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FAQ`s

FAQ`s

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Use this section to find the most frequently asked questions. If you cannot find your question below, use the form on the side to send us your question and we will reply to you shortly.

General

"Administrator" must be a licensed physician, physician assistant, or registered nurse licensed to practice in this state or an individual having at least 1 year of supervisory or administrative experience in home health care or in a related facility, and who is responsible for overseeing all the Agency's activities.

"Admission" means a decision by the home health agency, during or after an evaluation visit to the patient's home, that there is reasonable expectation that the patient's medical, nursing, and social needs for skilled care can be adequately met by the agency in the patient's place of residence. Admission includes completion of an agreement with the patient or the patient's legal representative to provide home health services.

"Client" means an elderly, handicapped, or convalescent individual who receives home health skilled or non-skilled, companion or homemaker services in the individual's home or place of residence.

"Director of Nursing" means a registered who has at least 1 year of supervisory experience as a registered nurse; and who is responsible for overseeing the professional nursing and home health aid delivery of services of the agency.

"Home Health Agency" means an organization that provides home health services and staffing services.

"Home health agency personnel" means persons who are employed by or under contract with a home health agency and enter the home or place of residence of patients at any time in the course of their employment or contract.

"Home health services" means health and medical services and medical supplies furnished by an organization to an individual in the individual's home or place of residence. The term includes organizations that provide one or more of the following:

HOME HEALTH DISCIPLINES

Nursing Services: Our team of Nurses have been thoroughly screened and trained to meet the challenges of day to day activities and are required to attend continuing educational classes to stay up-to-date with the latest changes, discoveries, and treatments in the medical/Nursing field. Our Nurses provide services for: Wound Care Management, Cardiac Care, Post-Operative Care, Parenteral & Enteral Nutrition therapy, Diagnosis teaching and instructions, Safety Measures & Percussions, Instructions on Medication regime, High Tech, IV therapy, Infusion, Respite Care, Diabetic Care Management, etc.

Aid Services: Home Health Aides provide Personal Care to our patients under the supervision of a Registered Nurse or a Registered Therapist. Home Health Aides provide: Personal Care, Assist with bathing, Prepare and serve light meals, Light housekeeping, Assist with ADL's, Assist with ambulation and transfers, Assist with self administration of medications, Companionship.

THERAPY SERVICES: Our highly skilled therapist evaluate each patient's physical impairments and functional limitations and establish a Care Plan in cohesion with the patient's physician to achieve optimal rehab outcomes. Our Therapist can offer: Physical therapy services, assist in restoring and maintaining maximum musculoskeletal functions. From hip fractures to sprains to patients with unsteady gait, our therapist are specialized in helping the patient restore their confidence in their ability to ambulate themselves throughout their living environment. Speech Therapy assists in improving swallowing disorders and communicative activities of daily living. Occupational Therapy strives to improve the level of independence in day to day living activities.

MEDICAL SOCIAL WORKERS: Facilitate long term planning to promote independence and to explore opportunities available through the variety of community resources designed to assist the elderly with personal concerns alleviating anxieties and psychological traumas.

Our QUALITY ASSURANCE PROGRAM is designated to systematically monitor, measure, and evaluate care standards, appropriateness of care and services provided to assure clients with the highest possible level of service. That's why every service we provide is supervised by our professionals and administered from the initial consultation to recovery or treatment completion. It is the policy of our Agency that home health services shall be available and shall be rendered to the total population of our area of services, regardless of the recipient's race, sexual orientation, religion, age, sex, disabilities, ethnic/cultural background, or national origin

Try to make at least minor decisions for yourself. Make sure that you know your rights as individuals such as when to bathe, eat, have visitors, etc. Try to do as much for yourself as possible when it comes to picking out clothes, deciding what activities to do and trying to dress yourself.

  • Require to be looked as an individual, what you likes and dislikes, by allowing you to do as much as you can for yourself, always getting the staff/family to offer choice.
  • Require to be allowed to speak and not be spoken over and respected for your possible different cultures and beliefs.
  • Try reassessing guidelines for each of you on a regular basis to ensure any changes are monitored, example medication, etc as this can have an affect on you or your health.
  • Try to participate in activities that you can carry out, like helping with the shopping, writing letters or making calls.

In many situations, social services are needed by adults who are receiving home health services. Our nurses or therapist may request orders for social services to your physician. In addition to these referrals, a request for social services may be initiated by you or by another individual acting upon behalf of you. The social worker is responsible for providing the indicated services or for referral to the appropriate resource outside our Agency if the services are not available within our scope of services.

Among the services provided by the social worker are:

  • Services which will enable individuals to attain and/or maintain as good physical and mental health as possible;
  • Services to assist patients who are receiving care outside their own homes in planning for and returning to their own homes or to other alternate care;
  • Services to encourage the development and maintenance of family and community interest and ties;
  • Services to promote maximum independence in the management of their own affairs;
  • Protective services, including evaluation of need for and arranging for guardianship; and appropriate family planning services which include assisting the family in acquiring means, food or other needed resources.
  • Services are offered in making the necessary referral and follow-up.

All of our employees will provide care and services to our clients within the ethical framework established by the home health care standards, professional requirements and the law during the perform of their duties.

All clients/caregivers will be provided with the information regarding service hours of the Agency (see Inside Front Cover) and access to staff for emergencies. Agency will provide adequate, qualified staff for emergency response and troubleshooting related to any services provided to client/caregiver. Emergency Response:

  1. On initial visit, client/caregiver will be provided with an Agency business card and telephone number, and will be educated on Agency's twenty-four (24) hours, seven (7) days per week, availability of Home Care staff.
  2. Phone calls may be made to the Agency during the office regular business hours Monday-Friday to reach the office staff.
    1. Emergency calls may be handled after office hours and on weekends by dialing the office number.
      1. Notify the answering service of your name/phone number and a representative will contact you ASAP
      2. If caller chooses only to leave a message, the Agency staff will follow up on call the next business day.
      3. Emergency Services are available after office hours, including weekends and holidays.
      4. All clients/caregivers are instructed on admission to contact 911 in the event of a life threatening emergency.
    2. On-call representatives will handle all problems, or will contact the Director of Nursing for clinical issues.
    3. The Director of Nursing/On-Call Nurse is responsible for determining the necessity for a home visit, notifying the physician and/or taking other appropriate actions.
  3. The on-call representative will keep a log of all calls and actions taken.

