Posted by: Robert Markette
December 16, 2005

I heard an interesting story yesterday.  A home health agency has a client that is a quadripelegic.  This client has decided to live by herself.  The agency, as any good provider would, has taken steps to ensure that the patient has means to call for help in an emergency.  Neverheless, one of the agencies that regulates home health told the provider that if the patient were to be injured or die in a fire or as the result of some other mishap, the agency would be responsible.

For most people, this story elicits the following response, “What, why does the agency have any liability, if she want to live alon, that is her choice.”  This response is not completely unfounded.  Of course, in today’s litigious environment, that would not guarantee the agency did not get sued if something happened. 

This means that the agency should take some steps to shield itself.  This situtation can be compared to a discharge against doctor’s orders in a hospital setting.  If the patient wants to leave and is capable of leaving, the hospital cannot force them to stay.  Similarly, if a quadripelegic patient wishes to live alone, the agency cannot force them to have a roommate.  The agency should clearly advise the patients of the risks living alone pose to an individual with the patient’s needs.  The patient should sign the form acknowledging that she has been advised of these risks and the agency should keep a copy in the file.  I am suggesting this, as a way to prove later that the agency at least informed the patient of the risks.  Of course, the patient will be very aware of the risks, as it is his life.  I am also no suggesting you have a duty to legal obligation to provide this notice,  I am however, suggesting that it would be a helpful piece of documentation to have if you were involved in litigation later.  You can then say, “We advised the patient of the risks and he knowingly and voluntarily chose to live alone.”  

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