Care Under Medicare

Who qualifies for Medicare coverage?
To qualify for Medicare coverage:

  • The patient must be 65 years old or older.
  • The patient currently receives Social Security benefits or is enrolled in the railroad retirement system.
  • The patient is younger than 65 years old and has received Social Security disability benefits for at least two years (24 months).
  • The patient suffers from permanent kidney failure.

If the patient is 65 or older and still working, will Medicare pay for home health service?
Yes, a patient can use Medicare. However, if a patient is covered by an employer’s insurance plan, the employer’s health insurance could be used in conjunction with Medicare.
Are home visits covered under Medicare?
Yes, if each of the following conditions is met:

  • The patient’s physician has requested home healthcare and established a plan of care.
  • The agency is Medicare-certified.
  • The patient cannot leave home without assistance.
  • The patient requires nursing care, physical therapy or speech therapy that is reasonable and necessary throughout the patient’s episode of care.

Do patients have to pay Aspen Healthcare for visits?
No. Aspen Healthcare will bill Medicare directly. Medicare has two parts:

  • Part A – hospital insurance that is part of the patient’s Social Security benefit
  • Part B – medical insurance the patient pays for monthly

Do patients decide whether to use Part A or Part B of Medicare?
No. Part A and Part B will pay for covered home healthcare services. Aspen Healthcare will inform the patients of their coverage.
Does Medicare cover outpatient physical therapy?
Yes, if the physician refers the patient and the patient qualifies for outpatient therapy.
Does Medicare pay for hospice services?
Yes, if the patient qualifies for hospice services.
Are services for mental illness covered?
Yes, if the patient qualifies for home healthcare under Medicare.

Medical Information

Hours / On-Call Guidelines
Aspen Healthcare’s regular business hours are Monday through Friday from 8:30 am to 5:00 pm, except on company holidays. Please feel free to contact your local Aspen Healthcare office from our Contact Page.

After Hours Healthcare
Aspen Healthcare’s telephones are answered 24 hours a day. An on-call nurse is available to accept patient calls, referrals for service and arrange services for urgent patient needs.

Weather Conditions
During inclement weather conditions, Aspen Healthcare will do everything it can to meet patients’ medical needs. When streets are unsafe for travel, home care professionals will, if possible, inform patients if they are unable to make the scheduled visits. Aspen Healthcare staff members will stay in contact with local authorities so home visits may resume as soon as possible.

On-Call Guidelines
An Aspen Healthcare nurse is available 24 hours a day, even after regular office hours. If a patient’s condition changes, please contact your Aspen Healthcare office to determine if further care or action is required. Aspen Healthcare professionals can be reached after regular business hours at the local branch main office number. Aspen Healthcare does not deliver routine supplies or equipment after regular business hours. Additionally, Aspen Healthcare healthcare professionals do not carry additional medicines and cannot administer medications not requested by the patient’s physician.

HOSPICE – Always call your local office or nurse first.

HOME HEALTH – The following situations may require additional medical care:

  • Chest Pain – Chest pain usually indicates the patient requires medical attention. Contact 911 or the local hospital.
  • Elevated Temperature – Contact The Aspen Healthcare on-call nurse if the patient’s temperature rises above 100°. A home visit may be necessary.
  • Respiratory Distress – Respiratory distress usually indicates the patient requires additional medical care. Contact 911 or the local hospital.
  • Catheters – Catheters usually are not an emergency unless the patient cannot urinate. If the catheter does not drain properly or comes out and the patient cannot urinate, call the Aspen Healthcare on-call nurse. The nurse may need to make a home visit or schedule an early visit the next day.
  • Feeding Tubes – Call the Aspen Healthcare on-call nurse if a feeding tube comes out completely or partially. Do not try to replace it.
  • Falls or Injuries – Contact 911 or the local hospital immediately.

