client’s behalf.
  1. If a state court has not adjudged a patient/client to lack legal capacity to make health care decisions as defined by state law, the patient’s/client’s representative may exercise the patient’s/client’s rights.
  1. If a patient/client has been adjudged to lack legal capacity to make health care decisions under state law by a court of proper jurisdiction, the patient/client may exercise his or her rights to the extent allowed by court order.
  1. Be advised of the contact information for the Agency Administrator, including the Administrator’s name, business address, and business phone number in order to receive complaints.
  1. To lodge a complaint against this Agency or receive information regarding any Texas home health agency by calling the toll free Texas Home Health Hotline 1-800-458-9858. The Hotline may also be utilized to lodge complaints regarding implementation of the advanced directive requirement. The Home Health Hotline is answered 24 hours a day, 365 days a year.
  1. Be informed of his or her rights;
  1. Exercise his or her rights at any time;
  1. Be free from neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and/or misappropriation of patient property by anyone furnishing services on behalf of the organization;
  1. Voice and report grievances or complaints regarding treatment or care that are (or fail to be) delivered, the lack of respect for property and/or person, or the violation of any rights to the organization, CHAP, and state or local agencies;
  1. Be informed how to contact (including contact information and hours of operation) the CHAP hotline to ask questions, report grievances, or voice complaints.

You have the right:

  • To change the service plan you and your case worker agreed to and to determine, with your provider agency, what assistance you need, how often you need the assistance, and at what time of day and what days of the week you want help.
  • To select, for any reason, another provider from which to receive services (except when you have been informed that your services may be terminated based on failure to comply with service delivery provisions).
  • To refuse all or part of any services and to be informed of the likely consequences of such refusal.
  • To receive education or training for yourself and for members of your family or household on the management of your services.
  • To receive services even if they may not meet all of your needs.

Your Responsibilities

You must:

  • sign the service plan that you agree to with the home and community support service agency.
  • obtain approval from your case worker before receiving more hours of service per week.
  • comply with all employer responsibilities if choosing the consumer directed services option.

Information about Advance Directives

If you have not executed Advance Directives and would like to, please ask your health care provider or your physician for the appropriate forms.

Quality Improvement Organization (QIO)/ Beneficiary and Family Centered Care (BFCC)

The patient/client has the right to be informed how to report to the QIO/BFCC in their region, if the complaint is in regards to the quality of services not meeting professionally recognized standards of health care.

The patient/client has the right to report to the QIO/BFCC-Region 3 by calling Toll Free: 1-844-430-9504. Fax: 1-844-878-7921. TTY: 1-855-843-4776

Or writing to:


5700 Lombardo Center Dr., Suite 100 Seven Hills, OH 44131

The patient/client may find more information at Complaints may also be emailed to

Personal care attendants Responsibilities

Personal Care Tasks

  • Bathing
  • Feeding
  • Shaving
  • Brushing teeth
  • Washing, drying and brushing/combing hair
  • Washing hands/face
  • Applying makeup and non-prescription lotion
  • Dressing
  • Changing diapers
  • Assisting on/off bedpan
  • Help with use of urinal
  • Assisting with feminine hygiene needs
  • Assisting with clothing during toileting
  • Assisting with hygiene
  • Preparing toileting supplies and equipment
  • Emptying catheter bag or colostomy bag
  • Changing external catheter
  • Transferring you from one position to another on the bed or
  • chair
  • Assisting you with putting on/removing leg braces and
  • prostheses
  • Assisting with wheelchair
  • Reminding you to take your medicine
  • Preparing your meals

Housekeeping Tasks

  • Cleaning living area: dusting and
  • vacuuming
  • Cleaning bathroom
  • Cleaning stove and counters
  • Defrosting and cleaning refrigerator inside and out
  • Carrying out trash
  • Washing and drying your clothes
  • Changing your bed linens and making bed
  • Washing your dishes
  • Preparing grocery or household item shopping list
  • Going to store to buy and pick up grocery items or medications
  • Putting food away

Escort: Accompanying you to the doctor’s clinic or other Destinations (Note: Additional time is not allotted for Escort services for purposes other than to medical Appointments. However, an individual may substitute Escort services for time allotted to another task.)

The Personal care attendants Responsibilities DO NOT INCLUDE:

  • Vacuum and Mop the entire House
  • Wash Windows
  • Clean cupboards and closets
  • Mow Lawns

Transportation (Unless prior arrangements are made)

Skilled procedures unless delegated by the RN and approved by the patient/client; · changing a catheter

  • changing a colostomy
  • washing infected parts of the body
  • tube feeding
  • injections
  • giving you medicine that is ordered by your doctor
  • applying an ointment to your skin that is ordered by your doctor

Services that also help those you live with unless those

Persons also receive attendant services from HHSC. For


  • cleaning floor and furniture in parts of your house you do not use
  • cooking for everyone who lives with you
  • buying groceries or household items that are not for your use
  • washing and drying clothes and bed linens
  • belonging to others who live with you

If uncovered services are needed, please notify the Agency or the Nurse so an attempt can be made to assist with this need.

Patient/Client Responsibilities

Patient/client responsibilities include the following:

  1. To provide medical and personal information necessary to plan and carry out care, including information on advanced directives.
  1. To follow instructions agreed upon by you and the Agency and to inform the Agency when instructions are not followed.
  1. To have and maintain contact with your physician to allow the physician to order and supervise your care.
  1. To provide information and releases when required for billing purposes.
  1. To allow the Agency to act on your behalf in filing appeals of denied payments of service and to the fullest extent possible in such appeals.
  1. To be available to the staff for home visits at reasonable times.
  1. To notify the Agency if you are going to be unavailable for a visit.
  1. To provide a safe working environment for the home health staff.
  1. To notify the Agency of any changes in treatment made.
  1. To inform the Agency of any dissatisfaction with service or care.
  1. To participate with the Agency staff in developing a patient/client and family Emergency Preparedness and Response Plan.

Agency Responsibilities

  1. To be available to respond to the physician in a timely manner.
  1. To submit written documentation and medical information to the physician in a timely manner, to include:
  • Plan of Care
  • Clinical Update Summaries
  • Discharge Summary
  1. To follow the Plan of Care as ordered by the physician.
  1. To notify the physician of changes in the patient’s/client’s status.
  1. To provide the patient/client with the amount of assistance requested to complete the 2-1-1 registration process for evacuation assistance.
  1. To triage patients/clients during an emergency/disaster, offering assistance according to triage level and need.
  1. To re-evaluate patients/clients following an emergency/disaster and providing care according to need.


The Agency complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, marital status, religion, or source of payment.