Our clients have the right to confidentiality, and it is to be respected and maintained. Our clients place their trust in us, and we must be very careful to protect their right to confidentially.
HIPAA
All protected patient information shall be kept safeguarded pursuant to the policies and procedures of SARA Companion Home Care Services, Inc. and in accordance with Health Insurance Portability and Accountability Act of 1996 (HIPAA), the regulations issued there under and any applicable state law to prevent impermissible disclosure, loss or misuse and to ensure that only authorized persons have access to such protected information. For more information, please refer to your HIPAA manual which is enclosed with your orientation packet.
Patient Rights
Our patients have the right:
- To execute such rights, in writing prior to the initiation of care, as evidenced by written documentation in the clinical record;
- Patients have the right to be treated by the physician of their choice, the right to participate in the planning of their care, and the unrestricted right to communicate with their physician and any other persons responsible for the planning of their care.
- Patients have the right to health care that meets all professional standards and which is performed by personnel who are qualified through education and experience to carry out the services for which they are responsible.
- Patients have the right to courteous, respectful, considerate, individualized and humane health care that is given without discrimination as to race, color, creed, sex, national origin or handicap.
- Patients have the right to be treated with consideration, dignity, respect and full recognition of his/her dignity and individuality by all agency personnel, who are made aware of the “Patient’s Right and Grievance Procedure” by the governing body of SARA.
- Patients have the right to request information about their diagnosis, prognosis, and treatment, including alternatives to care and risks involved in terms that they and their families can readily understand, so that they can give their informed consent.
- Patients have the right to participate in the development of the plan of care and discharge plan and be advised of all treatments the agency is to provide, and when and how the services will be provided, and the names and function of any persons and/or affiliated agency providing such services.
- Patients have the right to make decisions concerning: (a) Medical care, including rights to accept or refuse medical/surgical/nursing treatment and to be informed of the possible health consequences of this action.,(b) The right to participate in formulating advance directives.,(c) The written policies of the agency in respect to the implementation of these specific rights, and the patients have received a copy of such.
- The agency may not discriminate against individuals on the basis of whether he/she has an advance directive.
- The patient has the right to know that their medical record contains information as to whether he/she has signed an advance directive.
- Patients have the right to coordination and continuity of health care.
- Patients have the right to appropriate instruction from health care personnel so that they can achieve an optimal level of wellness and self-care.
- Patients have the right to privacy, including confidential treatment of patient records, and to refuse release of records to any individual outside the agency except in the case of the patient’s transfer to a health care facility or as required by law or third-party payment contract.
- Patients have the right to request all health records that pertain to them and also have (a) The right to challenge them., (b) The right to have their records corrected for accuracy.,(c) The right to transfer all such records in the case of continuing care.
- Patients have the right to receive written information on all agency services and the charges for them as well as any or all charges for which the patient is personally responsible.
- Patients have the right to be notified of any changes in policy or rates no later than 30 days to change. All changes will be given orally and in writing.
- If a patient lacks capacity to exercise these rights, the right shall be exercised by an individual guardian or entity legally authorized to represent the patient.
Confidentiality
The New York State HIV confidentiality law (Article 27-F of the Public Health Law) strictly protects the confidentiality of information about individuals who have undergone HIV-related testing, have HIV infection, HIV-related illness or AIDS, or are the “contacts” of these individuals. SARA Companion Services recognizes that it is essential to protect the confidentiality of such information in order to encourage people to learn their HIV status, obtain the HIV-related care and services they may need, and limit the harms that may result from the inappropriate use or disclosure of HIV-related information.
Employees of this agency are authorized to access HIV-related information about a client, and/or to disclose such information about a client to other employees within this agency, only in the following circumstances:
~~~ the job title of the employees receiving and/or disclosing the client’s HIV-related information is as follows: Director of Patient Services, Nursing Department (Field nurse, Intake nurse)
~~~ the employee receiving and/or disclosing the client’s HIV-related information (a) has been educated about applicable confidentiality requirements and (b) has signed the Employee Attestation and
~~~ the employee accessing or receiving the client’s HIV-related information has a reasonable need for that information in order to perform his/her duties in connection with the provision, supervision or administration of agency’s services to the client. In all other circumstances, employees may access and/or disclose HIV-related information only with a client’s consent.
