As our Client*, you will be informed of your rights in writing by receipt of this Client Bill of Rights and Responsibilities additionally you have the right:

• To be given information about your care in a form you and/or your family and other caregivers can reasonably be expected to understand.
• To be provided with a copy of the Agency's criteria for admission and discharge from service upon request.
• To be provided information concerning your condition as it relates to the care provided.
• To be informed of your responsibilities in the care process.
• To be provided with information concerning the nature, reason and method of care to be rendered and the identity and professional status of the individuals responsible for providing that care.
• To be informed of the expected consequences of any refusal on your part to permit care.
• To have access to or receive a copy of your clinical record upon written request.
• Upon admission to the Agency and prior to changes in policy and/or services, to receive information regarding: the ownership or control of the agency; the type and frequency of services offered, including skilled nursing, therapeutic services, home health aide, and other paraprofessionals services; written information regarding the charges for services provided, policy regarding payment and the extent to which services will be covered and the expected charges for which the client will be responsible.
• To be advised of changes in financial responsibility in writing no later than 15 working days after the agency becomes aware of the changes.
• To receive an itemized and detailed explanation of the bill for the services rendered by the agency regardless of the source of payment upon request.
• To be informed upon admission of the Agency's mechanism for receiving, reviewing, and resolving complaints made by clients.
• To be informed of any financial benefit to the referring agency when referred to another organization, service or individual.
• To have Medicare information made available upon request and to have answers to your questions about Medicare to help you make health care decisions.

As our Client you have the right to expect the Agency to develop and maintain a written plan for your care and to participate in all decisions affecting your admission to the Agency, services provided, and plans for discharge, including the right:

• To participate, along with your family and advocates, in the establishment of your plan of care.
• To be advised in advance of any changes in the plan of care before the change is made.
• To refuse all or part of your care to the extent permitted by law.
• To not receive experimental treatment or participate in research unless you give written voluntary informed consent.
• To review and recommend changes in the Agency's policies and services, without fear of coercion, discrimination or reprisal.
• To file a grievance or complaint including one of discrimination to the Agency administrator and have that complaint investigated within 5 working days.
• To contact the state regulatory Agency in writing or via the state home health agency hotline seeks information on agencies in the state and/or files a complaint. The patient also has the right to use the hotline to lodge complaints concerning the implementation of advanced directives requirements. The state agency operates 24 hours a day, seven days a week. Illinois Department of Public Health Central Complaint Registry 1-800-252-4343

As our client you have the right to expect continuity in the care provided to you by the Agency, including the right:

• To receive care in a timely manner, coordinated and appropriate to your needs.
• To be admitted for service only if the Agency has the ability to provide safe, professional care at the level of intensity needed. (If the Agency is unable to meet your needs, you will be referred available alternatives services.)
• To have access to the Agency's management personnel and to be informed of the Agency's policy for supervision, including how to contact Agency management personnel as needed.
• To receive timely prior notice of the need for transfer to another organization or level of care, and of the alternatives, if any, to such a transfer.
• To receive timely prior notice of impending discharge, continuing care requirements, and other available services if needed at the time of discharge from Agency services.
• To receive care from properly trained personnel.
• As our Client, you have the right to be treated with consideration, respect and dignity, including the right:
• To be treated without regard to race, color, religion, sex, age, gender preference, national origin or handicap. To receive culturally competent services.
• To have your privacy respected and all your medical, financial, and other care related information treated as confidential. To be advised of your rights of privacy.
• To have your property treated with respect.
• To voice grievances to the agency, state health department or consumer affairs representative and other outside representative of your choice without coercion, discrimination, reprisal, or unreasonable interruption of service.
• Have your pain recognized and addressed appropriately, to have your pain assessed by a competent professional. To be educated about your role in managing pain and the potential limitations and side effects of pain treatments.

As our client, you have a responsibility:

• To provide accurate and complete information about your present and past illness and condition, medications and other matters relating to your health and care.
• To treat staff with dignity and respect.
• To review and sign time sheets.
• To communicate any and all concerns to the office.
• To return all used and unused AHHC documents upon discharge from care.
• To reasonably protect and store your valuables.
• To inform the office of new orders or changes in the physician's plan of care, to adhere to the physician's plan of treatment and to participate in the development of the plan of care.
• Inform the agency when you will not be home or are unable to have a nurse in your home.
• Inform the office when you have a change in insurance coverage.

*All rights and responsibilities specified, as they pertain to individuals who have been deemed dependent in accordance with state law, are assumed by the person(s) authorized as representatives to act on their behalf.