Terms and Conditions 

Please read this agreement carefully.  This Agreement contains a mandatory arbitration provision (Section 20) and provisions that govern how claims that you and we have against each other are resolved.  Specifically, the arbitration provision (with limited exceptions for those optin out or proceeding in small claims court) requires disputes between us to be submitted to binding and final arbitration on an individual basis, rather than jury trials or class actions. Read carefully, including your right, if applicable, to opt out of the arbitration provision (Section 20).

The patient or representative signing below has been informed of the home care treatment and product options available to them and of the selection of providers from which the patient may choose. The patient further authorizes Aeroflow Urology, and its parent company, Aeroflow Inc., under the direction of the patient’s prescribing physician, to provide home medical equipment, supplies and services. The patient has acknowledged that the Client/Patient Service Agreement has been explained and that the patient understands the information.

The patient understands their right to formulate and to issue Advance Directives to be followed should they become incapacitated.

All benefits and payments must be made directly to Aeroflow, Inc. for any Aeroflow furnished home medical equipment, products and services. Aeroflow will seek such benefits and payments on the patient’s behalf. It is understood that, as a courtesy, Aeroflow will bill Medicare/Medicaid or other federally funded sources and other payers and insurer(s) providing coverage, with a copy to Aeroflow. The patient is responsible for providing all necessary information and for making sure all certification and enrollment requirements are fulfilled. Any changes in insurance coverage must be reported to Aeroflow within 10 days of the change.

The patient or representative requests and authorizes Aeroflow, the prescribing physician, hospital, and any other holder of information relevant to service or equipment provided by Aeroflow, to release information upon request, to Aeroflow, any payer source, physician, or any other medical personnel or agency involved with service. The patient also authorizes Aeroflow to review medical history and payer information for the purpose of providing treatment, equipment, or products.

All payment and all sums that may become due for the services or products provided are due at the time services are rendered unless payment arrangements have been approved in advance by Aeroflow staff. These sums include, but are not limited to, all deductibles, co-payments, out-of-pocket requirements, and non-covered services. If for any reason and to any extent, Aeroflow does not receive payment from the patient’s payer source because the patient is no longer eligible for coverage or because the service or product is not covered, the patient’s balance will be due in full, within 30 days of receipt of invoice. Aeroflow accepts cash, checks, & most major credit cards. Payments by check may be converted into electronic fund transfers and funds may be debited from your account as soon as the same day payment is received.

All patient owed charges not paid within 30 days of billing date shall be assessed late charges and are subject to legally allowable interest charges. In such an event, the patient will be liable for all charges, including collection costs and all attorneys’ fees, as applicable. Balances older than 90 days may be subject to additional collection fees and interest charges of 1.5% per month. We realize that temporary financial problems may affect timely payment to your account. If such problems do arise, we encourage you to contact us promptly for assistance in the management of your account.

I understand, and consent to Aeroflow sending me email or text reminders of any balance I owe.

I understand if I have an unpaid balance to Aeroflow and do not make satisfactory payment arrangements, my account may be placed with an external collection agency.

In order for Aeroflow or their designated external collection agency to service my account, and where not prohibited by applicable law, I agree that Aeroflow and the designated external collection agency are authorized to (i) contact me by telephone at the telephone number(s) I am providing, including wireless telephone numbers, which could result in charges to me, (ii) contact me by sending text messages (message and data rates may apply) or emails, using any email address I provide.  I understand the methods of contact may include using pre-recorded/artificial voice message and/or use of an automatic dialing device, as applicable.

Furthermore, I consent to the designated external collection agency to share personal contact and account related information with third party vendors to communicate account related information via telephone, text, e-mail, and mail notification.

If the patient’s service or equipment is covered by Medicare, Medicare will pay a monthly rental fee for a period not to exceed 13 months, after which ownership of the equipment is transferred to the Medicare beneficiary/patient. After equipment ownership is transferred, it is the beneficiary/patient's responsibility to arrange for any required equipment service or repair through the manufacturer. Examples of this type of equipment include, but not limited to nebulizers, enteral pumps, and CPAP/BIPAP/ASV/RAD.

Aeroflow has the following services available for patients: breast pumps, incontinence supplies, catheters, CPAP/BPAP/ASV/RAD equipment & supplies, compression, enteral nutrients, continuous glucose monitoring and supplies, and ostomy.

Aeroflow is only responsible for equipment repairs and replacement for rented equipment during the rental period. The patient or their representative will be notified of warranty coverage for any covered Aeroflow equipment sold or rented. Aeroflow will honor all warranties under applicable law and according to manufacturer's guidelines. The patient will need to refer to the manufacturer's warranty guidelines for what constitutes a voided warranty.