    Our Agency will take steps as necessary to ensure that qualified persons with disabilities, including those with impaired sensory or speaking skills, receive effective notice concerning benefits of services or written material concerning waivers of rights or consent to treatment. All aids needed to provide this notice are provided without cost to the person being served. The identification of special needs and disabilities are a part of the referral process. Information regarding special services will be posted and presented to individuals upon admission.

    For Persons With Hearing Impairments: The Agency will perform a maximum effort to contract a qualified sign-language interpreter for persons who are deaf/hearing impaired and who use sign-language as their primary means of communication . The following agency offer the needed services : The Florida Coordinating Council for the Deaf and Hard of Hearing: 4052 Esplanade Way, Bin #A06. Tallahassee, FL 32399 Voice : 850 - 245-4913 Toll Free Voice : 866-602 - 3275 TTY : 850-245-4914 Toll Free TTY: 866-602-3276

    For Persons With VIsual Impairments :
    Staff communicate the content of written materials concerning the benefits, services, waivers of rights, and consent to treatment forms by reading them out loud to visually impaired persons. Large print, taped and braille materials are available upon request. Please contact the Director of Social Services for these materials.

    For Persons With Speech Impairments:
    Writing materials , TDD, computers, and communication boards are available to facilitate communication concerning program services and benefits, waivers bf rights and consent to treatment forms.

    As a recipient of Federal financial assistance, our Agency does not exclude, deny benefits to or otherwise discriminate against any person on the grounds of race, color, national origin, disability or age in admission to, participation in, or receipt of the services and benefits of any of its programs and activities or in employment therein, whether carried out by our Agency directly or through a contractor or any other entity with which our Agency arranges to carry out its programs and activities.

    This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and Regulations of the U.S. Department of Health and Human Serv ic es issued pursuant to the Acts, Title 45 Code of Federal Regulations Part 80, 84, and 91. (Other Federal Laws and Regulations provide similar protection against discrimination on grounds of sex and creed). In case of question please contact the Agency Section 504 Coordinator, (Agency's information in the cover of the book).

    All information received by persons employed by or providing services to the Agency and/or received by the Agency through reports or inspections shall be deemed privileged and confidential, and shall be stored and maintained in such a manner as to maintain the confidentiality of same, following HIPAA guidelines. The above information shall include, but not be limited to, client records as well as personnel records. Accessibility to information shall be limited to authorized personnel within the Agency. Information shall not be disclosed without the written consent of the client/guardian and/or employee. Release of informat i on shall be accomplished only upon the approval of the Agency Administrator and/or Designee. At the start of employment all employees shall be instructed in the confidentiality policy of the Agency, and will read and sign a "Confidentiality Statement". This shall become part of the employee's personnel record. Breach of confidentiality may be grounds for immediate termination of employment.

    Diminished vision is a visual deterioration not correctable by standard eye glasses, contact lenses, medicine, or surgery that interferes with a person's ability to perform everyday activities.

    What Causes Diminished Vision?
    Impaired vision can result from a variety of diseases and injuries that affect the eye. Many people with impaired vision have age related diabetic retinopathy, macular degeneration, glaucoma or cataract.

    How Does Diminished Vision Affect People's Lives?
    People with diminished vision experience physical, financial, and psychological changes that reduces their quality of life. Without proper assistance and training, patients may have difficulty using magnifying devices and completing necessary activities of daily living tasks such as: Meal preparation, Reading, Financial management, Home maintenance, Grooming, Shopping, Community and leisure activities. A Medicare beneficiary with impaired vision may be eligible for rehabilitation services designed to improve functioning, by therapy, to improve performance of activities of daily living including self-care and management skills in a home setting.

    Our clients/caregivers have the option to exercise their rights, participate in their care plan, voice grievance/complaints and recommend changes in our policy and procedures without fair of reprisal, discrimination. Any complaint/concern brought to us (preferable to our administrator) will be thoroughly investigated, responded in writing, including a corrective action plan if needed.

    As a home health care patient you have the responsibility to: Give accurate and complete health information concerning your past illness, hospitalization, medications, allergies, and other pertinent items, Assist in developing and maintaining a safe environment, Inform the Home Health Care Agency when you will not be able to keep a home health care visit, Participate in the development and update of your home health care plan and comply with prescribed medical regimen, Adhere to your developed (updated home health care plan), Request further information concerning anything you do not understand, Give information regarding concerns and problems you have to a home health care agency staff member. Agree to accept all care givers without regard to race, color, religion, age, gender, preference, handicap, or national origin and provide safe environment for our staff including pets (dogs, snakes, etc) and any kind of harms. Remain under a physicians care while receiving skilled services. Provide the Agency with all requested insurance and financial records. Signs required consents and release forms. Accept the responsibility of any refusal of treatment, reviewed and understand your responsibilities as described above.

    You are entitled to care in your preferred language. This service is provided at no charge to you, our agency's staff will make every attempt to meet your language needs. If you require additional assistance, please contact our office.
    Medicare has established a new requirement for payment of the home health services that you may need. To meet this new requirement, you will need to have a face-to-face visit with a physician, nurse practitioner, clinical nurse specialist, certified nurse midwife, or physician's assistant for a matter related to your need for home health. This "special" visit can occur 90 days before your start receiving home care services or up to 30 days after the home care nurse or therapist admits you.

