patient handbook - english

8/6/2019 Patient Handbook - English

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Patient InformationHandbook


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Table of Contents

Welcome Page 2

Patient Rights Page 3

Patient Responsibilities Page 4

Complaints & Grievances Page 5

Advance Directives Page 6

Personal Safety Page 7

Biomedical Waste Disposal Page 8

Hand Hygiene Page 9

Notice of Privacy Practices Page 10

OASIS Statement of Patient Privacy Rights Page 13

Privacy Act Statement Health Care Records Page 14

Medicare Coverage Criteria Page 15

Emergency / Disaster Preparedness Page 16

The Home Health Aide Page 17

Available Services Page 18

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Welcome to

Thank you for selecting Gables Gate Health Center, Inc. as your home healthservices provider. We realize you have many providers to choose from and aregrateful that you chose us. Our agency is dedicated to providing the highest quality ofcare in your place of residence in order to promote your physical and emotionalwellbeing and that of your family and/or caregivers. Our excellent staff is highly trainedand supervised to ensure all of your home care needs are met.

Your care is very important to us. Beginning with a clinical assessment, followed by acarefully designed plan of care, it is our goal to enhance your quality of life byproviding you with the health care services you need. We also desire to see eachpatient achieve the highest level of independence possible.

This Handbook will provide you with information regarding our services, as well asyour rights as a home care patient. If you need additional information, or have anyquestions, do not hesitate to call us at any time.

Once again, thank you for choosing Gables Gate Health Center, Inc.

Best regards,

Management and Staff

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Patient Rights

1. The patient is fully informed of his or her rights.

2. The patient has the right to appropriate andprofessional care.

3. The patient has the right to request servicesfrom the home care agency of his or her choice.

4. The patient has the right to request fullinformation from the agency concerning servicesprovided alternatives available, licensure andaccreditation.

5. The patient has the right to informationnecessary to a) give informed consent prior tothe start of any procedure or treatment; or b)refuse part or all treatment within the confines of

the law and to be informed of the consequences.

6. The patient has the right to treatment with theutmost dignity and respect by all agencyrepresentatives, regardless of his/her naturalorigin, age, gender, sexual orientation, religion,beliefs, and mental/physical disability.

7. The patient has the right to receive a timelyresponse from the agency to his or herquestions. The patient will be admitted forservice only if the agency has the ability toprovide safe professional care at the level of

intensity needed. (The patient has the right toreasonable continuity of care.)

8. The patient has the right to an individualizedplan of care and teaching plan. The care plan isdeveloped by the entire health care team whichincludes the patient and/or family when possible.

9. The patient has the right to participate in allaspects of care including changes and beadvised prior to any change being made.

10. The patient has the right to request and to beprovided a copy of the plan of care.

11. The patient has the right to be informed withinreasonable time of anticipated termination ofservice or plans for transfer to another healthcare facility or provider.

12. The patient has the right to voice grievances andsuggest changes in service or staff without fearof reprisal or discrimination.

13. The patient has the right to have personal healthinformation kept confidential. Only those whoare legally authorized to know, or have amedical need to know, will see the patients

health information.

14. The patient has the right to know why theagency needs to ask questions during theassessment.

15. The patient has the right to refuse to answequestions during the assessment.

16. The patient has the right to look at his/hepersonal health information and makecorrections, if he/she feels the information isincorrect.

17. The patient has the right to be fully informed oagency policies and charges for servicesincluding eligibility for thirdpartyreimbursements.

18. The patient and the public have the right tohonest, accurate, and forthright informationregarding the home care industry, in generaland this agency in particular, that is, cost pevisit, employee qualifications, etc.

19. The patient has the right to know the name o

the responsible person coordinating his or hercare, how to contact that person during regularworking hours and the procedures for contacafter hours in case of emergency.

20. The patient must be notified both orally and inwriting the extent to which payment may beexpected from Medicare, charges not coveredand charges the patient may have to pay.

21. The Agency can be reached at (305) 388-8883to voice concerns, complaints, and/o

compliments.

22. The Home Health Agency Hotline at 1-888-419-3456 is operational from 8:00 a.m. to 5:00 p.m.Monday through Friday, except State & FederaHolidays, to receive complaints and answequestions with respect to home health care.

23. The Central Abuse Registry at 1-800-96-ABUSE(1-800-962-2873) is operational 24 hours eachday to report abuse, neglect or exploitation.


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Patient Responsibilities

1. The patient has the responsibility to provide, to the best of his or her knowledge, accurate and

complete information about a) past and present medical history; b) unexpected changes in his orher condition; and c) whether he or she understands the course of action selected.

2. The patient is responsible for following the treatment recommended by his or her physician, caremanager and/or other healthcare professional responsible for his or her plan of care.

3. The patient is responsible for his or her actions if he or she refuses treatment or does not follow thephysicians orders, if applicable.

4. The patient is responsible for complying with the procedures established by the agency and anysubsequent amendments to the rules.

