We believe that all clients/patients receiving services from EdLucy, Inc. dba One Step Ahead should be informed of their rights. Therefore, you are entitled to:
1. Be fully informed in advance about care/service to be provided, including the disciplines that furnish care and the frequency of visits, as well as any modifications to the plan of care
2. Be informed, both orally and in writing, in advance of care being provided, of the charges, including payment for care/service expected from third parties and any charges for which the client/patient will be responsible
3. Receive information about the scope of services that the organization will provide and specific limitations on those services
4. Participate in the development and periodic revision of the plan of care
5. Refuse care or treatment after the consequences of refusing care or treatment are fully presented
6. Be informed of client/patient rights under state law to formulate an Advanced Directive, if applicable
7. Have one’s property and person treated with respect, consideration, and recognition of client/patient dignity and individuality
8. Be able to identify visiting personnel members through proper identification
9. Be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of client/patient property
10. Voice grievances/complaints regarding treatment or care, lack of respect of property or recommend changes in policy, personnel, or care/service without restraint, interference, coercion, discrimination, or reprisal
11. Have grievances/complaints regarding treatment or care that is (or fails to be) furnished, or lack of respect of property investigated
12. Confidentiality and privacy of all information contained in the client/patient record and of Protected Health Information
13. Be advised on agency’s policies and procedures regarding the disclosure of clinical records
14. Choose a health care provider, including choosing an attending practitioner, if applicable
15. Receive appropriate care without discrimination in accordance with practitioner orders, if applicable
16. Be informed of any financial benefits when referred to an organization
17. Be fully informed of one’s responsibilities
CLIENT/PATIENT RESPONSIBILITIES
1. Client/Patient agrees that rental equipment will be used with reasonable care, not altered or modified, and returned in good condition (normal wear and tear excepted).
2. Client/Patient agrees to promptly report to EdLucy, Inc. dba One Step Ahead any malfunctions or defects in rental equipment so that repair/ replacement can be arranged.
3. Client/Patient agrees to provide EdLucy, Inc. dba One Step Ahead access to all rental equipment for repair/replacement, maintenance, and/or pick-up of the equipment.
4. Client/Patient agrees to use the equipment for the purposes so indicated and in compliance with the practitioner’s prescription.
5. Client/Patient agrees to keep the equipment in their possession and at the address, to which it was delivered unless otherwise authorized by EdLucy, Inc. dba One Step Ahead
6. Client/Patient agrees to notify EdLucy, Inc. dba One Step Ahead of any hospitalization, change in customer insurance, address, telephone number, practitioner, or when the medical need for the rental equipment no longer exists.
7. Client/Patient agrees to request payment of authorized Medicare, Medicaid, or other private insurance benefits are paid directly to EdLucy, Inc. dba One Step Ahead for any services furnished by EdLucy, Inc. dba One Step Ahead.
8. Client/Patient agrees to accept all financial responsibility for home medical equipment furnished by EdLucy, Inc. dba One Step Ahead
9. Client/Patient agrees to pay for the replacement cost of any equipment damaged, destroyed, or lost due to misuse, abuse or neglect.
10. Client/Patient agrees not to modify the rental equipment without the prior consent of EdLucy, Inc. dba One Step Ahead
11. Client/Patient agrees that any authorized modification shall belong to the titleholder of the equipment unless equipment is purchased and paid for in full.
12. Client/Patient agrees that title to the rental equipment and all parts shall remain with EdLucy, Inc. dba One Step Ahead at all times unless equipment is purchased and paid for in full.
13. Client/Patient agrees that EdLucy, Inc. dba One Step Ahead shall not insure or be responsible to the client/patient for any personal injury or property damage related to any equipment; including that caused by use or improper functioning of the equipment; the act or omission of any other third party, or by any criminal act or activity, war, riot, insurrection, fire or act of God
14. Client/Patient understands that EdLucy, Inc. dba One Step Ahead retains the right to refuse delivery of service to any client/patient at any time.
15. Client/Patient agrees that any legal fees resulting from a disagreement between the parties shall be borne by the unsuccessful party in any legal action taken.
When the client/patient is unable to make medical or other decisions, the family should be consulted for direction.
The client/patient and caregiver(s) will also receive a copy of the DMEPOS Supplier Standards, which is included in the Client/Patient Handouts forms.
SUPPLIER STANDARDS
EdLucy, Inc. dba One Step Ahead adheres to the following standards as required by the Centers for Medicare and Medicaid Service:
1. A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.
2. A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to this information must be reported to the National Supplier Clearinghouse within 30 days.