Advanced Directives
SARA Companion home Care Services recognizes that all persons have a fundamental right to make decisions relating to their own medical treatment, including the right to accept or refuse medical care. It is the policy SARA Companion Home Care Services to encourage individuals and their families/caregivers to participate in decisions regarding care and treatment. Valid advance directives, such as living wills, durable powers of attorney, health care proxy’s and MOLST (Medical Orders for Life-Sustaining Treatment) orders will be followed to the extent permitted and required by law.
- Adult: a person 18 years or older, or a person legally capable of consenting to his/her own medical treatment.
- Advance Directives: a document in which a person states choices for medical treatment.
- Attending Physician: the physician who is primarily responsible for the medical care of a patient while receiving home health care services.
- MOLST (Medical Orders for Life-Sustaining Treatment): a medical order to help physicians and other health care providers discuss and convey a patient’s wishes regarding end-of- life care, including cardiopulmonary resuscitation (CPR), other life-sustaining treatments, as well as comfort care measures such as pain and symptom management.
- Patient Self Determination Act: a federal statute enacted as part of the 1990 Omnibus Budget Reconciliation Act (OBRA) (PL 101-508) which requires, among other things, that health care facilities provide information regarding the right to formulate advance directives concerning health care decisions.
- Patient Representative: a person appointed to make decisions for someone else. They may be formally appointed (as in a durable power of attorney or health care proxy for health care) or in the absence of a formal appointment, may be recognized by virtue of a relationship with the patient (such as the patient’s next of kin or close family/caregiver).
Medical Aid in Dying (MAiD) Policy and Procedure
Policy
Sara Companion HomeCare Services is committed to providing compassionate, respectful, patient-centered care to every individual we serve.
Based upon the organization’s sincerely held moral convictions, Sara Companion HomeCare Services does not participate in Medical Aid in Dying (MAiD) as authorized under New York State law.
Although the Agency does not participate in MAiD, patients who inquire about or choose to pursue Medical Aid in Dying will continue to receive compassionate, non-discriminatory care. The Agency will continue providing all medically appropriate home care services within its scope of practice and licensure.
Employees shall treat every patient and family member with dignity, respect, compassion, and professionalism regardless of their personal healthcare decisions.
Purpose
This policy establishes the Agency’s procedures for responding to inquiries regarding Medical Aid in Dying while maintaining compliance with New York State law, protecting employee conscience rights, and ensuring continuity of patient care.
Scope
This policy applies to all Agency employees, contractors, volunteers, students, supervisors, and administrative personnel.
Agency Participation
Sara Companion HomeCare Services will:
- – Provide compassionate and supportive care.
- – Provide factual non-directive information when requested.
- – Continue all medically appropriate home care services.
- – Refer patients to outside resources for additional information.
- – Continue providing comfort care, symptom management, and end-of-life support.
Sara Companion HomeCare Services will not:
- – Recommend or encourage Medical Aid in Dying.
- – Determine whether a patient qualifies for MAiD.
- – Assess eligibility or decision-making capacity for MAiD.
- – Serve as an attending or consulting provider.
- – Prescribe or obtain MAiD medications.
- – Store, transport, prepare, or administer MAiD medications.
- – Assist a patient in taking, swallowing, or self-administering MAiD medications.
- – Be present solely for the purpose of participating in a MAiD event.
Procedure for Employees Receiving a MAiD Inquiry
If a patient or family member asks about Medical Aid in Dying, employees shall:
Step 1 – Listen Respectfully
The employee shall:
- – Remain calm and compassionate.
- – Allow the patient to express concerns.
- – Avoid expressing personal opinions.
- – Avoid attempting to persuade the patient either for or against MAiD.
Employees should respond using neutral language such as:
“I understand this is an important question. Sara Companion HomeCare Services does not participate in Medical Aid in Dying because of our organization’s policy. However, I can help connect you with resources that may provide additional information.”