5. The patient is responsible for treating our personnel with consideration, courtesy and respect.

6. The patient is responsible for notifying the Agency, as soon as possible, if he or she will beunavailable for a scheduled visit.

7. The patient is responsible for advising the Agency of any problems or dissatisfaction he or she mayhave with the services.

8. The patient is responsible for providing accurate financial and insurance information.

9. The patient is responsible for assuring that the financial obligations of his or her health care arefulfilled as promptly as possible.

The Agencys patients and their caregivers have theright to mutual respect and dignity. Our Agency

personnel are prohibited from accepting personalgifts and borrowing from patients. If an Agency

patient refuses to comply with the plan of care, and ifthis refusal threatens our ability to appropriately

provide the prescribed care according to thephysician or Care Manager, the Agency may be

forced to refer the patient to another source for homecare services or another type of care.

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Complaints & Grievances

Patient Complaint and Grievance Process:

Gables Gate Health Center maintains a log

to record the complaint, date received, andpatient or staff involved, and the date ofresolution. Our staff accepts complaintsverbally or in writing.

We initiate investigation of all complaints,regardless of their nature, within 24 hours ofreceiving the complaint.

Appropriate staff members participate in theinvestigation, which may include aconference with the patient or patientsrepresentative and any involved office andfield personnel.

All investigations are completed 5 days fromthe date we receive the complaint.

If the patient is not satisfied with theresolution of the complaint, he/she mayappeal this decision directly to the StateHome Health Hotline at 1-888-419-3456.

Our Performance Improvement Committeereviews all complaints monthly and quarterlyto ensure compliance with policies and toidentify trends or problem areas.

Patient / Family reports concerns/grievancesto Home Health Agency

Director of Patient Care Servicesinvestigates complaint within 24 hours

Director of Patient Care Services rendersdetermination within five (5) days

Patient satisfied withdetermination/resolution

Patient not satisfied ContactAgency Administrator

Agency Administrator meets

with Governing Body andrenders determination within

five (5) days

Patient not satisfied Contact Home HealthConsumer Hotline: 1-888-419-3456

Patient satisfied withdetermination/resolution

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Advance DirectivesWho has the right to make your health caredecisions?You do, if you are an adult able to make andcommunicate your health care decisions. This includes

the right to accept or refuse medical or surgicaltreatment. You also have the right to plan and directthe type of health care you may receive in the future ifyou are unable to express your wishes. You can dothis by making an Advance Directive.

What is an Advance Directive?An Advance Directive tells, in writing, your choices fortreatments you want or do not want or about howhealth care decisions will be made for you becauseyou cannot express your wishes. Your AdvanceDirective expresses your personal wishes based onyour beliefs and values. It may relieve your familyfrom the burden of guessing what you want?

Who can make an Advance Directive?Adults have the right to make decisions about theirmedical care under state law.

How do I make an Advance Directive?There are two ways to make a formal AdvanceDirective. You can complete either a Living Will or aHealth Care Surrogate document. These forms areavailable from your health care provider, Division ofHealth or a legal counselor. You do not need a lawyerto complete these forms. However, two persons mustwitness your signature to these forms. The forms

themselves describe who may not be a witness.

What is a Living Will?A Living Will informs your physician of your choices toaccept or refuse treatment. It tells your physician thatif you develop an illness or injury that cannot be cured,are near death, or in a vegetative state, he or sheshould not use life-prolonging measures whichpostpone but do not prevent death. A Living Will goesinto effect only when two physicians agree in writingthat you are near death and you are unable to expressyour health care choices.

What is a Health Care Surrogate Document?This is a form in which you give another person theright to make health care treatment decisions for you.In some areas of health care, a health care agent isnot allowed to make decisions for you unless you givehim or her specific authority in these areas when youcomplete the form. These areas are listed on theform.

What is the difference between a Living Will and aHealth Care Surrogate Document?A Living Will goes into effect only when you are near

death or in a vegetative state and have no cognitiveabilities. It deals only with the use or non-use of lifeprolonging measures. A Health Care Surrogate alsogoes into effect when you can no longer make healthcare decisions, but you do not have to be close todeath or in a vegetative state. The Health CareSurrogate allows another person to speak for you andmake health care decisions for you that are not limited

just too artificial life support. The type of decisions thisperson can make depends upon the extent of authorityyou give when you complete the form.

Should I have both a Living Will and a Health CareSurrogate?

It is necessary to have both a Living Will and a HealthCare Surrogate. If you do have both documents, youshould make sure they do not conflict. If they doconflict, a health care provider will follow theinstructions of a Health Care Surrogate rather thaninstructions in the Living Will.

What if I change my mind?You can cancel or replace a Living Will or a HealthCare Surrogate at any time. The different ways youcan do this are explained on the forms you completewhen you make a Living Will or appoint a Health CareSurrogate.

Does my health care provider have to follow myAdvance Directives?Some health care providers and physicians may havepolicies or beliefs which prohibit them from honoringcertain Advance Directives. It is important to discussyour Advance Directives with these people to makethem aware of your wishes and to determine if they wilhonor your Advance Directives. If they will not, youmay want to choose another health care provider.