    Charge are per visits :

    RN, Therapist, Social Worker: $100 . 00 , LPN : $95 . 00, HHA : $65.

    This rate may vary according Private Insurance, Copayments, Self Pay option (Ask our Admission Nurse/Therapist explain to you the Section One and Two of our Service Agreement for more information about charges).

     

    Improve the accuracy of patient identification

    • Reduce the risk of healthcare associated infections
    • Accurately and completely reconcile medications across the continuum of care
    • Reduce the risk of patient harm resulting from falls
    • The organization identifies safety risks inherent in its patient population
    Key ways to protect yourself from fraud:

    • Review your claims summaries thoroughly to ensure you received each service listed and that all the details are correct.

    • Never share (or allow to use for other person) your Medicare/Insurance Number, except with your doctors or other Medicare providers. Guard your social security/Medicare/Insurance number.

    • Report suspected fraud by calling 1-800-MEDICARE, or your Insurance carrier. The sooner you see and report errors, the sooner Medicare/Insurance can investigate and stop the fraud .

    This Agency can provide a service or a combination of services in your home, all under the direction of a physician. Working with your doctor, our qualified staff will plan, coordinate and provide care tailored to your needs. Our services may include : Skilled Nursing, Home Health Aide (Nursing Assistant), Physical, Occupational, and Speech Therapy, Infusion (IV therapy), Medical Social Workers, Homemaking, Personal Care and Companion Services shall become part of the employee's personnel record. Breach of confidentiality may be grounds for immediate termination of employment.

    Admission to this Agency can only be made under the directions of a physician, based upon the patient's identified care needs, homebound status, face to face compliance, and the type of services required that we can provide directly or through coordination with other organizations. If we cannot meet your needs, either directly by our Agency or indirectly through service agreement with other providers, we will not admit you or will not continue to provide services to you.

    Your right to appeal the decision

    You have the right to an immediate, independent medical review (appeal), while your services continue, of the decision to end Medicare coverage of these services. If you choose to appeal, the independent reviewer will ask for your opinion and you should be available to answer questions or supply information. The reviewer will also look at your medical records and/or other relevant information. You do not have to prepare anything in writing, but you have the right to do so if you wish. Our Agency will bring to you a detail form at least 48 hrs before your discharge.

    The Home Health Aide is an employee who has been specifically trained to provide personal care and related services to the patient. In order to receive an aide, you must be receiving the services of a registered nurse, physical therapist or speech therapist.

    The Home Health Aide MUST perform personal care:

    1. Bath , sponge or shower
    2. Shampoo
    3. Skin care
    4. Make patient's bed only

    Additional duties which may be included at each visit:

    • Personal undergarments only: i.e. nightgowns and pajamas
    • Straighten bathroom - Clean tub and sink
    • Ambulation if requested by nurse or therapist
    • Meal preparation-One light meal of sandwiches, salad or soup. Aide will wash dishes associated with this meal.

    Duties not included in services:

    Mopping floors, Re-lining drawers, Bathing Pets, Washing windows and furniture, Shopping at more than one store, Defrosting and cleaning refrigerators, Transporting patients in aide's cars, Cleaning ovens, Vacuuming mattresse, Wiping or washing walls, Vacuuming any room other than patients bedroom.

    Services will not cover for housekeeping or companion service.

    In the event that the patient is alone and unable to physically assume household duties, or, if the patient's spouse is equally disabled, the Home Health Aide may also assume responsibility for :

    1. Shopping- once a week
    2. Laundry- for patient only
    3. Prepare meals for patient only
    4. Wash dishes for patient.

    Because of the number of patients and the traveling involved, we are unable to promise specific times of day for each visit, however, every effort will be made to accommodate your schedule and needs. If you have a Doctor's appointment, please call our office the day before and we will schedule our visits around your doctor's visits.

    All Patients requiring Biohazardous Waste Disposal while rendering medical treatment in your house, the Agency will be placing a biohazardous waste container in your home. We are required by state law to dispose of biohazardous waste in this manner. The waste box or sharps container in your home is only to be used to dispose of biohazardous waste. This container is not to be used for any other purpose. Our agency has contracted to pick up this waste within twenty-eight days after set up. The waste must be removed within this time limit in order to comply with state law. The above company will contact you to arrange for pickup of the container within the time frame mentioned above. Please help us by accommodating them when they call.

    THE WASTE CONTAINER MUST STAY INSIDE YOUR HOME UNTIL IT IS REMOVED BY THE WASTE MANAGEMENT COMPANY. NEVER PUT THE WASTE CONTAINER IN THE GARBAGE OR OUTSIDE YOUR HOME FOR ROADSIDE PICKUP. THIS IS ILLEGAL! IF IT HAPPENS, OUR AGENCY OR YOU COULD FACE PROSECUTION IF THE WASTE HARMS ANOTHER PERSON .

    If you need your container removed prior to the scheduled pickup or you have any questions regarding the waste management system in your home, call our Agency office and speak to your case manager. If you would like to continue this service after you have been discharged from home health services please call the above company.

    Home care is a very helpful choice for both the person with Alzheimer's disease and their families because it provides the very kind of care that is most important, service in the comfort and familiarity of the patient's own place of residence.

    Criteria for home care admission, for persons with end stage dementia, may not always be well known. The issues of mobility, nutrition and weight, verbal communication problems with infection and overall decline are evaluated . The psychological and physical support provided by home care teaching and supportive equipment can greatly relieve the family caregiver.

    Caring for a person with Alzheimer's Disease (AD) is a challenge that calls upon the patience, creativity, knowledge, and skills of each caregiver. Our home heath agency treats patients with every kind of terminal condition and many different forms of dementia, including persons with ADRDs.

    A proper assessment of a patient addresses the needs of the person and his or her caregivers and family in a comprehensive fashion. This is especially important to the family of a person suffering from ADRDs, since this person may have difficulty communicating his or her needs to family members.