3. An authorized individual (one whose signature is binding) must sign the application for billing privileges.
4. A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the Medicare program, any State health care programs, or from any other Federal procurement or non-procurement programs.
5. A supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.
6. A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge Medicare covered items that are under warranty.
7. A supplier must maintain a physical facility on an appropriate site.
8. A supplier must permit CMS or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.
9. A supplier must maintain a primary business telephone listed under the name of the business in a local directory or a toll-free number available through directory assistance. The exclusive use of mobile communications devices is prohibited.
10. A supplier must have comprehensive liability insurance in the amount of at least $300,000 that covers both the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations.
11. A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from calling beneficiaries in order to solicit new business.
12. A supplier is responsible for delivery and must instruct beneficiaries on use of Medicare covered items, and maintain proof of delivery.
13. A supplier must answer questions and respond to complaints of beneficiaries, and maintain documentation of such contacts.
14. A supplier must maintain and replace at no charge or repair directly, or through a service contract with another company, Medicare-covered items it has rented to beneficiaries.
15. A supplier must accept returns of substandard (less than full quality for the particular item) or unsuitable items (inappropriate for the beneficiary at the time it was fitted and rented or sold) from beneficiaries.
16. A supplier must disclose these supplier standards to each beneficiary to whom it supplies a Medicare-covered item.
17. A supplier must disclose to the government any person having ownership, financial, or control interest in the supplier.
18. A supplier must not convey or reassign a supplier number; i.e., the supplier may not sell or allow another entity to use its Medicare billing number.
19. A supplier must have a complaint resolution protocol established to address beneficiary complaints that relate to these standards. A record of these complaints must be maintained at the physical facility.
20. Complaint records must include: the name, address, telephone number, a summary of the complaint, and any actions taken to resolve it.
21. A supplier must agree to furnish CMS any information required by the Medicare statute and implementing regulations.
22. All suppliers of DMEPOS and other items and services must be accredited by a CMS-approved accreditation organization in order to receive and retain a supplier billing number. The accreditation must indicate the specific products and services for which the supplier is accredited in order for the supplier to receive payment for those specific products and services
23. All DMEPOS suppliers must notify their accreditation organization when a new DMEPOS location is opened. The accreditation organization may accredit the new supplier location for 3 months after it is operational without requiring a new site visit.
24. All DMEPOS supplier locations, whether owned or subcontracted, must meet the DMEPOS quality standards and be separately accredited in order to bill Medicare. An accredited supplier may be denied enrollment or their enrollment may be revoked, if CMS determines that they are not in compliance with the DMEPOS quality standards.
25. All DMEPOS suppliers must disclose upon enrollment all products and services, including the addition of new product lines for which they are seeking accreditation. If a new product line is added after enrollment, the DMEPOS supplier will be responsible for notifying the accrediting body of the new product so that the DMEPOS supplier can be re-surveyed and accredited for these new products.
26. Must meet the surety bond requirements specified in 42 C.F.R. 424.57(c). Implementation date- May 4, 2009.
27. A supplier must obtain oxygen from a state- licensed oxygen supplier.
28. A supplier must maintain ordering and referring documentation consistent with provisions found in 42 C.F.R. 424.516(f).
29. DMEPOS suppliers are prohibited from sharing a practice location with certain other Medicare providers and suppliers.
30. DMEPOS suppliers must remain open to the public for a minimum of 30 hours per week with certain exceptions.
HOW TO MAKE YOUR HOME SAFE FOR MEDICAL CARE
At EdLucy, Inc. dba One Step Ahead, we want to make sure that your home medical treatment is done conveniently and safely. Many of our clients/patients are limited in strength, or unsteady on their feet. Some are wheelchair - or bed-bound. These pages are written to give our clients/patients some easy and helpful tips on how to make the home safe for home care.
Fire Safety and Prevention
Electrical Safety
Safety in the Bathroom
Because of the smooth surfaces, the bathroom can be a very dangerous place, especially for persons who are unsteady.
Safety in the Bedroom
It’s important to arrange a safe, well-planned and comfortable bedroom since a lot of your recuperation and home therapy may occur there.
Safety in the Kitchen
Your kitchen should be organized so you can easily reach and use the common items, especially during your recuperation while you are still a bit weak.