Does my state offer specific Advanced Directiveinformation?

Many states have their own information andregulations concerning Advance Directives and requirehome health agencies to make the informationavailable to you. If your state has specific informationthen it supersedes all of the above informationregarding Advanced Directives.

For additional information concerning Advance Directives,call the Home Health Agency Hotline:1-888-419-3456.


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Personal Safety

DO NOT ALLOW PEOPLE IN YOUR HOME THAT YOU DONT KNOW. ALL GABLES GATE HEALTHCENTER STAFF WEAR IDENTIFICATION BADGES.

Safety in Your Home:

Keep emergency numbers in clear view,near the telephone.

Maintain clear and well-lit pathways, hallsand steps. Clear all pathways of danglingelectrical cords and pets. Avoid clutter andclear items such as magazines andnewspapers from the floor.

Eliminate loose carpets and/or scatter rugs.

Wear closed shoes to protect your feet frominjury.

Avoid excesses in temperature. Yourawareness of heat and cold may be dulleddue to medication, the illness itself or aging.

Spills should be cleaned up immediately.Wet floors may lead to falls and behazardous.

Store perishable food in the refrigerator;check expiration dates on all food items andthrow out expired food.

Safety bars may be purchased and installedin the bathrooms.

Side rails may be purchased and installedfor your bed.

Install smoke detectors and change thebatteries in them every six months.

Place non-skid treads on stairways, ramps,and in your bathtub and shower.

Use rubber mats for the shower and tubfloors.

Use grab bars, not towel bars.

Do not smoke if using oxygen.

Pay attention to emergency exit signs whenleaving a building or home.

Ensure that all electrical wires and plugs arein good condition (not exposed).

Do not overload electrical outlets byplugging in more than one or two sources atany given time.

An easily reachable night-light, with an on/ofswitch, will help if you get up during thenight. Keep a flashlight near the bed foemergency use during power outages.

Equipment should be frequently checkedand maintained for proper functioning andsettings.

Use medical equipment only for the purposeit is intended.

Call 911 in case of an emergency (medicalfire, etc.)

Safety in Your Health:

1. Prescription Drugs: Consult your doctorbefore taking over-the-countermedications. Read labels before eachuse. Always follow directions. Store drugsproperly. Throw out unused or outdatedprescriptions. Keep all medications out ofthe reach of children.

2. Nutrition: A healthy diet keeps you fitand gives you energy. Eat from the fourfood groups. Limit your intake of salt,sugar, fats and cholesterol.

3. Exercise: Consult your physician toestablish an appropriate exerciseprogram. Start slowly and increasegradually.

4. Rest: Get enough sleep to feel restedeach morning.


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Biomedical Waste Disposal

Florida law requires that certain waste be discarded in a special way that is designed to protect the public and prevent the spreadof illness. This waste includes: needles, syringes, finger-sticks, supplies used for Chemotherapy, dressings/bandages oany product that has been saturated with blood and/or bloody body fluids. In order to be in compliance with the State ofFlorida Department of Health and Rehabilitation Services, Rule 64E-16, Administrative Code for Biomedical Waste, Gables GateHealth Center will enforce the following at no cost to you:

If your doctor has ordered any injections for you, Gables Gate Health Center will instruct its Biomedical Waste Transporter todeliver a red sharps container to your home. All used syringes and needles will be put into the sharps container. Everymonth, or sooner if necessary, the Biomedical Waste Transporter will pick up the old sharps container and leave a new one atyour home.

If you have a wound that requires dressing/bandage, a box with a red plastic bag inside will be placed in your home for the

used dressing. Every month, or sooner if necessary, the box will be picked up by the Biomedical Waste Transporter.

The sharps container and the box are NEVER to be thrown in the trash. Once you are discharged from our services, thesharps container and/or the box will be picked up by the Biomedical Waste Transporter at your home. Following dischargefrom our services, you may package the used syringes and needles to reduce exposure to the public, use a local sharpsexchange program or you may continue to contract with the Biomedical Waste Transporter used by our Agency. Acontainers must be clearly marked with type of contents. For more information, or if you have any questions, please call us a(305) 388-8883.

HOW TO AVOID NEEDLE STICKS:

DONT throw loose needles into the garbage.

DONT flush, bury or burn needles.

DONT put needles into a container that is not strong enough

to keep the needles from sticking through the sides.

DONT use clear plastic or glass containers.

DONT mix needles with things that you recycle.

DONT leave needles where other people can get them.

HOW TO DISPOSE OF SHARPS IF YOU DO NOT USE THE SERVICES OF A BIOMEDICAL WASTE TRANSPORTER:

Put needles into a container that has a lid and that is strong enough to keep

the needles from sticking through the sides, such as liquid detergent bottles or metal cans.

Throw the container away before it is full all the way to the top.

Put the container lid on tight and use heavy tape to keep it on.

Put the container in the center of your garbage.