Charges

Payment for Aspen Healthcare services can be made through Medicare, Medicaid, worker’s compensation, private insurance, or private pay. For most services, there is no cost to patients if they qualify for Medicare. Some insurance companies may require pre-certification and may limit the number and type of home health visits Aspen Healthcare can provide. Additionally, a deductible or a co-payment for service may be required.

Patients will be informed of any additional charges for services not covered under Medicare or other insurance before they receive such services. Before or at the time of admission, patients, guardians, caregivers or family members will be informed about all charges and payment methods. Aspen Healthcare will provide patients (or the individual responsible for payment) with an estimate of such possible service charges. Aspen Healthcare will not admit or continue to visit patients if Aspen Healthcare cannot meet their needs, either directly or indirectly through service agreements with other home health agencies.

Additional Information

Compliance
Since its inception, Aspen Healthcare has demonstrated its commitment to ethical business behavior and compliance with the letter and spirit of ever-changing rules, regulations and laws.

The company formalized these expectations in writing, and Aspen Healthcare’s Compliance and Ethics Program continues to evolve with changes in the home care and hospice industries. This Program includes attention to ethics and assures the public of Aspen Healthcare’s long-standing reputation for complying with state and federal laws in every activity.

Additionally, there is an auditing and monitoring system for key compliance risk areas to prevent errors. Citizens, patients, caregivers, referral sources, and employees may contact Aspen Healthcare’s Compliance Officer at 208-529-0800, 24 hours a day, 7 days a week, to request additional compliance information or to report concerns.

Code of Ethics and Ethics Committee
Ethical behavior is considered essential to the effectiveness of Aspen Healthcare. Aspen Healthcare provides its employees with written guidelines for compliance and ethics. Staff members are invited to contact the Compliance and Ethics Office with any relevant ethical concern or question. The Ethics Committee regularly meets to discuss and resolve general and specific ethical issues with input from administrators, clinicians and legal counsel.

Aspen Healthcare Code of Ethics
Aspen Healthcare has established this Code of Ethics in recognition of our responsibility to our patients, staff and the communities we serve. It affirms Aspen Healthcare’s corporate policy of conducting business and operations in accordance with both the law and the highest standard of business ethics.It is the responsibility of every Aspen Healthcare employee, independent contractors, vendor and others who render services for and/or on behalf of Aspen Healthcare to act in a manner that is consistent with Aspen Healthcare’s Mission Statement and its supporting polices. Our performance is guided by the company’s values that support and advance our mission. Our mission is to strive to consistently exceed our customers’ expectations by maintaining an ethical, positive, efficient and financially sound workplace environment that allows our organization’s caring, multi-skilled and empowered employees to provide high quality home based services through a system of clinically superior programs.
1. Aspen Healthcare requires all employees’ compliance with all laws and regulations to which it is subject. When the application of a law or regulation is uncertain, the guidance of the company’s Compliance Officer and/or General Counsel shall be sought. Aspen Healthcare requires independent contractors, vendor and others who render services for and/or on behalf of Aspen Healthcare to affirm that their services will be provided in accordance with all laws and regulations.
2. Aspen Healthcare’s policy is to maintain contacts with governmental officials and other government personnel, whether directly or indirectly, as proper business relationships. Such contacts must never suggest undue influence or cast doubt on Aspen Healthcare’s integrity. Furthermore, Aspen Healthcare is committed to ensuring the accuracy of all filings with the government.
3. Aspen Healthcare maintains accurate and reliable corporate records which disclose all disbursements and other transactions to which Aspen Healthcare is a party.
4. Aspen Healthcare requires the undivided loyalty of its employees in the exercise of their responsibilities. Except as may be otherwise approved by the Board of Directors or an appropriate committee thereof, personal investments or other activities which may create a conflict of interest are prohibited, and circumstances which may give the appearance of a conflict of interest are to be avoided.
5. Aspen Healthcare requires all employees, independent contractors, vendors and others who render services for and/or on behalf of Aspen Healthcare to report wrongdoing or suspected wrongdoing. Reports of wrongdoing may be orally to one’s supervisor, through the Compliance Helpline (208-529-0800) or in writing. Reports of wrongdoing or suspected wrongdoing may be made anonymously, however, such reports allow for limited feedback and follow up. All reports must be directed or forwarded to the Compliance Officer for appropriate follow up and investigation.
6. It is a violation of this Code for personnel not to report a violation of this Code or to fail to report any wrongdoing or suspected wrongdoing.
7. It is our policy to promptly and thoroughly investigate reports of wrongdoing or suspected wrongdoing or violations of this Code. Personnel must cooperate with these investigations. No reprisals or disciplinary action will be taken or permitted against personnel for good faith reporting of and/or cooperating in the investigation of illegal or suspected illegal acts or violations of this Code.
8. Personnel who violate the Code or commit illegal acts are subject to discipline up to and including dismissal.9. Aspen Healthcare conducts Ethics Committee Meetings to facilitate discussion of ethical questions; to furnish ethics educational resources; to educate staff, physicians, patients and caregivers about ethics; to provide advise, training and consultation to the staff on actual and potential questions of ethics; and to analyze specific ethical questions and assist in the resolutions.The company’s Board of Directors has adopted the foregoing Code of Ethics to apply to Aspen Healthcare.