Getting Around Safely
If you are now using assistant devices for ambulating (walking), here are some key points:
What To Do If You Get Hurt
In case of emergency, contact:
Fire, Police, Ambulance: 911
Hospital: ________________________________________ Phone: _________________________
Home Care Agency: _______________________________ Phone: __________________________
Doctor: _________________________________________ Phone:__________________________
DME Supplier: EdLucy, Inc. dba One Step Ahead Phone 618-842-2531
If you have any questions about safety that aren’t in this information, please call us and we will be happy to give you recommendations for your individual needs.
HIPAA PRIVACY NOTICE
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 COMMITMENT TO YOUR PRIVACY
It is our duty to maintain the privacy and confidentiality of your protected health information (PHI). We will create records regarding your and the treatment and service we provide to you. We are required by law to maintain the privacy of your PHI, which includes any individually identifiable information that we obtain from you or others that relates to your past, present or future physical or mental health, the health care you have received, or payment for your health care. We will share protected health information with one another, as necessary, to carry out treatment, payment or health care operations relating to the services to be rendered at the location.
As required by law, this notice provides you with information about your rights and our legal duties and privacy practices with respect to the privacy of PHI. This notice also discusses the uses and disclosures we will make of your PHI. We must comply with the provisions of this notice as currently in effect, although we reserve the right to change the terms of this notice from time to time and to make the revised notice effective for all PHI we maintain. You can always request a written copy of our most current privacy notice from our Privacy Officer.
PERMITTED USES AND DISCLOSURES
We can use or disclose your PHI for purposes of treatment, payment and health care operations. For each of these categories of uses and disclosures, we have provided a description and an example below. However, not every particular use or disclosure in every category will be listed.
OTHER USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION
We may also use your PHI in the following ways:
SPECIAL SITUATIONS
Subject to the requirements of applicable law, we will make the following uses and disclosures of your PHI:
Note: HIV-related information, genetic information, alcohol and/or substance abuse records, mental health records and other specially protected health information may enjoy certain special confidentiality protections under applicable state and federal law. Any disclosures of these types of records will be subject to these special protections.
OTHER USES OF YOUR HEALTH INFORMATION
Certain uses and disclosures of PHI will be made only with your written authorization, including uses and/or disclosures: (a) of psychotherapy notes (where appropriate); (b) for marketing purposes; and (c) that constitute a sale of PHI under the Privacy Rule. Other uses and disclosures of PHI not covered by this notice or the laws that apply to us will be made only with your written authorization. You have the right to revoke that authorization at any time, provided that the revocation is in writing, except to the extent that we already have taken action in reliance on your authorization.
YOUR RIGHTS
1. You have the right to request restrictions on our uses and disclosures of PHI for treatment, payment and health care operations. However, we are not required to agree to your request unless the disclosure is to a health plan in order to receive payment, the PHI pertains solely to your health care items or services for which you have paid the bill in full, and the disclosure is not otherwise required by law. To request a restriction, you may make your request in writing to the Privacy Officer.
2. You have the right to reasonably request to receive confidential communications of your PHI by alternative means or at alternative locations. To make such a request, you may submit your request in writing to the Privacy Officer.
3. You have the right to inspect and copy the PHI contained in our Pharmacy records, except: (i) for psychotherapy notes, (i.e., notes that have been recorded by a mental health professional documenting counseling sessions and have been separated from the rest of your medical record); (ii) for information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding; (iii) for PHI involving laboratory tests when your access is restricted by law; (iv) if you are a prison inmate, and access would jeopardize your health, safety, security, custody, or rehabilitation or that of other inmates, any officer, employee, or other person at the correctional institution or person responsible for transporting you; (v) if we obtained or created PHI as part of a research study, your access to the PHI may be restricted for as long as the research is in progress, provided that you agreed to the temporary denial of access when consenting to participate in the research; (vi) for PHI contained in records kept by a federal agency or contractor when your access is restricted by law; and (vii) for PHI obtained from someone other than us under a promise of confidentiality when the access requested would be reasonably likely to reveal the source of the information. In order to inspect or obtain a copy your PHI, you may submit your request in writing to the Medical Records Custodian. If you request a copy, we may charge you a fee for the costs of copying and mailing your records, as well as other costs associated with your request. We may also deny a request for access to PHI under certain circumstances if there is a potential for harm to yourself or others. If we deny a request for access for this purpose, you have the right to have our denial reviewed in accordance with the requirements of applicable law.
4. You have the right to request an amendment to your PHI but we may deny your request for amendment, if we determine that the PHI or record that is the subject of the request: (i) was not created by us, unless you provide a reasonable basis to believe that the originator of PHI is no longer available to act on the requested amendment; (ii) is not part of your medical or billing records or other records used to make decisions about you; (iii) is not available for inspection as set forth above; or (iv) is accurate and complete. In any event, any agreed upon amendment will be included as an addition to, and not a replacement of, already existing records. In order to request an amendment to your PHI, you must submit your request in writing to Medical Record Custodian at our Pharmacy, along with a description of the reason for your request.