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Hand Hygiene

Why is hand hygiene important? It prevents thespread of germs that can make you sick. According to theCenters for Disease Control and Prevention (CDC), handhygiene is the single most important means of preventingthe spread of infection. Most people don't realize that fourout of five germs that cause illness are spread by hands. Sogood hand hygiene is extremely important for the wholefamily.

What causes & spreads colds and stomach flus?Colds and stomach flus can be caused by viruses orbacteria, which are each a kind of germ. Even though manypeople believe so, things like cold weather and not getting

enough sleep do not actually cause infections or colds orstomach flu.

How can colds and flus be spread?Many people know that if a sick person talks closely (within 3feet) or coughs on someone, a cold or flu can be spread.What people often don't realize is that a more important waythat colds and flus spread is by the hands. Sharing food,shaking hands with a sick person or touching objects that asick person has touched can all spread colds and flus fromone person to another. This is why keeping your handsclean is so important.

How can I practice hand hygiene to help prevent thespread of colds and flus?There are two ways to practice hand hygiene:

Use soap and water; or Use a waterless, alcohol-based hand sanitizer.

Why are hand sanitizers a good op tion? Handsanitizers are a convenient way to get rid of germs whenhands are not visibly soiled. Because water, soap or towelsare not needed, hand sanitizers can be taken with you andused any time, any place.

For example, hand sanitizers can be carried in your purse,backpack and in the car. And of course, they can be keptthroughout the home or office -- giving you and your family aconvenient way to get rid of the germs on your hands.

How much alcohol-based hand sanitizer should I usewhen I clean my hands? The correct amount to use is anickel-sized amount (or about the size of your thumbnail).

How long should I rub my hands together whenusing hand sanitizer? You should rub your hands togetheruntil they are dry, no matter how many seconds it takes.

Once the sanitizer is completely rubbed in, it will kill thegerms on your hands.

How long should I wash my hands with soap andwater to adequately clean them? Most experts agree thatyou should wash your hands for at least 15 seconds. Thismay seem like a long time, but shorter washings may notremove enough germs to prevent infections from spreading.

Don't alcohol-based hand sanitizers make yourhands dry? Many studies have shown that alcohol-basedhand sanitizers cause less dryness and irritation to hands

than frequently washing with soap and water.

Can alcohol-based hand sanitizers make bacteriamore resistant to antibiotics? No. Many people haveheard about this problem with antibacterial products, whichcontain antibiotics and can contribute to making bacteriaresistant. One advantage of alcohol-based hand sanitizers isthat they do not contain antibiotics, so they will not makebacteria more resistant!

When should I p ractice hand hygiene?

After using the toilet Before eating or handling food After sneezing, coughing or blowing your nose After handling pets After shaking hands with people who are sick

After changing diapers Before and after cleaning cuts and scrapes

After having any contact with blood or other bodily fluid

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Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED ANDDISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW

IT CAREFULLY.

Gables Gate Health Center, Inc. (Agency)and its employees are committed to obtaining,maintaining, using and disclosing patientsProtected Health Information (PHI) in a mannerthat protects patient privacy.

The Agency is required by law to provide you withthis Notice of Privacy Practices with respect toPHI, to maintain privacy of PHI, to state the usesand disclosures of PHI that Gables Gate Health

Center may make, and to list the rights ofindividuals and our legal duties with respect totheir PHI.

The Agency is required to abide by the terms ofthe Notice of Privacy Practices currently in effect.We reserve the right to amend this Notice ofPrivacy Practices and to make the provisions ofthe new Notice of Privacy Practices effective forall PHI that we maintain. You will be provided acopy of the amended Notice of Privacy Practices.

USE AND DISCLOSURE OF PROTECTEDHEALTH INFORMATION:

The Agency may use or disclose your PHI, asdefined in the Privacy Rule of the AdministrativeSimplification provisions of the Health InsurancePortability and Accountability Act (HIPAA) of1996, for treatment, payment or healthcareoperations purposes. PHI may be used ordisclosed for other purposes only after Agencyhas obtained your written authorization Agencyhas established policies to guard against

unnecessary disclosure of PHI.

CIRCUMSTANCES UNDER WHICH, ANDPURPOSES FOR WHICH PROTECTEDHEALTH INFORMATION MAY BE USED ANDDISCLOSED:

Treatment: Agency may use PHI to coordinatecare within Agency and with others involved inyour care, such as your attending physician andother health care professionals who have agreed

to assist Agency in coordinating care. Foexample, Agency may disclose your health careinformation to individuals outside of Agencyinvolved in your care including family memberspharmacists, suppliers of medical equipment orother health care professionals.

For Payment: Agency may disclose you PHI toinsurance companies, hospitals, physicians, andhealth plans for payment purposes, or to collect

payment from third parties for the care youreceive from Agency. For example, Agency mayprovide information regarding your health carestatus so that the insurer will reimburse you or theAgency. Agency also may need to obtain prioapproval from your insurer and may need toexplain to the insurer your need for home careand the services that will be provided to you.

