{"ref":"GA-HH-PR-03","title":"Admission Agreement, Informed Consent, and Disclosure of Charges","category":"Client rights","summary":"Explains how the Agency verifies payment before the first visit, completes the written home health services agreement, obtains informed consent to care and written consent to release information, tells the patient orally and in writing what Medicare, Medicaid, or other payers are expected to pay and what the patient may owe, and gives the required written notices before non-covered care or before care is reduced or ended.","inShort":["Before care starts, the nurse goes through the services agreement with the patient and the patient signs consent to care.","The patient is told, out loud and in writing, what Medicare, Medicaid, or insurance should pay and what the patient may have to pay.","If coverage or charges change, the office tells the patient before the next visit.","A patient can refuse or stop any care at any time. Respect it, write it down in the patient’s words, and tell the supervising nurse the same day.","No one is turned away because they cannot pay. Tell the office if a patient is worried about cost."],"primaryCitation":"42 CFR §484.50(c)(7)","citations":["Ga. Comp. R. & Regs. 111-8-31-.09","Ga. Comp. R. & Regs. 111-8-31-.09(f)","Ga. Comp. R. & Regs. 111-2-2-.32","O.C.G.A. §31-9-2"],"federalCitations":["42 CFR §484.50(c)(4)","42 CFR §484.50(c)(7)","42 CFR §484.50(c)(8)","42 CFR §405.1200","42 CFR §405.1202","42 CFR §411.408"],"surveyorAsks":["Show me the signed services agreement and consent for this patient. Who signed it, and when?","How did you tell this patient, before care began, what Medicare or Medicaid would pay and what the patient might owe?"],"forms":[{"ref":"GA-HH-PR-03-A","title":"Home Health Services Agreement and Consent"}],"headings":["Terms of Reference","1. Purpose","2. Scope","3. Definitions","4. Policy Statement (42 CFR §484.50(c)(7) and Ga. Comp. R. & Regs. 111-8-31-.09(f))","5. Before the First Visit: Verifying Payment","6. The Services Agreement","7. Obtaining Informed Consent","8. Consent to Release of Information","9. Telling the Patient About Payment and Charges","10. Notices Before Non-Covered Care and Before Reducing or Ending Care","11. Changes to the Agreement and Withdrawal of Consent","12. Responsibilities","13. Records and Compliance Monitoring","14. Staff Training","15. References","16. Related Policies and Forms","17. Approval","18. Revision History"],"version":"1.0","sample":false,"pack":"ga-hha","state":"Georgia","service":"Home health","guides":[{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}