This checklist can help you (and your family or friends who are helping you) monitor your home health care. Use this checklist to help ensure that you’re getting good quality home health care.
| When I get my home health care |
Yes |
No |
Comments |
| 1. The staff is polite and treats me and my family with respect. |
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| 2. The staff explains my plan of care to me and my family, lets us
participate in creating the plan of care, and lets us know ahead of time of any
changes. |
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| 3. The staff is properly trained and licensed to perform the type
of health care I need. |
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| 4. The agency explains what to do if I have a problem with the
staff or the care I’m getting. |
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| 5. The agency responds quickly to my requests. |
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| 6. The staff checks my physical and emotional condition at each
visit. |
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| 7. The staff responds quickly to changes in my health or behavior. |
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| 8. The staff checks my home and suggests changes to meet my
special needs and to ensure my safety. |
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| 9. The staff has told me what to do if I have an emergency. |
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| 10. The agency and its staff protect my privacy. |
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