For Health Care Operations: Agency may useand disclose health information for its ownoperations in order to facilitate the function of the

Agency and as necessary to provide quality careto all of the Agency s patients. For example, theAgency may use PHI to evaluate its staffperformance, combine PHI with other Agencypatients in evaluating how to more effectivelyserve all Agency patients, disclose PHI to Agencystaff and contracted personnel for trainingpurposes.

Patient Contacts: Agency may contact patientsto remind them of appointments for treatment ormedical care or to recommend possible treatment

alternatives.

Fundraising Activities: Agency may useinformation about you including your nameaddress, phone number and the dates youreceived care in order to contact you to raisemoney for Agency. Agency may also release thisinformation to a related Agency foundation. If youdo not want the Agency to contact you, notifyGables Gate Health Center at (305) 388-8883 toindicate that you do not wish to be contacted.


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CIRCUMSTANCES AND PURPOSES UNDERWHICH PROTECTED HEALTH INFORMATIONMAY BE USED AND DISCLOSED WITHOUTFIRST RECEIVING YOUR WRITTENCONSENT:

Public Health: Agency may disclose PHI forpublic activities, including prevention or control of

disease, injury or disability, report disease, injury,vital events such as birth or death and to conductpublic health surveillance, investigations andinterventions. Report adverse events, productdefects, to track products or enable productrecalls, repairs and replacements and to conductpost-marketing surveillance and compliance withrequirements of the Food and DrugAdministration. Notifying a person who may havebeen exposed to a communicable disease or whomay be at risk of contracting or spreading adisease. Notifying employers regarding

workplace safety purposes or to provideinformation regarding work-related injury orillness.

Abuse, Neglect or Domestic Violence:Agency may notify government authorities ifAgency believes a patient is the victim of abuse,neglect or domestic violence. Agency will makethis disclosure only when specifically required bylaw or the patient agrees to the disclosure.

Health Oversight Activities: Agency may

disclose PHI to a health oversight agency foractivities including audits, civil administrative orcriminal investigations, inspections, licensure ordisciplinary action.

Judicial And Administrative Proceedings:Agency may disclose PHI in the course of any

judicial or administrative proceeding in responseto an order of a court or administrative tribunal asexpressly authorized by such order or inresponse to a subpoena, discovery request orother lawful process.

Law Enforcement Purposes: As permitted orrequired by State law, Agency may disclose PHIfor law enforcement purposes. For example, wemay be required to release PHI as required bylaw for reporting certain types of wounds or otherphysical injuries pursuant to the court order,warrant, subpoena or summons or similarprocess; Identifying or locating a suspect, fugitive,material witness or missing person; Notifying law

enforcement officials if Agency is suspicious thayour death is the result of criminal act; In anemergency in order to report a crime.

Coroners; Medical Examiners; and FuneraDirectors: Agency may disclose PHI tocoroners, medical examiners, and funeradirectors for purposes of determining your causeof death or for other duties, as authorized by law.

Organ, Eye or Tissue Donation: Agency mayuse or disclose PHI to organ procuremenorganizations or other entities engaged in theprocurement, banking or transplantation oforgans.

Research Purposes: Agency may, under veryselect circumstances, use PHI for researchBefore Agency discloses PHI for such researchpurposes, the project will be subject to a speciaapproval process. Agency will request you

written authorization before granting access toyour individual identifiable health information forresearch.

To Advert a Serious Threat to Health orSafety: Agency may disclose PHI if Agency, ingood faith, believes that such disclosure isnecessary to prevent or lessen a serious andimminent threat to your health or safety or to thehealth and safety of the public.

Specialized Government Functions: With

consent, the Agency may use or disclose PHI tofacilitate specified government functions relatingto military and veterans, national security andintelligence activities, protective services for thePresident and others, medical suitabilitydeterminations and inmates and law enforcementcustody. We may release PHI to authorizedfederal intelligence, counterintelligence, and othernational security activities authorized by law.

Worker's Compensation: Agency may releasePHI for worker's compensation or similar

programs providing benefits for work relatedillnesses.

AUTHORIZATION TO USE OR DISCLOSEPROTECTED HEALTH INFORMATION:

Other than what is stated above, Agency will notdisclose PHI without your written authorization. Iyou or your representative authorizes Agency to


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use or disclose PHI, you may revoke thatauthorization in writing at any time.

YOUR RIGHTS CONCERNING PRIVACY ANDCONFIDENTIALITY:

Right to request restrictions: You mayrequest restrictions on certain uses anddisclosures of PHI. You have the right to request

a limit on Agency disclosure of PHI to someonewho is involved in your care or the payment ofyour care. However, Agency is not required toagree to your request. If you wish to make arequest for restrictions, please contact GablesGate Health Center.

Right to receive confidential communications:You have the right to request that Agencycommunicate with you at a certain location. Forexample, you may ask that the Agency onlyconduct communications pertaining to PHI with

you privately with no other family memberspresent. If you wish to receive confidentialcommunications, please contact Gables GateHealth Center at (305) 388-8883. We will not askyou the reason for your request and willaccommodate all reasonable requests.

