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Participant Rights

At Senior CommUnity Care, we are dedicated to providing you with quality health care services so that you may remain as independent as possible. Our staff seeks to affirm the dignity and worth of each participant by assuring the following rights:

The Program of All-Inclusive Care for the Elderly, also called PACE, is a special program that combines medical and long-term care services in a community setting.

When you join a PACE program, you have certain rights and protections. Senior CommUnity Care must fully explain your rights to you or someone acting on your behalf in a way you can understand at the time you join.

You have the right to be treated with respect.

You have the right to be treated with dignity and respect at all times, to have all of your care kept private, and to get compassionate, considerate care. You have the right:

  • To get all of your health care in a safe, clean environment
  • To be free from harm. This includes physical or mental abuse, neglect, physical punishment, being placed by yourself against your will, and any physical or chemical restraint that is used on you for discipline or convenience of staff and that you do not need to treat your medical symptoms or to prevent injury
  • To be encouraged to use your rights in the PACE program
  • To get help, if you need it, to use the Medicare and Medicaid feedback and appeal processes, and your civil and other legal rights
  • To be encouraged and helped in talking to Senior CommUnity Care staff about changes in policy and services you think should be made
  • To use a telephone while at the Day Center
  • To not have to do work or services for Senior CommUnity Care

You have a right to protection against discrimination.

Discrimination is against the law. Every company or agency that works with Medicare and Medicaid must obey the law. They cannot discriminate against you because of your:

  • Race/Ethnic Origin
  • Religion
  • Age
  • Sex
  • Sexual orientation
  • Mental or physical ability
  • Source of payment for your health care (for example, Medicare or Medicaid)

If you think you have been discriminated against for any of these reasons, contact a staff member at the Senior CommUnity Care to help you resolve your problem.

If you have questions, you can call the Office for Civil Rights at 1-800-368-1019.

TTY users should call 1-800-537-7697.

You have the right to information and assistance.

You have the right to get accurate, easy-to-understand information and to have someone help you make informed health care decisions. You have the right:

  • To have someone help you if you have a language or communication barrier so you can understand all information given to you
  • To have Senior CommUnity Care interpret the information into your preferred language in a culturally competent manner, if your first language is not English and you can’t speak English well enough to understand the information being given to you
  • To get marketing materials and participant rights in English and in any other frequently-used language in your community. You can also get these materials in Braille, if necessary
  • To get a written copy of your rights from the PACE program
  • Senior CommUnity Care must also post these rights in a public place in the Day Center where it is easy to see them
  • To be fully informed, in writing, of the services offered by Senior CommUnity Care. This includes telling you which services are provided by contractors instead of Senior CommUnity Care staff. You must be given this information before you join, at the time you join, and when there is a change in services
  • To look at, or to get help to look at, the results of the most recent review of Senior CommUnity Care. Federal and State agencies review all PACE programs. You also have a right to review how Senior CommUnity Care plans to correct any problems that are found at inspection

You have a right to a choice of providers.

You have the right to choose a health care provider within the Senior CommUnity Care network and to get quality health care. Women have the right to get services from a qualified women’s health care specialist for routine or preventive women’s health care services.

You have a right to access emergency services.

You have the right to get emergency services when and where you need them without Senior CommUnity Care’s approval. A medical emergency is when you think your health is in serious danger—when every second counts. You may have a bad injury, sudden illness, or an illness quickly getting much worse. You can get emergency care anywhere in the United States.

You have a right to participate in treatment decisions.

You have the right to fully participate in all decisions related to your health care. If you cannot fully participate in your treatment decisions or you want to have someone you trust help you, you have the right to choose that person to act on your behalf. You have the right:

  • To have all treatment options explained to you in a language you understand, to be fully informed of your health status and how well you are doing, and to make health care decisions. This includes the right not to get treatment or take medications. If you choose not to get treatment, you must be told how this will affect your health
  • To have Senior CommUnity Care help you create an advance directive. An advance directive is a written document that says how you want medical decisions to be made in case you cannot speak for yourself. You should give it to the person who will carry out your instructions and make health care decisions for you
  • To participate in making and carrying out your plan of care. You can ask for your plan of care to be reviewed at any time
  • To be given advanced notice, in writing, of any plan to move you to another treatment setting and the reason you are being moved

You have the right to have your health information kept private.

You have the right to talk with health care providers in private and to have your personal health care information kept private as protected under State and Federal laws. You also have the right to look at and receive copies of your medical records.

There is a new patient privacy rule that gives you more access to your own medical records and more control over how your personal health information is used. If you have any questions about this privacy rule, call the Office for Civil Rights at 1-800-368-1019. TTY users should call 1-800-537-7697.

You have the right to file a complaint.

You have the right to complain about the services you receive or that you need and don’t receive, the quality of your care, or any other concerns, or problems you have with Senior CommUnity Care through the feedback process. You have the right to a fair and timely process for resolving concerns with the Senior CommUnity Care program. You have the right:

  • To a full explanation of the feedback process
  • To be encouraged and helped to freely explain your concerns to Senior CommUnity Care staff and outside representatives of your choice. You must not be harmed in any way for telling someone your concerns. This includes being punished, threatened, or discriminated against
  • To appeal any treatment decision by Senior CommUnity Care, staff, or contractors

You have a right to leave the program.

If, for any reason, you do not feel that the PACE program is what you want, you have the right to leave the program at any time.