By accepting these Terms and Conditions, the patient agrees that if the patient’s insurance does not cover all items ordered, even if the item is one that the patient or the healthcare provider has good reason to think is necessary, Aeroflow will not charge the insurance company and the patient will have financial responsibility for payment for the non-covered item(s). The patient also agrees that Aeroflow has offered alternative covered items (if any) and the cost of the non-covered item, and that the patient has then accepted financial responsibility for the non-covered item.

Due to Federal and State Pharmacy Regulations ancillary items prescribed for home health care cannot be re-dispensed and cannot be returned for credit. Sale items cannot be returned. The patient or their representative must notify Aeroflow within 24 hours if the set-up of any equipment is improper or the equipment is defective. In the event of defective equipment, Aeroflow will exchange the equipment.
Rented home medical equipment must be returned to Aeroflow when the physician orders discontinuance or when the patient is deceased.

Please be advised there is a $25.00 fee for all returned checks.

By signing and submitting this form, the patient or representative consents to receive phone calls, texts, e-mails, and pre-recorded messages from Aeroflow or any of its subsidiaries regarding Aeroflow products and services, at the phone number(s) or email address provided; including wireless number if provided. These calls may be generated using an automated technology and normal carrier charges may apply.
Please be aware that most standard email is not a secure means of communication and your protected health information that may be contained in our emails to you will not be encrypted. This means that there is risk that your protected health information in the emails could be intercepted and read by, or disclosed to, unauthorized third parties. Use of alternative and more secure methods of communication with us, such as telephone, fax or the U.S. Postal Service are available to you. If you do not wish to accept the risks associated with non-secure unencrypted email communications from us containing your protected health information, please indicate that you do not wish to receive such emails from us by contacting us at 844-867-9890. If you agree to receive information from Aeroflow via email or text, you agree to accept the security and privacy risks of this type of communication.

I agree that if I consent to SMS notifications regarding my order, text alerts will be sent to the number I provide. I understand that anyone with access to the mobile phone or carrier account associated with the number I have provided will be able to see this information.

We are committed to protecting the privacy of children. Aeroflow's websites and ordering ability are not directed at users under the age of 18. If you are under the age of 18, you are not permitted to register with Aeroflow, submit personal information, or place orders. You represent and warrant that you are 18 years or older if you register with Aeroflow, submit personal information, or place orders.

The products and/or services provided to the patient by Aeroflow are subject to the supplier standards contained in the federal regulations shown at 42 Code of Federal Regulations Section 424.57(c). These standards concern business professional and operational matters (e.g., honoring warranties and hours of operation). The full text of these standards can be obtained at http://ecfr.gpoaccess.gov. Upon request we will furnish you a written copy of the standards.

Aeroflow maintains accessibility through our after-hours voicemail service and can be reached by calling the main telephone number (888-345-1780). All voicemails will be received and returned on the next business day. This service is free to patients/clients. The recorded message advises patients that calls will be returned within the next business day and are advised that if a life- threatening medical emergency arises, the patient or caregiver should contact their local emergency services number immediately for assistance (usually 911).

In the event the patient should become dissatisfied with any portion of their Aeroflow provided home care experience, a complaint may be lodged with Aeroflow without concern for reprisal, discrimination, or unreasonable interruption of service. The patient has the right to present questions or grievances to an Aeroflow staff member and to receive a response in a reasonable period of time. For concerns regarding quality of care or other services, please contact Aeroflow’s office by phone or mail. Grievances can also be reported to the NC Division of Services intake unit, Medicare, or Aeroflow’s Medicare accreditation agency, ACHC. All contact information and our process for handling complaints can be found below.

The following procedure details the steps that Aeroflow will take when a client’s/patient’s complaint/grievance is received:

After receiving the concern, the Aeroflow Customer Service Supervisor will take the following steps:

1. Contact the person making the concern within 5 days, if contact has not already been established.
2. Determine what actions the caller feels should be initiated regarding the concern.
3. Speak with involved employees and conduct additional training as appropriate.
4. Attempt to resolve the concern to the client/patient's satisfaction.
5. Report status of activities to client/patient within2 days following receipt of concern.
6. Send complaint information to the Compliance Department so they can record it to the Complaint Log.
7. If the complaint remains unresolved, the Compliance Department will have a department supervisor contact the patient within 5 working days.
8. Within 14 days the company shall provide written notification to the patient of the results of the investigation.

Patient Satisfaction Surveys: Aeroflow sends patient surveys via email approximately 5-7 days after the order has been shipped. Data is collected and analyzed on a weekly basis. By signing below, you acknowledge that you have been informed of this patient satisfaction survey procedure.