Right to inspect and copy PHI: You mayinspect and copy PHI, including medical andbilling records. Psychotherapy notes and certainother materials are exempted by law. Submit arequest to the Agency to inspect and copy

records containing PHI should be submitted toGables Gate Health Center at (305) 388-8883. Ifyou request a copy of PHI, the Agency maycharge a reasonable fee for copying andassembling costs associated with your request.

Right to amend health care information: Youmay amend your records, if you believe that PHIis incorrect or incomplete. You have to requestan amendment for as long as the information iskept by the Agency. Your request for anamendment of records must be made in writing to

Gables Gate Health Center. Agency may denythe request if it is not in writing or does notinclude a reason for the amendment. In addition,your request may be denied if PHI records werenot created by Agency, if the records you arerequesting are not part of Agency records, if thehealth information you wish to amend is not partof the health information you are permitted toinspect and copy, or if, in the opinion of the

Agency, the records containing PHI are accurateand complete.

Right to an accounting of disclosures: Youmay request an accounting of disclosures of PHmade by the Agency for any reason other than fortreatment, payment or health operations. Youmust submit your request in writing to GablesGate Health Center. Your request must specify

the time period for the accounting after March 12006. Accounting requests may not be made foperiods in excess of six (6) years. Agency wouldprovide the first accounting you request duringany 12-month period without chargeSubsequent accounting requests may be subjecto a reasonable fee.

Right to a paper copy of this notice: Youhave a right to a separate paper copy of thisNotice at any time even if you have received thisNotice previously. To obtain a separate pape

copy, please contact Gables Gate Health Centerat (305) 388-8883.

COMPLAINTS: You have the right to expresscomplaints to Gables Gate Health Center and tothe Department of Health and Human Services ifyou believe your privacy rights have beenviolated. Agency requests that your complaint besubmitted in writing. Agency encourages you toexpress any concerns you may have regardingthe privacy of your information. There will be noretaliation for filing a complaint.

HOW TO CONTACT US: If you havequestionsor concerns regarding the privacy orconfidentiality of your PHI, please call GablesGate Health Center at (305) 388-8883.


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HomeHealthAgencyOutcome and Assessment Information Set (OASIS)

STATEMENT OF PATIENT PRIVACY RIGHTS

As a home health patient, you have the privacy rights listed below:

You have the right to know why we need to ask you questions.

We are required by law to collect health information to make sure:1) you get quality health care, and2) Payment for Medicare and Medicaid patients is correct.

You have the right to have your personal health care information kept confidential.

You may be asked to tell us information about yourself so that we will know which home health services will be best for you. Wekeep anything we learn about you confidential. This means, only those who are legally authorized to know, or who have amedical need to know, will see your personal health information.

You have the right to refuse to answer questions.

We may need your help in collecting your health information. If you choose not to answer, we will fill in the information as bestwe can. You do not have to answer every question to get services.

You have the right t o look at your personal health in formation.

We know how important it is that the information we collect about you is correct. If you think we made a mistake, ask us tocorrect it. If you are not satisfied with our response, you can ask the Centers for Medicare & Medicaid Services, the federalMedicare and Medicaid agency, to correct your information.

NOTICE ABOUT PRIVACY

For Patients Who Do Not Have Medicare or Medicaid Coverage

As a home health patient, there are a few things that you need to know about our collection of your personal health careinformation.

Federal and State governments oversee home health care to be sure that we furnish quality homehealth care services, and that you, in particular, get quality home health care services.

We need to ask you questions because we are required by law to collect health information tomake sure that you get quality health care services.

We will make your information anonymous. That way, the Centers for Medicare & MedicaidServices, the federal agency that oversees this home health agency, cannot know that theinformation is about you.

We keep anything we learn about you confidential.

This is a Medicare & Medicaid Approved Notice.

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PRIVACYACT STATEMENT - HEALTH CARE RECORDS

THIS STATEMENT GIVES YOU ADVICE REQUIRED BY LAW (the Privacy Act of 1974).

THIS STATEMENT IS NOT A CONSENT FORM. IT WILL NOT BE USED TO RELEASE OR TO USE YOUR HEALTH CARE INFORMATION.

I. AUTHORITY FOR COLLECTION OF YOUR INFORMATION, INCLUDING YOUR SOCIAL SECURITY NUMBER, AND WHETHER OR NOT YOU AREREQUIRED TO PROVIDE INFORMATION FOR THIS ASSESSMENT. Sections 1102(a), 1154, 1861(o), 1861(z), 1863, 1864, 1865, 1866, 1871, 1891(b)of the Social Security Act.

Medicare and Medicaid participating home health agencies must do a complete assessment that accurately reflects your current health and includesinformation that can be used to show your progress toward your health goals. The home health agency must use the "Outcome and AssessmentInformation Set" (OASIS) when evaluating your health. To do this, the agency must get information from every patient. This information is used by theCenters for Medicare & Medicaid Services (CMS, the federal Medicare & Medicaid agency) to be sure that the home health agency meets quality standardsand gives appropriate health care to its patients. You have the right to refuse to provide information for the assessment to the home health agency. If yourinformation is included in an assessment, it is protected under the federal Privacy Act of 1974 and the "Home Health Agency Outcome and AssessmentInformation Set" (HHA OASIS) System of Records. You have the right to see, copy, review, and request correction of your information in the HHA OASISSystem of Records.