 

Derek P. Collette
Secretary of the Board
Aspen Healthcare

Privacy Statement
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.”

Aspen Healthcare
3470 Washington Parkway
Idaho Falls, ID 83404
208.529.0800

This Privacy Notice covers an affiliated covered entity (“ACE”) made up of the entities and components listed on the last page of this Notice.

We are required under the federal health care privacy rules (the “Privacy Rules”), to protect the privacy of your health information, which includes information about your health history, symptoms, test results, diagnoses, treatment, and claims and payment history (collectively, “Health Information”). We are also required to provide you with this Privacy Notice regarding our legal duties, policies and procedures to protect and maintain the privacy of your Health Information. We are required to follow the terms of this Privacy Notice unless (and until) it is revised. We reserve the right to change the terms of this Privacy Notice and to make the new notice provisions effective for the Health Information that we maintain and use, as well as for any Health Information that we may receive in the future. Should the terms of this Privacy Notice change (while you are receiving service), we will make a revised copy of the notice available to you. Privacy Notices will also be posted and available electronically on our web site.

Permitted Uses and Disclosures of Your Health Information
1. General Uses and Disclosures. Under the Privacy Rules, we are permitted to use and disclose your Health Information for the following purposes, without obtaining your permission or Authorization:

Treatment. We are permitted to use and disclose your Health Information in the provision and coordination of your health care. For example, we may disclose your Health Information to your primary health care provider, consulting providers, and to other health care personnel who have a need for such information for your care and treatment.

Payment. We are permitted to use and disclose your Health Information for the purposes of determining coverage, billing, and reimbursement. This information may be released to an insurance company, third party payor, or other authorized entity or person involved in the payment of your medical bills and may include copies or portions of your medical record, which are necessary for payment of your bill. For example, a bill sent to your insurance company may include information that identifies you, your diagnosis, and the procedures and supplies used in your treatment.

Health Care Operations. We are permitted to use and disclose your Health Information during our health care operations, including, but not limited to: quality assurance, auditing, licensing or credentialing activities, and for educational purposes. For example, we can use your Health Information to internally assess our quality of care provided to patients.

Uses and Disclosures Required by Law. We may use and disclose your Health Information when required to do so by law, including, but not limited to: reporting abuse, neglect and domestic violence; in response to judicial and administrative proceedings; in responding to a law enforcement request for information; or in order to alert law enforcement to criminal conduct on our premises or of a death that may be the result of criminal conduct.