Aeroflow conducts weekly patient satisfaction surveys. All inbound callers who have not been surveyed in the last 60 days will receive a survey request. Surveys are sent out every Monday to the patient’s telephone number. Data collected/analyzed from previous surveys every Monday after new surveys are sent. Survey results are sent out to all managers each Monday. By signing below, you acknowledge that you have been informed of this patient satisfaction survey procedure.
I am the patient or the patient's authorized representative and agree to the terms and conditions contained in this form and any other documentation provided by Aeroflow Healthcare (collectively, this "Agreement"), including the following:

• I have been informed by Aeroflow of the medical necessity for the services prescribed by my physician. I understand that in the event my insurer deems that services are not reasonable and necessary, my insurer may deny payment and I will be fully responsible for payment.
  
• I acknowledge that the Responsible Party (as defined in this document) is primarily responsible to pay the charges for the equipment and services listed in this agreement and may be charged for any loss or damage to any rental equipment.
  
• I have notified Aeroflow of any changes to the insurance or if the patient has joined a Medicare managed care program. I will immediately notify Aeroflow of any such changes in the future.
  
• I have received and fully inspected the equipment listed in this agreement and it is complete and in good working order without defects. 
• I have been instructed on the proper care, use, service, safe operation, and maintenance of the equipment listed in this Agreement as appropriate.
  
• I have been instructed and understand the warranty coverage.

Patient / Guardian Signature ___________________    Date _______________
Print Name ________________
If the patient is unable to sign, what is the reason?  _____________________________________________________
Representative's Address and phone # ______________________________________________

All giveaways hosted on Aeroflow Urology's marketing channels are open to legal residents of the fifty (50) United States and the District of Columbia. Entrants must be 18 years of age or older at the time of entry. Employees, affiliates, and partners are not eligible to participate. Aeroflow Urology will randomly select the winner(s) at the end of each promotion; or at the end of each month for the Refer a Friend campaign. The winner(s) will be notified via email and/or social media and will have five business days to respond. If no response is received within that time frame, the winner forfeits the prize package. Aeroflow Urology will, at their sole discretion, determine if another winner will be chosen. The company will have no liability for any losses or damages of any kind caused by prize possession. By participating in each giveaway, entrants agree to be bound by the content rules. Subject to change without notice.

• Patient Service Agreemen
• Release of Information Agreement   
• Assignment of Benefits
• Where to access Medicare DMEPOS Supplier Standards  
• Advanced Directives   
• Delivery Ticket/invoice denoting equipment delivered   
• Client/Patient Bill of Rights & Responsibilities  
• Home safety information  
• Equipment, Supply, Cleaning and Maintenance procedures (included with equipment)  
• Important company phone numbers  
• Scope of services 
• Warranty Information 
• Complaint resolution protocol, along with important state and federal contact phone numbers   
• Purchase options for capped rentals and information on purchasing inexpensive or routinely purchased DME
• Infection control   
• Plan of care (if applicable)  
• Emergency planning and patient emergency contact information  
• Patient Satisfaction Survey (sent out separately)  
• I understand that Aeroflow prohibits smoking by employees while providing services to an individual's home.   
• HIPAA Notice of Privacy Practice

By signing below, I understand and agree that I have received the information above and agree to abide by all of the guidelines, including local, state and federal laws.
Patient/POA Signature: _______________  Date: ____________________
Print Name _________________________
Aeroflow Representative Signature: ________________Date: ______________________
**Required** 
Emergency Contact Name: _________________________________________    
Emergency Contact Phone Number: __________________________________    
If patient does not have an emergency contact, list the reason:____________________________________

Effective Date: 07/01/2020

Name: __________________________
Email Address: _______________________ Phone # :_______________________________
Cell #:_________________________ Emergency Contact Name and Number: ________________________________________

Place a check mark beside the Yes or No based on Patient's response.

Was the patient able to safely and adequately maneuver and operate the delivered equipment?
_____ YES        _____ NO 
Are there any specific areas of concern?  _____ YES        _____ NO 
If yes, what? ____________________________________________________
Problem/Need: See diagnosis and prescription
Other:_________________________________________________________ 
GOAL: Patient/Caregiver will be knowledgeable in the safe operation, cleaning, and troubleshooting of delivered equipment.
Other:_________________________________________________________
Technician Signature:__________________________ Date _______________
Patient/Guardian Signature: _____________________________ Date_______________

1. Mandatory Individual Arbitration of Disputes; No Class Actions.

   You and Aeroflow agree that any and all disputes, claims or controversies directly or indirectly arising out of or relating to these Terms and Conditions or any aspect of the relationship between you, on the one hand, and Aeroflow, on the other hand, whether based in contract, tort, statute, fraud, misrepresentation or any other legal theory – including, but not limited to, claims relating to your account, Aeroflow products and services, and communications from or on behalf of Aeroflow (“Disputes”) – shall be submitted to the American Arbitration Association (AAA), or its successor, for confidential, final, and binding arbitration to be resolved by a single arbitrator.