II. PRINCIPAL PURPOSES FOR WHICH YOUR INFORMATION IS INTENDED TO BE USED

The information collected will be entered into the Home Health Agency Outcome and Assessment Information Set (HHA OASIS) System No. 09-70-9002. Your health care information in the HHA OASIS System of Records will be used for the following purposes: support litigation involving the Centers for Medicare & Medicaid Services; support regulatory, reimbursement, and policy functions performed within the Centers for Medicare & Medicaid Services or by a contractor or

consultant;

study the effectiveness and quality of care provided by those home health agencies; survey and certification of Medicare and Medicaid home health agencies; provide for development, validation, and refinement of a Medicare prospective payment system; enable regulators to provide home health agencies with data for their internal quality improvement activities; support research, evaluation, or epidemiological projects related to the prevention of disease or disability, or the restoration or maintenance of

health, and for health care payment related projects; and support constituent requests made to a Congressional representative.

III. ROUTINE USES

These"routine uses specify the circumstances when the Centers for Medicare & Medicaid Services may release your information from the HHA OASISSystem of Records without your consent. Each prospective recipient must agree in writing to ensure the continuing confidentiality and security of yourinformation. Disclosures of the information may be to:

1. the federal Department of Justice for litigation involving the Centers for Medicare & Medicaid Services;2. contractors or consultants working for the Centers for Medicare & Medicaid Services to assist in the performance of a service related to

this system of records and who need to access these records to perform the activity;3. an agency of a State government for purposes of determining, evaluating, and/or assessing cost, effectiveness, and/or quality of health care

services provided in the State; for developing and operating Medicaid reimbursement systems; or for the administration of Federal/State homehealth agency programs within the State;

4. another Federal or State agency to contribute to the accuracy of the Centers for Medicare & Medicaid Services' health insurance operations(payment, treatment and coverage) and/or to support State agencies in the evaluations and monitoring of care provided by HHAs;

5. Quality Improvement Organizations, to perform Title XI or Title XVIII functions relating to assessing and improving home health agency quality ofcare;

6. an individual or organization for a research, evaluation, or epidemiological project related to the prevention of disease or disability, the restorationor maintenance of health, or payment related projects;

7. a congressional office in response to a constituent inquiry made at the written request of the constituent about whom the record is maintained.

IV. EFFECT ON YOU, IF YOU DO NOT PROVIDE INFORMATION

The home health agency needs the information contained in the Outcome and Assessment Information Set in order to give you quality care. It isimportant that the information be correct. Incorrect information could result in payment errors. Incorrect information also could make it hard to be surethat the agency is giving you quality services. If you choose not to provide information, there is no federal requirement for the home health agency to

refuse you services.NOTE: This statement may be included in the admission packet for all new home health agency admissions. Home health agencies may request youor your representative to sign this statement to document that this statement was given to you. Your sign ature is NOT required. If you or yourrepresentative signs the statement, the signature merely indicates that you received this statement. You or your representative must be supplied with acopy of this statement.

CONTACT INFORMATION

If you want to ask the Centers for Medicare & Medicaid Services to see, review, copy, or correct your personal health information that theFederal agency maintains in its HHA OASIS System of Records:

Call 1-800-MEDICARE, toll free, for assistance in contacting the HHA OASIS System Manager.TTY for the hearing and speech impaired: 1-877-486-2048.


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Medicare Coverage Criteria

The Medicare Benefit Policy Manual Chapter 7 Section 30 states the following:

Conditions Patient Must Meet to Qualify for Coverage of Home Health Services(Rev. 1, 10-01-03) A3-3117, HHA-204, A-98-49

To qualify for the Medicare home health benefit, under 1814(a)(2)(C) and 1835(a)(2)(A) of theAct, a Medicare beneficiary must meet the following requirements:

Be confined to the home;

Under the care of a physician;

Receiving services under a plan of care established and periodically reviewed by aphysician;

Be in need of skilled nursing care on an intermittent basis or physical therapy orspeech-language pathology; or

Have a continuing need for occupational therapy.

For purposes of benefit eligibility, under 1814(a)(2)(C) and 1835(a)(2)(A) of the Act,"intermittent" means skilled nursing care that is either provided or needed on fewer than 7 dayseach week or less than 8 hours of each day for periods of 21 days or less (with extensions inexceptional circumstances when the need for additional care is finite and predictable).

A patient must meet each of the criteria specified in this section. Patients who meet each of thesecriteria are eligible to have payment made on their behalf for services discussed in 40 and 50.


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Emergency / Disaster Preparedness

Emergency / Disaster Preparedness Tips:

If you need to evacuate, the best idea is to arrange to stay with a relative or friend.

