If you've selected your home health agency carefully, you'll probably avoid most problems. If a problem or concern should come up, report it directly to the head administrator of the agency. You may also report a complaint to your state's department of health, Medicare, or your local Better Business Bureau.

Every state has a State Health Insurance Program that provides free information and help. The counselors should be able to answer questions about your home health benefits. This program is operated either by your State Office on Aging or by your state insurance department. Look in the blue pages of your phone book to find your state government office or check on the Web at www.n4a.org. Or you can call the Eldercare Locator at 1-800-677-1116 to learn how to reach your state office. You can call the health insurance program to complain about quality of care, to report possible fraud, and to get answers to your questions about your home health benefits under Medicare, Medicare supplemental, Medicaid, long-term care insurance, and some private insurance programs. You can also get a copy of your home health agency's most recent inspection report, called a "survey report," from your state office.

Patient's Bill of Rights

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

A home care patient has the right to:

• be fully informed of all his or her rights and responsibilities by the home care agency

• choose his or her own care providers

• appropriate and professional care that fits with the doctor's orders

• receive a timely response from the agency to his or her request for service

• be admitted for service only if the agency can provide safe, professional care at the level of intensity needed

• receive reasonable continuity of care

• get all the information necessary to give informed consent prior to the start of any treatment or procedure (See Informed Consent for more on this.)

• be told of any change in the plan of care before the change is made

• refuse treatment as allowed by law and to be informed of the likely consequences of such a decision

• be informed of your rights under state law to write advance directives (see our document Advance Directives).

• have health care providers follow advance directives as the state law requires

• be informed beforehand if there are plans to stop services 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 service is denied because you are unable to pay

• voice grievances and suggest changes in service or staff without fear of restraint or discrimination

• have a fair hearing if any service has been denied, reduced, or stopped, or for any other grievance caused by the agency's action. The fair hearing procedure should be set up by each agency to fit the patient situation (for example, funding source, level of care, diagnosis).

• be told what to do in case of an emergency

• be advised of the telephone number and hours of operation of the state's home health hotline, which takes questions and complaints about Medicare-certified and state-licensed home care agencies

Last Medical Review: 05/19/2009
Last Revised: 05/19/2009