Public Health Activities. We may disclose your Health Information for public health reporting, including, but not limited to: suspected abuse and neglect; reporting communicable diseases and vital statistics; product recalls and adverse events; or notifying person(s) who may have been exposed to a disease or are at risk of contracting or spreading a disease or condition.

Abuse and Neglect. We may disclose your Health Information to a local, state, or federal government authority, if we have a reasonable belief of abuse, neglect or domestic violence.

Regulatory Agencies. We may disclose your Health Information to a health care oversight agency for activities authorized by law, including, but not limited to, licensure, investigations and inspections. These activities are necessary for the government and certain private health oversight agencies to monitor the health care system, government programs, and compliance with civil rights.

Judicial and Administrative Proceedings. We may disclose your Health Information in judicial and administrative proceedings, as well as in response to an order of a court, administrative tribunal, or in response to a subpoena, summons, warrant, discovery request, or similar legal request.

Law Enforcement Purposes. We may disclose your Health Information to law enforcement officials when required to do so by law.

Coroners, Medical Examiners, Funeral Directors. We may disclose your Health Information to a coroner or medical examiner. This may be necessary, for example, to determine a cause of death. We may also disclose your health information to funeral directors, as necessary, to carry out their duties.

Organ Procurement Organizations. Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Research. Under certain circumstances, we may disclose your Health Information to researchers when their clinical research study has been approved and where certain safeguards are in place to ensure the privacy and protection of your Health Information.

Threats to Health and Safety. We may use or disclose your Health Information if we believe, in good faith, that the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public, or is necessary for law enforcement to identify or apprehend an individual.

Specialized Government Functions. If you are a member of the U.S. Armed Forces, we may disclose your Health Information as required by military command authorities. We may also disclose your Health Information to authorized federal officials for national security reasons and the Department of State for medical suitability determinations.

Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release your Health Information to the correctional institution or law enforcement official, where such information is necessary for the institution to provide you with health care; to protect your health or safety, or the health or safety of others; or for the safety and security of the correctional institution.

Workers’ Compensation. We may disclose your Health Information to your employer to the extent necessary to comply with state laws relating to workers’ compensation or other similar programs.

Fundraising. We may use or disclose your Health Information to make a fundraising communication to you, for the purpose of raising funds for our own benefit. Included in such fundraising communications will be instructions describing how you may ask not to receive future communications.

Marketing. We may use or disclose your Health Information to make a marketing communication to you that occurs in a face-to-face encounter with us or which concerns a promotional gift of nominal value provided by us.

Visit Reminders/Treatment Alternatives. We may use and disclose your Health information to remind you of your upcoming home visit or to provide you with treatment alternatives or other health-related benefits and services that may be of interest to you.

Business Associates. We may disclose your Health Information to business associates who provide services to us. Our business associates are required to protect the confidentiality of your Health Information.

Other Uses and Disclosures. In addition to the reasons outlined above, we may use and disclose your Health Information for other purposes permitted by the Privacy Rules.

2. Uses and Disclosures Which Require Patient Opportunity to Verbally Agree or Object. Under the Privacy Rules, we are permitted to use and disclose your Health Information: (i) for the creation of facility directories (ii) to disaster relief agencies, and (iii) to family members, close personal friends or any other person identified by you, if the information is directly relevant to that person’s involvement in your care or treatment. Except in emergency situations, you will be notified in advance and have the opportunity to verbally agree or object to this use and disclosure of your Health Information.

3. Uses and Disclosures Which Require Written Authorization. As required by the Privacy Rules, all other uses and disclosures of your Health Information (not described above) will be made only with your written authorization. For example, in order to disclose your Health Information to a company for marketing purposes, we must obtain your Authorization. Under the Privacy Rules, you may revoke your Authorization at any time. The revocation of your Authorization will be effective immediately, except to the extent that: we have relied upon it previously for the use and disclosure of your Health Information; if the Authorization was obtained as a condition of obtaining insurance coverage where other law provides the insurer with the right to contest a claim under the policy or the policy itself; or where your Health Information was obtained as part of a research study and is necessary to maintain the integrity of the study.

