As a client receiving services from Trifecta Home Care USA, you and your family members are being informed of the following rights before care is initiated. You will be provided with a copy of this Client Bill of Rights. in accordance with PA Regulation 611.57. Please retain the Client Bill of Rights for your records,

1. You hove a right to receive a listing of the services Trifecta Home Care USA provides and information on the specific services that will be provided to you.

2. You hove a right to ongoing participation in the development of the Plan of Care for the services we will provide to you.

3. You hove a right to be treated with courtesy, respect, privacy and freedom from abuse and discrimination,

4. You hove a right to expect properly trained staff ond coordinated services.

5. You hove a right to expect privacy of your personal information and confidentiality of health care records.

6. You have a right to refuse treatment or services.

7. You hove a right to be informed about Advanced Directives and Trifecta Home Care USA’s responsibility to implement them.

8. You hove a right to be informed of who is supervising your care and how they can be contacted.

9. You hove a right to submit complaints to Trifecta Home Care USA without fear of retaliation.

(a) You are encouraged to call or write the CEO/President and/or Agency Administrator with any concerns or complaints about your care.

(b) The complaint will be reviewed, and a plan of correction developed and implemented.

(c) You will be informed of the plan of correction, the implementation and the outcome of the plan

10. If Trifecta Home Care USA is unable to adequately address your complaint. you may call the Pennsylvania state toll free hot-line number for registering complaints from 8 AM to 4 PM. Monday through Friday.

11. You have a right to expect an itemized billing Statement semi—monthly, including the date of each service and the charge

12. You are a designated representative ore entitled to information regarding access to the Deportment of Health’s Registry of Providers and to select any licensed provider to provide your care, subject to your reimbursement mechanism or other relevant contractual obligations.