A public shelter should be your last resort.

If you choose to stay at home, be sure you have plenty of supplies.

Stay tuned to your local radio station and TV channels for updated reports.

If there is a hurricane watch or warning, you will be contacted by Gables Gate Health Center andbe reminded of what you need to do.

Things to Bring to a Shelter:

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Blanket and Pillow

Special Diet Foods

Wheelchair, Cane, Walker

Cot or Folding Lounge Chair (if available)

Identification

Toiletries

REMEMBER: Firearms and Petsare NOT permitted

Medications

Flashlight

Battery Operated Radio

You Should Always Have the Following Supplies at Home:

5-day Supply of Non-Perishable Foods (canned or boxed)

Hand Operated Can Opener

5-day Supply of Bottled Water

Flashlight and Extra Batteries

5-day Supply of Medication and Medical Supplies

Shutters or Plywood to Secure Windows


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The Home Health Aide

TheHome Health A ide's main function is to promote patient comfort and support. The main focus lies on providing personal careto the patient and assistance with Activities of Daily Living (ADLs). ADLs include the following:

Ambulation. Providing physical support to enable the patient to move about within or outside of the patients place ofresidence. Physical support includes holding the patients hand, elbow, under the arm, or holding on to a support belt worn bythe patient to assist in providing stability or direction while the patient ambulates.

Bathing. Helping the patient in and out of the bathtub or shower being available while the patient is bathing. Can also includewashing and drying the patient.

Dressing. Helping patients, who require assistance in dressing themselves, put on and remove clothing. Eating. Helping with feeding patients who require assistance in feeding themselves. Personal hygiene. Helping the patient with shaving. Assisting with oral, hair, skin and nail care. Toileting. Reminding the patient about using the toilet, assisting him to the bathroom, helping to undress, positioning on the

commode, and helping with related personal hygiene, including assistance with changing of an adult brief. Also includesassisting with positioning the patient on the bedpan, and helping with related personal hygiene.

Assistance with physical transfer. Providing verbal and physical cueing, physical assistance, or both while the patientmoves from one position to another, for example between the following: a bed, chair, wheelchair, commode, bathtub oshower, or a standing position. Transfer can also include use of a mechanical lift, if a home health aide is trained in its use.

Assistance with self-administered medication

* PLEASE KEEP IN MIND THAT THE HOME HEALTH AIDE IS NOT A PERSONAL MAID *

*** Medicare does not pay for Home Health Aide services unless accompaniedby some type of skil led care, such as Nursing or Physical Therapy ***

DutiesNOT INCLUDED within the scope of services provided by the Home Health Aide are:

Mopping Floors Shopping at more than one store

Washing Windows and Furniture Defrosting and Cleaning Refrigerators Wiping or washing walls

Reining Drawers Transporting patients in Aides car

Vacuuming mattresses Vacuuming any room other than patients bedroom

In the event that the patient is alone and unable to physically assume household duties, or, if the patients spouse is

equally disabled, the Home Health Aide may also assume responsibility for:

Shopping once a week Laundry for patient only Prepare Meals for patient only

Wash dishes for patient only

NOTE: Because of the number of patients and the traveling involved, we are unable to promise specific times of day for eachvisit. However, every effort will be made to accommodate your schedule and needs. If you have a Doctors appointment

please call our office the day before and we will schedule our visits around your Doctors visits.


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Available Services

Gables Gate Health Center provides skilled health care and support services directly to you in

your home on an intermittent, part-time basis as ordered by you physician.

The services to be provided, the anticipated number of visits and the length of each visit will bediscussed with you, your representative, or caregiver.

Our Services Include:

Skilled Nursing which provides an initial assessment of your needs, ongoing observationordered care and treatments, as well as education.

Physical Therapy which provides on going assessment, evaluation, instruction and therapeuticexercises to increase endurance and mobility.

Occupational Therapy which provides ongoing assessment, evaluation, instruction andtherapeutic exercises to improve self-care and activities of daily living.

Speech Therapy which provides ongoing assessment, evaluation, instruction and rehabilitativetreatments to restore maximum communication and swallowing ability.

Medical Social Services which provide evaluation of social, environmental and emotional needsto enhance coping and recovery.

Nutritional Guidance which evaluates nutritional needs to optimize health and healing.

Home Health Aide Services which provide assistance with personal care to maintain adequatehygiene while recuperating.

Gables Gate Health Center can also provide extended care upon completion of skilled services.There may be the occasion when you are able to bathe and dress yourself but you needassistance. If you feel you require further assistance please call our office to discuss your needs.

REMINDER:

Because of the number of patients and the travelinginvolved, we are unable to promise specific times of

day for each visit. However, every effort will be madeto accommodate your schedule and needs.

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Gables Gate Health Center, Inc.5600 SW 135th Avenue

Suite #108Miami, FL 33183

Miami-Dade CountyTel: (305) 388-8883Fax: (305) 388-8996

E-mail: gghomehealth@att net

patient handbook - english

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