Step 2 – Notify the Clinical Supervisor
The employee shall immediately notify:
- – Director of Patient Services
- – Clinical Supervisor
- – Administrator (if applicable)
The supervisor will determine whether additional clinical intervention or support services are needed.
Step 3 – Assess Immediate Needs
The supervising nurse should determine whether the patient’s inquiry reflects:
- – Uncontrolled Pain
- – Anxiety
- – Depression
- – Fear
- – Caregiver Stress
- – Unmet Palliative Care Needs
- – Unmet Hospice Needs
If appropriate, referrals should be made for:
- – Hospice
- – Palliative Care
- – Social Work
- – Chaplain or Spiritual Care
- – Behavioral Health
- – Physician Follow-up
Step 4 – Referral to Outside Resources
Employees shall not provide legal or clinical advice regarding MAiD.
Upon request, employees may provide contact information for:
- – The patient’s attending physician;
- – The patient’s hospital system or health system;
- – Hospice or palliative care providers;
- – Legal or advocacy organizations identified by the patient;
- – Other independent healthcare providers that discuss end-of-life options.
Employees shall not recommend any specific MAiD provider or organization unless approved by Agency administration.
Documentation Standards
All MAiD-related discussions shall be documented objectively in the clinical record.
Documentation should include:
- – Date and time.
- – Individuals present.
- – Patient’s exact statements when practical.
- – Neutral description of questions asked.
- – Educational information provided.
- – Referrals made.
- – Supervisor notification.
- – Patient response.
- – Any follow-up actions.
Documentation shall never include:
- – Personal opinions.
- – Moral judgments.
- – Religious counseling unless requested by the patient.
- – Statements discouraging or encouraging MAiD.
- – Speculation regarding patient eligibility.
Example documentation:
Patient asked about New York’s Medical Aid in Dying law and requested information. Patient was informed that Sara Companion HomeCare Services does not participate in MAiD based upon organizational policy. Patient was advised that information regarding outside healthcare resources may be provided upon request. Director of Patient Services notified. No immediate safety concerns identified. Patient continues receiving home care services.
Employee Responsibilities
Employees shall:
- – Follow this policy.
- – Maintain patient confidentiality.
- – Notify supervision promptly.
- – Continue providing ordered care.
- – Maintain professional boundaries.
- – Document accurately.
Employees shall not:
- – Participate in MAiD activities.
- – Witness execution of MAiD-related documents on behalf of the Agency.
- – Accept possession of MAiD medication.
- – Transport MAiD medication.
- – Assist with administration.
Employee Conscience Protection
Sara Companion HomeCare Services recognizes the sincerely held moral convictions of both the organization and its employees.
No employee shall be required to participate in any activity related to Medical Aid in Dying that conflicts with Agency policy.
Employees who decline participation in any MAiD-related activity consistent with this policy shall not be subject to:
- – discipline;
- – retaliation;
- – discrimination;
- – reduction in hours;
- – adverse employment action.
Employees remain responsible for continuing all other assigned patient care duties unless reassigned by supervision.
Questions regarding employee responsibilities shall be directed to the Director of Patient Services or Human Resources.
Patient Rights
Patients retain all rights afforded under New York law.
A patient’s inquiry regarding Medical Aid in Dying shall not:
- – affect admission,
- – affect continuation of services,
- – affect quality of care,
- – result in discrimination,
- – result in abandonment.
The Agency remains committed to compassionate end-of-life care regardless of a patient’s decisions.
Education
All employees shall receive education regarding:
- – this policy;
- – responding to MAiD inquiries;
- – documentation expectations;
- – patient rights;
- – hospice and palliative care resources;
- – professional communication.
Training shall occur during orientation and as needed thereafter.
Quality Assurance
The Director of Patient Services shall periodically review MAiD-related documentation and referrals through the Agency’s Quality Assurance and Performance Improvement (QAPI) program to ensure compliance with this policy, applicable laws, and documentation standards.
Effective: August 1, 2026
Reviewed and approved by: Stacey White, RN