5. You have the right to receive an accounting of disclosures of PHI made by us to individuals or entities other than to you for the six years prior to your request, except for disclosures: (i) to carry out treatment, payment and health care operations as provided above; (ii) incidental to a use or disclosure otherwise permitted or required by applicable law; (iii) pursuant to your written authorization; (v) to persons involved in your care or for other notification purposes as provided by law; (vi) for national security or intelligence purposes as provided by law; (vii) to correctional institutions or law enforcement officials as provided by law; (viii)as part of a limited data set as provided by law. To request an accounting of disclosures of your PHI, you must submit your request in writing to the Privacy Officer at our Pharmacy. Your request must state a specific time period for the accounting (e.g., the past three months). The first accounting you request within a twelve (12) month period will be free. For additional accountings, we may charge you for the costs of providing the list. We will notify you of the costs involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.
6. You have the right to receive a notification, in the event that there is a breach of your unsecured PHI, which requires notification under the Privacy Rule.
COMPLAINTS
If you believe that your privacy rights have been violated, you should immediately contact the company Privacy Officer. We will not take action against you for filing a complaint. You also may file a complaint with the Secretary of the U. S. Department of Health and Human Services, 200 Independence Ave. S.W., Washington, DC 20201
EMERGENCY PLANNING FOR THE HOME CARE CLIENT/PATIENT
This pamphlet has been provided by EdLucy, Inc. dba One Step Ahead to help you plan your actions in case there is a natural disaster where you live. Many areas of the United States are prone to natural disasters like hurricanes, tornadoes, floods, and earthquakes. Every client/patient receiving care or services in the home should think about what they would do in the event of an emergency. Our goal is to help you plan so that we can try to provide you with the best, most consistent service we can during the emergency.
Know What to Expect
If you have recently moved to this area, take the time to find out what types of natural emergencies have occurred in the past, and what types might be expected. Find out what, if any, time of year these emergencies are more prevalent. Find out when you should evacuate, and when you shouldn’t. Your local Red Cross, local law enforcement agencies, local news and radio stations usually provide excellent information and tips for planning.
Know Where to Go
One of the most important pieces of information you should know is the location of the closest emergency shelter. These shelters are opened to the public during voluntary and mandatory evaluation times. They are usually the safest place for you to go, other than a friend or relative’s home in an unaffected area.
Know What to Take with You
If you are going to a shelter, there will be restrictions on what items you can bring with you. Not all shelters have adequate storage facilities for medications that need refrigeration. We recommend that you call ahead and find out which shelter in your area will let you bring your medications and medical supplies, in addition, let them know if you will be using medical equipment that requires an electrical outlet. During our planning for a natural emergency, we will contact you and deliver, if possible, at least one week’s worth of medication and supplies. Bring all your medications and supplies with you to the shelter.
Reaching Us if There Are No Phones
How do you reach us during a natural emergency if the phone lines don’t work? How would you contact us? If there is warning of the emergency, such as a hurricane watch, we will make every attempt to contact you and provide you with the number of our cellular phone. (Cellular phones frequently work even when the regular land phone lines do not.) If you have no way to call our cellular phone, you can try to reach us by having someone you know call us from his or her cellular phone. (Many times cellular phone companies set up communication centers during natural disasters. If one is set up in your area, you can ask them to contact us.) If the emergency was unforeseen, we will try to locate you by visiting your home, or by contacting your home nursing agency. If travel is restricted due to damage from the emergency, we will try to contact you through local law enforcement agencies.
An Ounce of Prevention
We would much rather prepare you for an emergency ahead of time than wait until it has happened and then send you the supplies you need. To do this, we need for you to give us as much information as possible before the emergency. We may ask you for the name and phone number of a close family member, or a close friend or neighbor. We may ask you where you will go if an emergency occurs. Will you go to a shelter, or a relative’s home? If your doctor has instructed you to go to a hospital, which one is it? Having the address of your evacuation site, if it is in another city, may allow us to service your therapy needs through another company.
Helpful Tips
For More information
There is much more to know about planning for and surviving during a natural emergency or disaster. Review the information from FEMA. http://www.fema.gov/areyouready/emergency_planning.shtm.
The information includes:
An Important Reminder!!