    More than those with other diseases, these patients spend a long period at the end of their lives bed bound, mostly unresponsive, and in need of total care. As with all of our patients, it is the goal of our home care program to care for the ADRD patient while supporting and comforting family and loved ones regardless of the setting or the patient's daily abilities.

    • What is the name of each medicine?
    • What is it for?
    • What time should I take it ?  
    • How much of it should I take each time?
    • How should I take it?
    • Should I take it with food?
    • How long should I take it?
    • What should I do if I miss a dose?
    • Are there anymside effects? What should I do if I have any?
    • Is it safe to take with other medicine that I am taking, including over-the-countermmedicine, vitamins or herbals?
    • What food, drink or activities should I avoid while taking it?

    A lot of people-including you!

    Doctors check all of your med ici nes to make sure they are OK to take together.

    Pharmacists will check your new medicines to see if there are other medicines, foods or drinks you should not take with your new medicines.

    Nurses and other caregivers may prepare medicines or give them to you.

    What if you forget the instructions for taking a medicine or are not sure about taking it?

    Call your doctor or pharmacist. Don't be afraid to ask questions about any of your medicines.

    Oxygen can be used safely at home. These are the rules for Oxygen Safety:

    Oxygen is a drug, too much or too little oxygen may be harmful, use the amount ordered by your Doctor. Do not change the amount of oxygen you are using without first checking with him. If you feel you are not getting enough oxygen, talk to your Doctor.

    Fire safety

    Oxygen it self does not burn. Oxygen can feed a spark and cause it to become a large fire in seconds.

    Follow these rules to prevent a fire:

    NO Smoking, avoid open flames, do not use equipment with frayed cords or electrical shorts, avoid using electric razors and hair dryers while using oxygen, do not use an appliance with a control box such as a heating pad, Avoid static electricity, avoid nylon or woolen clothing. 

    Proper storage and handling of oxygen:

    Store liquid and cylinder oxygen away from heat and direct sunlight, place cylinders in a secure holder, never app l y any oily substance.

    Diabetes mellitus: Diabetes mellitus affects up to 5% of the population in the US, almost 14 million people.

    Definition: A disorder caused by decreased production of insulin, or by decreased ability to use insulin. Insulin is a hormone produced by the pancreas that is necessary for cells to be able to use blood sugar.

    Causes, incidence, and risk factors: The cause of diabetes mellitus is unknown, but heredity and diet are believed to play a role in its development. People with diabetes have the same nutritional needs as anyone else. Along with exercise and medications (insulin or oral diabetes pills), nutrition is important for good diabetes control. By eating well-balanced meals in the correct amounts, you can keep your blood glucose level as close to normal (non - diabetes level) as possible.

    What foods are healthy? No single food will supply all the nutrients your body needs, so good nutrition means eating a variety of foods. You and your dietitian/doctor should work together to design a meal plan that's right for you and includes foods that you enjoy together with your medication plan. A diabetes meal plan is a guide that tells you how much and what kinds of food you can choose to eat at meals and snack times. A good meal plan should fit in with your schedule and eating habits. The right meal plan will also help keep your weight where it should be. Whether you need to lose weight, gain weight, or stay where you are, your meal plan can help .

    There are many different causes and kinds of pain .

    Questions To Ask Your Caregivers:

    What pain medicine is being ordered or given to you? Can you explain the doses and times that the medicine needs to be taken? How often should you take the medicine? How long will you need to take the pain medicine? Can you take the pain medicine with food? Can you take the pain medicine with your other medicines? Should you avoid drinking alcohol while taking the pain medicine? What are the side effects of the pain medicine? What should you do if the medicine makes you sick to your stomach? What can you do if the pain medicine is not working? What else can you do to help treat your pain?

    Many falls can be prevented by making some changes, you can lower your chances of falling. Four things YOU can do to prevent falls:

    1. Begin a regular exercise program. Exercise is one of the most important ways to lower your chances of falling. It makes you stronger and helps you feel better. Lack of exercise leads to weakness and increases your chances of falling. Ask your doctor or health care provider about the best type of exercise program for you.
    2. Have your health care provider review your medicines. Ask your doctor or pharmacist to review all the medicines you take, including over-the-counter medicines. As you get older, the way medicines work in your body can change. Some medicines, or combinations of medicines , can make you sleepy or dizzy and can cause you to fall.
    3. Have your vision checked.
    4. Make your home safer. Remove things you can trip over (like papers, books , clothes, and shoes) from stairs and places where you walk. Remove small throw rugs or use double-sided tape to keep the rugs from slipping. Keep items you use often in cabinets you can reach easily without using a step stool. Have grab bars put in next to your toilet and in the tub or shower. Use non-slip mats in the bathtub and on shower floors. Improve the lighting in your home. As you get older, you need brighter lights to see well. Hang light-weight curtains or shades to reduce glare. Have handrails and lights put in on all staircases. Wear shoes both inside and outside the house. Avoid going barefoot or wearing slippers.

    Involving Medical Devices or Equipment, such as Oxygen, Glucmeter, Supplies, Ambulation Devices, etc., can lead to serious problems, including incorrect or delayed diagnosis and treatment or patient injuries.

    Please follow :

    • Use & Look after all Devices, Inspect all Devices before use, select the correct, comfortable one.
    • Ensure that t he Device is working properly a n d set up safely, our staff must monitor the progress/function of the Device, in the event of a problem know how to respond to reduce the risks.
    • Get any damaged Device checked by authorized technician
    • Store Devices safely
    • Keep any battery operated Device charged up
    • Check that the Device is regularly maintained
    • Check that any disposables are appropriate and safe to use
    • Remember, a safe medical device is one that does not injure a patient, user or caregiver.
    Everyone has a role in making health care safe. That includes family members, caregivers, doctors and health care professionals. Home care organizations all across the country are working to make health care safe. As the patient, you can make your care safer by being an active, involved and informed member of your health care team. Speak up if you have questions or concerns. If you still don't understand, ask again. It's your body and you have a right to know. Pay attention to the care you get. Make sure you get the right treatments and medicines by the right home care professional. Don't assume anything. Educate yourself about your condition. Learn about the home care services you will get. Learn about your care plan. Ask a trusted family member or friend to be your advocate (advisor or supporter). Know what medicines you take. Know why you take them. Medicine errors are the most common health care mistakes. Use a home care organization that has been carefully checked out. Participate in all decisions about your treatment and the home care services you receive. You are the center of the health care team.

