What Are my Rights as a Patient?

Federal law requires that all individuals receiving home care services be informed of their rights as a patient. Following is a model patient bill of rights the National Association for Home Care (NAHC) has developed, based on the patient rights currently enforced by law.

Home care patients have the right to:

• be fully informed of all his or her rights and responsibilities by the home care agency;
• choose care providers;
• appropriate and professional care in accordance with physician orders;
• receive a timely response from the agency to his or her request for service;
• be admitted for service only if the agency has the ability to provide safe, professional care at the level of intensity needed;
• receive reasonable continuity of care;
• receive information necessary to give informed consent prior to the start of any treatment or procedure;
• be advised of any change in the plan of care, before the change is made;
• refuse treatment within the confines of the law and to be informed of the consequences of his or her action;
• be informed of his or her rights under state law to formulate advanced directives;
• have health care providers comply with advance directives in accordance with state law requirements;
• be informed within reasonable time of anticipated termination of service or plans for transfer to another agency;
• be fully informed of agency policies and charges for services, including eligibility for third-party reimbursements;
• be referred elsewhere, if denied service solely on his or her inability to pay;
• voice grievances and suggest changes in service or staff without fear of restraint or discrimination;
• a fair hearing for any individual to whom any service has been denied, reduced, or terminated, or who is otherwise aggrieved by agency action. The fair hearing procedure shall be set forth by each agency as appropriate to the unique patient situation (i.e., funding source, level of care, diagnosis);
• be informed of what to do in the event of an emergency; and
• be advised of the telephone number and hours of operation of the state's home health hot line, which receives questions and complaints about Medicare-certified and state-licensed home care agencies.
• NAHC's affiliate, the Hospice Association of America, has developed the following model bill of rights for all individuals receiving hospice care. It also is based on the patient rights currently enforced by law.

• receive care of the highest quality;
• have relationships with hospice organizations that are based on ethical standards of conduct, honesty, dignity, and respect;
• in general, be admitted by a hospice organization only if it is assured that all necessary palliative and supportive services will be provided to promote the physical, psychological, social, and spiritual well-being of the dying patient. However, an organization with less than optimal resources may admit the patient if a more appropriate hospice organization is not available, but only after fully informing the client of its limitations and the lack of suitable alternative arrangements;
• be notified in writing of their rights and obligations before their hospice care begins. Consistent with state laws, the patient's family or guardian may exercise the patient's rights when the patient is unable to do so. Hospice organizations have an obligation to protect and promote the rights of their patients;
• be notified in writing of the care the hospice organization will furnish, the types of caregivers who will furnish the care, and the frequency of the services that are proposed to be furnished;
• be advised of any change in the plan of care before the change is made;
• participate in the planning of the care and in planning changes in the care, and to be advised that they have the right to do so;
• refuse services and to be advised of the consequences of refusing care;
• request a change in caregiver without fear of reprisal or discrimination;
• confidentiality with regard to information about their health, social, and financial circumstances and about what takes place in the home;
• expect the hospice organization to release information only as consistent with its internal policy, required by law, or authorized by the client;
• be informed of the extent to which payment may be expected from Medicare, Medicaid, or any other payor known to the hospice organization;
• be informed of any charges that will not be covered by Medicare, and the charges for which he or she may be liable;
• receive this information orally and in writing within 15 working days of the date the hospice organization becomes aware of any changes in charges;
• have access, on request, to all bills for service the patient has received regardless of whether they are paid out of pocket or by another party;
• be informed of the hospice's ownership status and its affiliation with any entities to whom the patient is referred;
• be informed of the procedure they can follow to lodge complaints with the hospice organization about the care that is, or fails to be, furnished, and regarding a lack of respect for property;
• know about the disposition of such complaints;
• voice grievances without fear of discrimination or reprisal for having done so; and
• be told what to do in the case of an emergency.