Patient Rights

You have the following rights concerning your Health Information:

1. Right to Inspect and Copy Your Health Information. Upon written request, you have the right to inspect and copy your own Health Information contained in a designated record set, maintained by or for us. A “designated record set” contains medical and billing records and any other records that we use for making decisions about you. However, we are not required to provide you access to all the Health Information that we maintain. For example, this right of access does not extend to psychotherapy notes, or information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative proceeding. Where permitted by the Privacy Rules, you may request that certain denials to inspect and copy your Health Information be reviewed. If you request a copy or summary of explanation of your Health Information, we may charge you a reasonable fee for copying costs, including the cost of supplies and labor, postage, and any other associated costs in preparing the summary or explanation.

2. Right to Request Restrictions on the Use and Disclosure of Your Health Information. You have the right to request restrictions on the use and disclosure of your Health Information for treatment, payment and health care operations, as well as disclosures to persons involved in your care or payment for your care, such as family members or close friends. We will consider, but do not have to agree to, such requests.

3. Right to Request an Amendment of Your Health Information. You have the right to request an amendment of your Health Information. We may deny your request if we determine that you have asked us to amend information that: was not created by us, unless the person or entity that created the information is no longer available; is not Health Information maintained by or for us; is Health Information that you are not permitted to inspect or copy; or we determine that the information is accurate and complete. If we disagree with your requested amendment, we will provide you with a written explanation of the reasons for the denial, an opportunity to submit a statement of disagreement, and a description of how you may file a complaint.

4. Right to an Accounting of Disclosures of Your Health Information. You have the right to receive an accounting of disclosures of your Health Information made by us within six (6) years prior to the date of your request. The accounting will not include: disclosures related to treatment, payment or health care operations; disclosures to you; disclosures based on your Authorization; disclosures that are part of a Limited Data Set; incidental disclosures; disclosures to persons involved in your care or payment for your care; disclosures to correctional institutions or law enforcement officials; or disclosures that occurred prior to April 14, 2003.

5. Right to Alternative Communications. You have the right to receive confidential communications of your Health Information by a different means or at a different location than currently provided. We will arrange for you to receive protected health information by reasonable means or at alternative locations. Your request must be in writing. We do not require an explanation for the request as a condition of providing communications on a confidential basis and will attempt to honor requests for confidential communications.

6. Right to Receive a Paper Copy of this Privacy Notice. You have the right to receive a paper copy of this Privacy Notice upon request, even if you have agreed to receive this Privacy Notice electronically.

If you want to exercise any of these rights, please contact our Privacy Officer. All requests must be submitted to us in writing on a designated form (which we will provide to you), and returned to the attention of our Privacy Officer at the address below.

Contact Information and How to Report a Privacy Rights Violation

If you have questions and/or would like additional information regarding the uses and disclosures of your Health Information, you may contact our Privacy Officer at:

Attn:Privacy Officer
3470 Washington Parkway
Idaho Falls, ID 83404
Telephone: 208.529.0800
Fax: 208.523.9829

If you believe that your privacy rights have been violated or that we have violated our own privacy practices, you may file a complaint with us. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services at Region IV, Office for Civil Rights, U.S. Department of Health and Human Services, Atlanta Federal Center, Suite 3B70, 61 Forsyth Street, SW., Atlanta, GA 30303-8909. Complaints filed directly with the Secretary must be made in writing, name us, describe the acts or omissions in violation of the Privacy Rules or our privacy practices, and must be filed within 180 days of the time you knew or should have known of the violation. Complaints submitted directly to us must be in writing and to the attention of our Privacy Officer. There will be no retaliation for filing a complaint.

The Effective Date of this Privacy Notice is September 1, 2013.

 

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