    Many accidents can be prevented in the home by following a few basic suggestions. Because we are concerned for your health and safety, we offer the following recommendations:

    • Remove scattered rugs to avoid falls.
    • Be sure there are no frayed edges or carpeting.
    • Keep all path ways clear and uncluttered to prevent falls and avoid the risk of fire hazard.
    • Do not overload electrical outlets, and do not hide cords under carpeting.
    • All stairs/ramps should have hand rails and non-skid surface.
    • In the kitchen, avoid loose-fitting clothing when using stove; use pot-holders or insulaed kitchen mitts to handle hot items. Keep cooking utensils within easy reach; whenever possible, sit while doing kitchen chores to prevent falls caused by becoming over-tired.
    • In the bathroom, use non-slip rugs, carpeting to prevent falling on wet floors; use non-slip strips or mats in the tub. Always test water temperature before entering tub or shower. Water temperature should be 120 degrees or less. Use grab bars, shower chairs and/or raised toilet seats for client who is very ill, weak, and/or tires easily. At night, use a night light to prevent falling in the dark . Keep telephone and other items that may b e needed during the night on a bedside stand , within easy reach for the client.
    • Install smoke detectors on all home levels; keep fire extinguisher in home; learn how to use it properly.
    • Plan a fire emergency escape route, and practice leaving your home by that route to avoid unnecessary loss of time and unnecessary stress should a real fire emergency occur. If use of oxygen is necessary in the home, be sure you are instructed as to what to do during an emergency situation.
    • POST FIRE AND OTHER EMERGENCY NUMBERS ON OR BY THE TELEPHONE

    Recommendations:

    In case of fire, do you have an emergency exit plan and an alternate exit plan?

    Once a fire starts, it spreads quickly and there may be a great deal of confusion, it is important for everyone to know what to do.

    • Develop emergency exit plan
    • Choose meeting place outside your home to be sure everyone has exited safely
    • Practice the plan to ensure that everyone can escape quickly and safely

    All Home Areas:

    Check all areas of your home for any frayed cords, check all electrical and telephone cords; remove rugs, runners and mats which can cause falls. Check all smoke detectors, electrical outlets and switches to ensure they are in good working condition. Practice your emergency exit plan with all members of your household.

    Recommendations:

    • Arrange furniture so that outlets are near lamps & appliances.
    • Minimize the use of extension cords. If used, extension cords/telephone cords should always be placed on floor against wall to avoid tripping over them. Furniture resting on cords, nails and staples can cause damage and create fire and shock hazards. Electric cords which run under carpeting may cause a fire. Remove cords, nails and staples from under furniture and carpeting, check for damaged wiring. Use tape to attach cords to walls/floors.
    • If an extension cord is needed, use one having sufficient amp or wattage rating.
    • If the rating on acord is exceeded because of the power requirements of one/more appliances being used on the cord, change cord to higher rated one or unplug some appliances. DO NOT USE FRAYER CORDS!

    Bedroom Areas:

    Recommendations:

    Are lamps/switches with in reach of each enable bed?

    • Lamps/switches should be located close each people during periods of darkness t o see where they are going.
    • Rearrange furniture so that lamps/switches are closer to bed. Install night lights.
    • Are cigarettes, ashtrays, lighters, or other located away from beds/bedding?
    • Bums are a leading cause of death smoking in bed is a major potential fire sources (hot plates, teapots, etc.) contributor to this problem. Never smoke in bed. Remove any possible source of heat/flames from areas around beds.

    Smoke Detectors Questions:

    Are smoke detectors properly located?

    Recommendations:

    • There should be a smoke detector located on every floor of your home. Follow manufacturer's instructions/advice for the best place to install your device.
    • Place detectors near ceiling or 6 -12 inches below ceiling on the wall.
    • Smoke detectors should be placed away from air vents.
    • Fire injuries and deaths are often caused by smoke and toxic gases, rather than by the fire itself. Smoke detectors provide early warning in the event of a fire. If you are unable to purchase a fire detector, some fire departments and/or local governments will provide assistance in acquiring and installing smoke detectors. Purchase a smoke detector if you do not have one, or call your local fire department for further information. Check and replace batteries and bulbs as directed by manufacturer. Replace any detector that an not be repaired. Vacuum the grill work of your smoke detector.

    Clean your hands : Use soap/warm water. Rub your hands really well for at least 15 seconds. Rub your palms, fingernails, in between your fingers, and the backs of your hands. Or, if your hands do not look dirty, clean/rub them with alcohol-based hand sanitizers, until your hands are dry. Clean your hands before touching or eating food, after you use the bathroom, take out the rash, change a diaper, visit someone who is ill, or play with a pet.

    Make sure our staff clean their hands or wear gloves. Our staff should wear clean gloves when they perform care to you. Don't be afraid to ask them if they should wear gloves.

    Cover your mouth and nose. When you sneeze or cough, the germs can travel 3 feet or more! Cover your mouth and nose to prevent the spread of infection to others.

    If you are sick, avoid close contact with others. Stay away from other people or stay home. Don 't shake hands or touch others. If you have any wound or skin lesion be alert for sign / symptoms of infection like discharge, fever.

    To protect both client and care givers, infection control procedures should be followed in the home setting.

    RECOMMENDATIONS:

    Hand washing, is perhaps the easiest, as well as the most important, and effective way to prevent transmitting infection from one person to another. Client/caregiver should wash their hands thoroughly before and after providing client care, as well as before and after contact with contaminated/potentially contaminated items. If in doubt as to what may or may not be contaminated, be safe.

