Being a patient of Careforce Homehealth, Inc., you have a right to be informed about your rights and responsibilities before we provide care, treatment, or services and to exercise those rights. Patient-Selected representative or Legal Representative may exercise your rights when you have been judged incompetent.
Patients have the right to: Dignity and Respect 484.50(c)(3)
• Have their property and person treated with respect
• Be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and misappropriation of property
Patients have the right to file complaints with the home health agency: Complaints 484.50(c)(3)
• Regarding their treatment and/or care that is provided
• Regarding treatment and/or care that the agency fails to provide
• Regarding the lack of respect for property and/or person by anyone who is providing services on behalf of the home health agency. Communicate a concern verbally and in writing regarding treatment or care, agency services, including complaints regarding the implementation of advanced directives as well as the right to ask questions about local home health agencies to: Careforce Homehealth, Inc. - Raymond DeLeon, RN – Administrator (Tel. No. 847-388-0060)
Language Services and Auxiliary Aides 484.50(c)(12): Patients have the right to be informed of the right to access auxiliary aids and language services and how to access these services.
Privacy and Access to Medical Records 484.50(c)(6): Patients have the right to a confidential clinical record and patients gave the right to access and to the release of patient information and clinical records
Patients have the right to: Decision Making, Content, and Services Provided 484.50(c)(4)(ii-viii)and(5)
• Participate in, and be informed about, and consent or refuse care in advance of and during treatment 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-identified goals, and anticipated risks and benefits; any factors that could impact treatment effectiveness; and any changes in the care to be furnished
• Receive all services outlined in the plan of care.
Free from Reprisal 484.50(c)(11): Patients have the right to be free from any discrimination or reprisal for exercising his or her rights or for voicing grievances to the HHA or an outside entity
Patients will be advised of: Financial Information 484.50(c)(7)(i-iv):
• The extent to which payment for home health services may be expected from Medicare, Medicaid, or any other federallyfunded or federal aid program known to the HHA.
• The charges for services that may not be covered by Medicare, Medicaid, or any other federally-funded or federal aid program known to the home health agency
• The charges the individual may have to pay before care is initiated;
• Any changes in the information regarding payment for service as soon as possible, in advance of the next home visit.
Patients have the right to receive proper written notice, in advance of a specific service being furnished, if the HHA believes that the service may be non-covered care; or in advance of the HHA reducing or terminating on-going care. (484.50(c)(8)
Discharge/Transfer Policy: Patients have the right to be informed of and receive a copy of the agency’s policy for transfer and discharge.
Advocacy Resources 484.50(c)(9);(10)
Patients will be advised of:
• The telephone number and hours of operation of the state’s home health hotline. The purpose of the state hotline is to receive questions and complaints about Medicare certified and state-licensed home care agencies as well as lodge complains about the implementation of Advance Directives.
COMMUNITY HEALTH ACCREDITATION PARTNER (CHAP): (800) 656-9656
ILLINOIS STATE HOME HEALTH HOTLINE: (800) 252-4343; 24 hours a day/7days a week
• The names, addresses, and telephone numbers of the following Federally-funded and State-funded entities that serve the area where the patient resides:
○ Agency on Aging – Cheryl Barrett - 160 N LaSalle St 7th Flr, Chicago, IL 60601 (217) 785-4477
Cook – Cheryl Barrett - 160 N LaSalle St 7th Flr, Chicago, IL 60601 (217) 785-4477
Du Page – Natasha Belli – 421 N County Farm Rd, Wheaton IL 60187 (630) 407-6500
McHenry – Jeri Colusy – 1910 S Highland Ave Ste 100, Lombard IL 60148 - (630) 293-5990
Kane – Jeri Colusy – 1910 S Highland Ave Ste 100, Lombard IL 60148 (630) 293-5990
Lake – Jeri Colusy – 1910 S Highland Ave Ste 100, Lombard IL 60148 (630) 293-5990
Will – Jeri Colusy – 1910 S Highland Ave Ste 100, Lombard IL 60148 (630) 293-5990
○ Protection and Advocacy Agency – Amy Wiatr-Rodriguez – 233 N Michigan Ave Suite 790, Chicago IL 60601 (312) 938-9858
○ Aging and Disability Resource Center – Amy Wiatr-Rodriguez – 233 N Michigan Ave Suite 790, Chicago IL 60601 (312) 938-9858
○ Quality Improvement Organization – KEPRO 5201 W Kennedy Blvd Ste 900, Tampa FL 33609 (855) 408-8557
○ Center for Independent Living – IL Network of Center for Independent Living – 1 W Old State Capitol Plz Ste 501, Springfield IL 62701 (800) 587-1227