It's Your Home, It's Your Life - Home Care to Help You

CLIENT BILL OF RIGHTS AND CONFIDENTIALITY This document will serve as a Written Consumer Notice, outlining general service responsibilities as well as general notification of the agency’s responsibilities as an employer and client’s responsibility while receiving service.

All clients receiving services from this agency, ElderLife Management, LLC dba an independently owned and operated Home Instead Senior Care franchise, are guaranteed the following rights:

1. To be treated with individuality, dignity, respect and consideration, as well as protected from physical, verbal and emotional abuse (including corporal punishment), neglect, all forms of misappropriation, and exploitation.

2. To have the right to privacy while receiving services.

3. To receive non-medical services regardless of race, national origin, sex, age, religion or disability, and to be assisted by this agency in the exercise of your civil rights as a client. Also informed in a language you understand.

4. To identify service needs and participate in planning the service schedule, with the right to verbalize preferences regarding activities and the day-to-day schedule.

5. To have the right to vote, make contracts, buy or sell real estate or personal property, or sign documents, unless the law or a court removes these rights.

6. To be fully informed, in advance of services, of the costs of non-medical services and receive proper notice of changes or increases in fees.

7. To know the company's capabilities and limits in providing non-medical services, which includes the ability to perform medication reminders (not administration) and a 25 lb lifting limit.

8. To review the Client Service Agreement, if a private pay client, with a Home Instead Senior Care representative, with the right to accept or refuse service.

9. To obtain a signed copy of the Client Service Agreement, if a private pay client, executed by the client or clients representative and a Home Instead Senior Care representative.

10. To expect confidentiality of all agency records, except in the case of court order, emergencies or as otherwise required or permitted by state and federal law.

11. To ask the office to correct information in your records. If the office refuses, you may include a written statement in the records of the reasons why you disagree.

12. To not be required to make public statements acknowledging gratitude to the agency for the agency’s services, or to perform in public gatherings, or to have identifiable photographs of them used without their written permission.
13. To receive services from a CAREGiver who has been screened, trained, bonded and insured through the agency, who is properly credentialed and has the appropriate licensure/certification to perform the level of care offered and who is an employee of the agency.

14. To receive services from the agency, who is responsible for the following as it relates to its CAREGivers: hiring/firing, daily supervision, scheduling, discipline, payroll, taxes, social security, workers’ compensation insurance, unemployment compensation payments, and overtime, if applicable. Prior to employment, the agency will conduct drug screens, reference checks and a criminal background/sex abuse registry check.

15. To understand what is expected of the client, who is responsible for any equipment used in the home by the CAREGiver, such as gloves, wipes, diapers, cleaning supplies, and all durable medical supplies/ equipment. Furthermore, to provide a safe home environment, inform care provider if you will be away, report changes in health and/or living conditions to care provider.

16. To obtain a copy of the Home Instead Senior Care state licensure.

17. To obtain information on the state authority in charge of investigations of all complaints or concerns against this agency.

18. To file grievances to agency and to outside representatives of their choice with freedom from restraint, interference, coercion, discrimination, or reprisal without fear of discrimination or retaliation if you feel your rights have been violated. To file a grievance, contact the owner or administrative assistant between the hours of 8:00 am and 4:00 pm, Monday-Friday or an outside representative of your choice at the agency contact information below.

19. To obtain a copy of all agency rules and regulations pertinent to the service recipient. Information shall be presented in a manner that promoted understanding by the service recipient of his or her rights, and the individual shall be given an opportunity to ask questions about the information. If the service recipient is unable to understand the information at the time of admission to service but later becomes able to do so, the information shall be presented to the service recipient at that time. If the service recipient is likely to continue indefinitely to be unable to understand the information, the licensee shall promptly attempt to provide the required information to a guardian or other appropriate person or an agency responsible for protecting the service recipients' rights.

20. Client has been given copy of list of community resources.

Your Personal Support Services Agency (Home Instead Senior Care) 615-553-4297

Your State Authority – State of Tennessee Licensure Office – Middle TN 615-532-6590

Tennessee Department of Human Services – Adult Protective Services - 888-277-8366

Disability Law and Advocacy Center of Tennessee - 800-342-1660

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