    WASH YOUR HANDS!!

    Use of latex or other disposable gloves. Gloves should be worn when handling and/or disposing of any of the following: Blood, Urine, Feces, Sputum, Any body fluid or secretion. Be sure to dispose of any contaminated/potentially contaminated item, eg., Kleenex, by placing in a sealable plastic bag. Our professional staff will instruct you on appropriate infection control measures including the proper methods for disposal. If you have any questions/concerns throughout the time services are being provided to you, ask your nurse or therapist, physician, or contact our office. For any questions/concerns regarding Infectious Disease, contact your Physician. Have disposable tissues available for everyone to use. Sanitize surface areas that are frequently touched. Use respiratory mask if needed.

    Make sure that your vaccinations are current, even for adults. Check with your doctor about shots you may need.

    Vaccinations are available to prevent these diseases:

    • Chickenpox
    • Mumps
    • Measles
    • Diphtheria
    • Tetanus
    • Hepatitis
    • Shingles
    • Meningitis
    • Flu ( also known as influenza)
    • Whooping cough
    • German measles ( also known as Rubella )
    • Pneumonia
    • Human papillomavirus ( HPV)

    Our Agency guarantees that home health care providers will adhere to the following, when delivering care to all patients. By adhering to the following universal precautionary measures, the risk of transmission of disease is decreased when the infection status of the patient is unknown.

    Gloves must be worn when delivering patient care, handling specimens, doing domestic cleaning, and handling items that may be soiled with blood or body fluids. Gloves or aprons must be worn during procedures or while managing a patient situation when there will be exposure to body fluids, blood, draining wounds or mucous membranes.

    Mask and protective eye wear or face shield must be worn during procedures that are likely to generate droplets of body fluids, blood or when the patient is coughing excessively.

    Hand washing : Hands must be washed before gloving and after gloves are removed. Hands and other skin surfaces must be washed immediately and thoroughly if contaminated with body fluids or blood and after all patient care activities. Home health care providers, who have open cuts, sores, or dermatitis on their hands must wear gloves for all patient contact.

    To prevent the transmission of all respiratory infections in healthcare settings, including influenza, the following infection control measures should be implemented at the first point of contact with a potentially infected person. They should be incorporated into infection control practices as one component of Standard Precautions.

    Visual Alerts : (in appropriate languages) instructing patients and persons who accompany them (eg., family, friends) to inform our health care personnel of symptoms of a respiratory infection (cough, shorts of breaths problems, running nose, fatigues, sneezing) when they are under our care and to practice Respiratory Hygiene/Cough Etiquette.

    Cover Your Cough : Stop the spread of germs that can make you and others sick! Influenza (flu ) and other serious respiratory illnesses like respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by cough, sneezing, or unclean hands.

    To help stop the spread of germs : Cover your mouth and nose with a tissue when you cough or sneeze, put your used tissue in the waste basket, if you don't have a tissue, cough or sneeze into your upper sleeve or elbow, not your hands, you maybe asked to put on a face mask to protect others, wash your hands often with soap and warm water for 20 seconds, if soap and water are not available, use an alcohol-based hand rub. Information about Personal Protective Equipment (PPE), demonstrates the sequences for donning and removing PPE.

    Masking and Separation of Persons with Respiratory Symptoms: During periods of increased respirratory infection activity in the community (eg., when there is increased absenteeism in schools and work settings and increased medical office visits by persons complaining of respiratory illness), we may request to wear masks to persons who are coughing. Either procedure masks (i.e., with ear loops) or surgical masks (i.e., with ties) maybe used to contain respiratory secretions (respirators such as N-95 or above are not necessary for this purpose). When space and chair availability permit in your place of residence, weencourage coughing persons to sit at least three feet away from others in common waiting areas.

    Droplet Precautions: We advise to our health care personnel to observe Droplet Precautions (i.e . , wearing a surgical or procedure mask for close contact), in addition to Standard Precautions, when examining a patient with symptoms of a respiratory infection, particularly if fever is present. These precautions should be maintained until it is determined that the cause of symptoms is not an infectious agent that requires Droplet Precautions.

    Purpose:

    To provide an atmosphere of respect and caring to ensure patient's ability and right to participate in medical decision making, to ensure patient's wishes about his/her care, treatment and services are respected in accordance with acceptable standards of practice, ethics and applicable laws, to assure compliance with the Patient Self-Determination Act (PSDA), to expand patient, family, staff knowledge base regarding advance," a directives and the process by which patient participation in medical decision making is fostered by the Agency.


    POLICY:

    1. At the time of Admission we will inform patients about the Agency's written policies on implementation of Advance Directives. The Agency recognizes the right of the competent adult to make a verbal or written declaration regarding decisions about his own medical care. This would include deciding to have the medical or surgical means or procedures calculated to prolong life provided, withheld or withdrawn.


    2. The Agency will accept and act upon written advance directives received from the patient or patient's caregiver, to the extent permitted and required by Law. A "Do Not Resuscitate" (DNR) order or a "Do Not Intubate" (DNI) order will be accepted only if properly executed by the patient's physician. Appropriate actions to be taken will be discussed with the patient and/or patient's caregiver when such order is received.

    3. Patients, patient caregivers, agency staff and the community will be educated on issues concerning advance directives. Patients and families/caregivers will be educated with printed material delivered at sign up date, containing all state mandatory regulations regarding Advance Directives that explained each topic like living will, DNR orders, testaments, etc. Agency staff trough orientations and in-services conducted in our Agency.

    4.The presence or absence of Advance Directives will not influence the decision to provide health care. If not properly executed Advance Directive has been presented, all staff will follow standard emergency procedures. Any change in the patient's Advance Directive will be communicated to all personnel.