During any emergency situation, if you are unable to contact our company and you are in need of your prescribed medication, equipment or supplies, you must go to the nearest emergency room or other treatment facility for treatment.
INFECTION CONROL
The patient/caregiver should observe all activities performed by healthcare workers to ensure that appropriate infection control measures are being utilize including handwashing prior to providing care, proper disposal of all contaminated products and germicidal cleaning of any medical accessories that came in contact with the patient.
MAKING DECISIONS ABOUT YOUR HEALTH CARE
Advance Directives are forms that say, in advance, what kind of treatment you want or don’t want under serious medical conditions. Some conditions, if severe, may make you unable to tell the doctor how you want to be treated at that time. Your Advance Directives will help the doctor to provide the care you would wish to have.
Most hospitals and home health organizations are required to provide you with information on Advance Directives. Many are required to ask you if you already have Advance Directives prepared.
This pamphlet has been designed to give you information and may help you with important decisions. Laws regarding Advance Directives vary from state to state. We recommend that you consult with your family, close friends, your practitioner, and perhaps even a social worker or lawyer regarding your individual needs and what may benefit you the most.
What Kinds Of Advance Directives Are There?
There are two basic types of Advance Directives available. One is called a Living Will. The other is called a Durable Power of Attorney.
A Living Will gives information on the kind of medical care you want (or do not want) become terminally ill and unable to make your own decision.
A Durable Power of Attorney is a legal agreement that names another person (frequently a spouse, family member, or close friend) as an agent or proxy. This person would then be make medical decisions for you if you should become unable to make them for yourself. A Durable Power of Attorney can also include instructions regarding specific treatments that want or do not want in the event of serious illness.
What Type of Advance Directive is Best for Me?
This is not a simple question to answer. Each individual’s situation and preferences are unique.
What Do I Do If I Want An Advance Directive?
How Does My Health Care Team Know I Have an Advance Directive?
You must tell them. Many organizations and hospitals are required to ask you if you have one. Even so, it is a good idea to tell your practitioners and nurses that you have an Advance Directive, and where the document can be found.
Many clients/patients keep a small card in their wallet that states the type of Advance Directive they have, where a copy of the document(s) is located, and a contact person, such as your Durable Power of Attorney “agent,” and how to contact them.
What If I Change My Mind?
You can change your mind about any part of your Advance Directive, or even about having an Advance Directive, at any time.
If you would like to cancel or make changes to the document(s), it is very important that you follow the same signature, dating, and witness procedure as the first time, and that you make sure all original versions are deleted or discarded, and that all health care providers, your caregiver(s), your family and friends have a revised copy.
What If I Don’t Want An Advance Directive?
You are not required by law to have one. Many home care companies are required to provide you with this basic information, but what you choose to do with it is entirely up to you.
For More Information...
This pamphlet has been designed to provide you with basic information. It is not a substitute for consultation with an experienced lawyer or knowledgeable social worker. These persons, or your home care agency, can best answer more detailed questions, and help guide you towards the best Advance Directive for you.
Grievance / Complaint Reporting
You may lodge a complaint without concern for reprisal, discrimination, or unreasonable interruption of service. To place a grievance, please call 618- 842-2531 and speak to the Customer Services Supervisor. If your complaint is not resolved to your satisfaction within 5 working days, you may initiate a formal grievance, in writing and forward it to the Governing Body. You can expect a written response within 14 working days or receipt.
You may also make inquiries or complaints about this company by calling Medicare at 1-800-MEDICARE and/or the Accreditation Commission for Health Care (ACHC) at 919-785-1214.
Warranty Information
All clients/patients who either purchase or rent equipment will be informed of the manufacturer’s warranty coverage and we will honor all warranties under applicable law. EdLucy, Inc.dba One Step Ahead will repair or replace, free of charge, equipment that is under warranty. Additionally, if available, an owner's manual with warranty information will be provided to beneficiaries for all durable medical equipment. The client/patient will be required to sign a form stating that they received and understand the warranty coverage.
EDLUCY INC DBA ONE STEP AHEAD & HOME MEDICAL EQUIPMENT
CODE OF ETHICS
If you are seeking insurance reimbursement, you will need a prescription from your doctor. We offer competitive cash prices for retail transactions. Contact us for more information.
In many cases insurance companies will cover most of the equipment we listed above with deductibles and copays. Please call us to check to see if your insurance company will cover your purchase.
We make every effort to keep our showroom stocked with your most needed products. Stop by today to see if we have what you need. We are also happy to answer your questions and offer recommendations that suit your needs.