    5. When a patient is transferred or referred to any other provider of health care services, the information given will include whether the patient has Advance Directives or does not have Advance Directives.

    6. Our Agency will provide services whether or not the patient has executed Advance Directives.

    Every competent adult has the right to make decisions concerning his or her own health, including the right to choose or refuse medical treatment. When a person becomes unable to make decisions due to a physical or mental change, such as being in a coma or developing dementia (like Alzheimer's disease), they are considered incapacitated. To make sure that an incapacitated person's decisions about health care will still be respected, the Florida legislature enacted legislation pertaining to health care advance directives (Chapter 765, Florida Statutes). The law recognizes the right of a competent adult to make an advance directive instructing his or her physician to provide, withhold, or withdraw life-prolonging procedures; to designate another individual to make treatment decisions if the person becomes unable to make his or her own decisions; and/or to indicate the desire to make an anatomical donation after death. By law hospitals, nursing homes, home health agencies, hospices, and health maintenance, organizations (HMOs) are required to provide their patients with written information, such as this pamphlet, concerning health care advance directives.

    What is an advance directive? It is a written or oral statement about how you want medical decisions made should you not be able to make them yourself and/or it can express your wish to make an anatomical donation after death. Some people make advance directives when they are diagnosed with a life-threatening illness. Others put their wishes into writing while they are healthy, often as part of their estate planning. Three types of advance directives are: A Living Will, A Health Care Surrogate Designation, An Anatomical Donation. You might choose to complete one, two, or all three of these forms.

    What is a living will? It is a written or oral statement of the kind of medical care you want or do not want if you become unable to make your own decisions. It is called a living will because it takes effect while you are still living. You may wish to speak to your health care provider or attorney to be certain you have completed the living will in a way that your wishes will be understood. What is a health care surrogate designation? It is a document naming another person as your representative to make medical decisions for you if you are unable to make them yourself. You can include instructions about any treatment you want or do not want, similar to a living will. You can also designate an alternate surrogate.

    Which is best? Depending on your individual needs you may wish to complete any one or a combination of the three types of advance directives.

    What is an anatomical donation? It is a document that indicates your wish to donate, at death, all or part of your body. This can be an organ and tissue donation to persons in need, or donation of your body for training of health care workers. You can indicate your choice to be an organ donor by designating it on your driver's license or state identification card (at your nearest driver's license office), signing a uniform donor form (seen elsewhere in this pamphlet), or expressing your wish in a living will.

    Am I required to have an advance directive under Florida law? No, there is no legal requirement to complete an advance directive. However, if you have not made an advance directive, decisions about your health care or an anatomical donation may be made for you by a court-appointed guardian, your wife or husband, your adult child, your parent, your adult sibling, an adult relative, or a close friend. The person making decisions for you may or may not be aware of your wishes. When you make an advance directive, and discuss it with the significant people in your life, it will better assure that your wishes will be carried out the way you want.

    What is a do not resuscitate form: is the mechanism used to inform emergency medical services personnel that the patient does not wish to have life-sustaining techniques performed in the event of respiratory or cardiac arrest. A properly completed form is signed by the patient's physician to document that the patient is terminally ill. It must also be signed by the patient or patient's health care surrogate and witnessed by two individuals. The form must be presented to the rescue staff.

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

    Our Agency is providing this Notice of Privacy Practices because the privacy of your health information is very important to you and to us, and in compliance with federal regulations. By "your health information" we mean the information that we maintain pecifically identifies you and your health status.

    Summary

    This Notice describes how we use your health information within our Agency and disclose it outside our Agency, and why. The Notice covers:

    • Uses or disclosures which do not require your written authorization.
    • Treatment, payment, and health care operations.
    • Uses or disclosures of your health information to which you may object.
    • Uses or disclosures required or permitted.
    • Uses or disclosures which require your written authorization.
    • Your rights as a patient regarding privacy of your health information.
    • Our duties in protecting your health information.
    • Complaints, contact person, effective date, and acknowledgement.

    Uses or disclosures which do not require your written authorization

    Treatment, Payment, and Health Care Operations. We use or disclose your health information to carry out your treatment; to obtain payment for your treatment; and to conduct health care operations. For example:

    • For treatment, we use your health information to plan, coordinate, and provide your care. We disclose your health information for treatment purposes to physicians and other health care professionals outside our agency who are involved in your care.
    • For payment, we use your health information to prepare documentation required by your insurance company or HMO or by Medicare or Medicaid. We disclose that part of your health information that these organizations require to pay us.
    • For health care operations, we use or disclose your health information, for example, to improve the quality of our services, to plan better ways of treating patients, and to evaluate staff performance.

    Uses or Disclosures of Your Health Information to Which You May Object

    We may use or disclose your health information for the following purposes, unless you ask us not to.

    • Informing family and friends. We may disclose your health information to family, friends, or others identified by you who are involved in your care.
    • Assistance in disaster relief efforts.
    • For fundraising activities. We may contact you or your family for fund raising purposes. If you do not wish to be contacted for this purpose, please contact the employee who is visiting you, and indicate that you do not wish to receive fundraising communication from us.
    • Confirming our visits to your home or other appointments.
    • Informing you about treatment alternatives or other health-related benefits and services that may be of interest to you. If you object to our use of your health information for any of these purposes please contact the employee in charge of your treatment.
    • Our Duties in Protecting Your Health Information. We are required by law to maintain the privacy of your health information. We must inform patients or their legal representatives of our legal duties and privacy practices with respect to health information. This Notice discharges that duty. We must abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all health information that we maintain. At any time, you may obtain a copy of the current notice from our staff.

    Uses or Disclosures Required or Permitted (HIPAA)

    Where we are required or permitted to do so, we may use or disclose your health information in the following circumstances without your written authorization. Federal government investigation, when required by the Secretary of Health and Human Services to investigate or determine our compliance with federal regulation. Federal, state or local law requirements. Public health activities, for example to report communicable diseases or death; or for matters involving the Food and Drug Administration. Reporting of abuse, neglect or domestic violence. Health oversight activities by a health oversight agency. (A health oversight agency is an organization authorized by the government to oversee eligibility and compliance and to enforce civil rights laws.) Judicial or administrative proceedings, for example responding to a court order or subpoena. Law enforcement purposes, for example to report certain types of wounds or other physical injuries or to identify or locate a suspect, fugitive, material witness, or missing person. Use by coroners, medical examiners, or funeral directors. Facilitating organ, eye, or tissue donation. Research, provided that very strict controls are enforced. Averting a serious threat to your health or safety or that of the public. Specialized government functions such as military or veterans' affairs; national security, and intelligence activities. Workers' compensation.

    Uses or disclosures which require your written authorization. Your written authorization, which you may revoke (in writing), is required if we use or disclose your health information for any other purpose, in particular: Our use of psychotherapy notes beyond treatment, payment, and health care operations. Marketing of goods or services to you.

    Your Rights As A Patient to Privacy Of Your Health Information Right to Request Restrictions. You have the right to request restrictions on our uses and disclosures of your health information, however we may refuse to accept the restriction. Right to Request Confidential Communications You have the right to request that we communicate with you confidentially, for example to speak with you only in private; to send mail to an arldress you designate; or to telephone you at a number you designate. OPTIONAL: your request must be in writing. We will make every attempt to honor your request. Right to Request Access to Your Health Information You have the right to request access to your health information in order to inspect or copy it. Your request must be in writing. We may deny your request and, if so, you may request a review of the denial. However, we will make every attempt to honor your request.

    Right to Request an Amendment of Your Health Information. You have the right to request an amendment to your health information. Your request must be in writing and must provide a reason for the amendment. We may deny your request and, if so, you may submit a statement of disagreement. However, we will make every attempt to honor your request. Right to Request an Accounting of Disclosures of Your Health Information You have the right to request an accounting of our disclosures of your health information for purposes other than treatment, payment, and health care operations. We will make every attempt to honor your request. We are not required to provide an accounting for disclosures for more than 6 years prior to the date of your request.

    Right to Obtain a Paper Copy of this Notice If you received this Notice electronically, you have the right receive a paper copy. To exercise any of these rights please write or telephone to our Agency.

    Complaints. Contact Person : You may complain to us and to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint. You may file your complaint with our agency by writing to the Administration.

    You may file a complaint with the Secretary of Health and Human Services by writing to: Secretary of Health and Human Services. U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201

    Our Agency is in a position to respond to patient and family needs by implementing strategies targeted to reduce avoidable hospitalizations. Our Agency can identify patients who are at higher risk of hospitalization. Our field staff can partner with these patients to Implement strategies, which reduce risk. Patients partnering with our field staff can learn to manage their own health. Our experience shows that when we partner with patients and physicians, acute care hospitalizations can be reduced. Specific interventions are implemented for those patients rated as high-risk to reduce the potential of unplanned hospitalization. A dialogue with the patient and family is necessary to determine their wishes, goals and desires to be met by the Interdisciplinary team. The team 's responsibility is to commit to achieving the patient's stated goals.

    It is the responsibility of our home care nurse to accurately complete the hospitalization risk assessment in a timely manner (as needed) and to then communicate the high-risk status of patients to appropriate managers, other disciplines, and oncall staff.

    Our home care nurse is also responsible for the selection of appropriate individualized interventions that may be used to assist in reducing avoidable acute care hospitalizations. Examples of interventions that an agency may offer include: Patient emergency planning, Medication management, Front-loading visits, Phone monitoring, Telemonitoring, Teletriage, Fall prevention, Immunization, Patient self-management, Disease/case management.

    Our nurses are able to correctly, effectively, and efficiently communicate his/her risk assessment findings to physicians to obtain necessary orders.

    It can be difficult to understand what your doctors and other caregivers are telling you about your care and treatment. This information has questions and answers to help you understand caregivers.

    Questions to ask your caregivers:

    • Is there someone who can help you understand your doctor, nurse, and other caregivers?
    • Is there someone who can help you understand how to take your medicine?
    • Is there any written information in your language?
    • Is there any written information in your language that is easy to read?
    • Is there someone who speaks your language who can help you talk to caregivers?
    • Is there a support group for people like you? For people with your illness or condition?
    • Are there other resources for you?

    What can you do If you don't understand what your caregiver is saying? Tell them you don't understand. Use body language. If you don't understand shake your head to show that "No, I don't understand." Ask lots of questions. By asking questions you're helping them understand what you need.

    What can you do if they explain and you still don't understand? Tell them you still don't understand. Try to be as clear as possible about what you do not understand. Caregivers have a duty to help you understand. You should not leave until you understand what to do and what is happening to you.

    What if the caregiver Is rushed and doesn't have time to answer your questions? Ask them if you need to schedule another appointment when they can answer your questions.

    What can you do if you speak another language? Ask for someone who speaks your language. This person can help you talk to caregivers. This person should work for the Agency. Their job is to help people who speak other languages. This person may not be in the office. He or she may be on the telephone. You have the right to get free help from someone who speaks your language. Ask if there is paper work in your language.

    What can you do If you have trouble reading? Or if you cannot read? Don't be embarrassed. Tell your caregivers. They can help you. They can explain paper work to you. They may even have paper work that is easy to read and understand.

    Your doctor's Instructions are not clear. Should you try to figure it out yourself? No. Instructions from your doctor or others are important. Tell them what you think the instructions are. Tell them if they need to write down the instructions. Tell them if you have a family member or friend who helps you take your medicine. Ask the doctor to have someone talk to your family member or friend, too.

    What if you don't understand written instructions? Tell your caregivers. Tell them that you need to have the instructions read to you. Tell them you need instructions that are easy to read. Or that you need instructions in your language.

    Copyright © 2015 by South Florida Pediatric Homecare.
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