   As of June 23, 2025, information regarding AAA and its arbitration processes, rules, and procedures is available at the website: https://www.adr.org.

   You and Aeroflow further agree that the arbitration will take place on an individual basis, that class arbitrations and class actions are not permitted, and that you and Aeroflow agree to give up the ability to participate in any class action. For avoidance of doubt, you and Aeroflow are agreeing to give up the ability to bring a lawsuit in court (except small claims discussed below); and I am giving up the ability to bring or participate in a class action in any form or forum, even if the Dispute is determined not to be subject to arbitration.

   YOU UNDERSTAND THAT YOU ARE WAIVING ANY RIGHT YOU MIGHT OTHERWISE HAVE TO A TRIAL BEFORE A JUDGE OR JURY.

2. Exceptions and Option to Opt Out.

   The only exceptions to Section 20 are the following:

   1. You or Aeroflow may seek to resolve a Dispute in small claims court if it qualifies.
   2. You may also opt out of arbitration entirely and litigate any Dispute individually if you provide us with a written notice, personally signed by you, of your decision to do so by certified mail to 3165 Sweeten Creek Rd, Asheville, North Carolina 28803-2115 within 30 days of the date that you first accepted any version of these Terms that contained an arbitration provision.
   3. If your last purchase of an Aeroflow product or service was on April 10, 2024, or earlier, Section 20 shall be inapplicable and any Dispute between you and Aeroflow will not be subject to arbitration.
3. Notice and Informal Resolution Required Before Initiating Arbitration.

   You and Aeroflow agree that, prior to initiating an arbitration (i.e., before filing an arbitration demand with AAA), you and Aeroflow will attempt to negotiate an informal resolution of the Dispute.

   To begin this process, you will send a detailed notice of your dispute (“Notice”) by certified mail to 3165 Sweeten Creek Rd, Asheville, North Carolina 28803-2115. The Notice must contain all of the following information:

   (1) your full name, address, and the email address associated with your account (if you have an account);

   (2) the facts giving rise to the Dispute and, if you are represented by counsel, the legal basis for the Dispute;

   (3) a description of the relief you want, including any money damages you request;

   (4) your signature verifying the accuracy of the Notice and, if you are represented by counsel, authorizing Aeroflow to disclose information about you to your attorney.

   Aeroflow will likewise identify itself and provide the information in (2)-(4) in any Notice we send you. Any Notice sent to you from Aeroflow will be sent to the address associated with your account or most recent purchase of an Aeroflow product or service.

   After receipt of a Notice, you and Aeroflow shall engage in a good-faith effort to resolve the dispute for a period of 60 days, which both sides may extend by written agreement (“Informal Dispute Resolution Period”). During this time, neither you nor Aeroflow may initiate arbitration, and applicable statute of limitations shall be tolled.

   As part of this period, you and Aeroflow agree to participate in a telephone settlement conference if requested. Arbitration may not be initiated until the conference occurs, if requested.

4. Initiating Arbitration and Arbitration Rules.

   If the conditions precedent to arbitration are satisfied and you or Aeroflow initiate arbitration (i.e., file an arbitration demand), the arbitration shall be administered by the AAA in accordance with the AAA Consumer Arbitration Rules and the AAA Mass Arbitration Supplementary Rules (“AAA Rules”), available at https://www.adr.org.

   The AAA arbitrator shall resolve the Dispute and is empowered to do so, except that any dispute relating to interpretation, applicability, scope, or enforceability of these terms or the agreement’s formation, including arbitrability and claims of unconscionability, voidness, or voidability, shall be resolved in court.

   Any dispute as to whether a party complied with the conditions precedent to arbitration under Section 20(3) must also be resolved in court.

   A demand for arbitration filed with AAA must include certification of compliance with Section 20.3 and Federal Rule of Civil Procedure 11(b)(1)-(4).

   The U.S. Federal Arbitration Act (9 U.S.C. § 1 et seq.) governs this arbitration agreement. The prevailing party shall be entitled to recover reasonable attorneys’ fees, costs, and expenses—except if the individual resides in California.

   The arbitrator may consider but is not bound by rulings in unrelated arbitrations. Arbitration awards apply only to the specific case and cannot be cited in other matters except for enforcement.

   Upon initiating arbitration, you must send a copy of the Demand for Arbitration via certified U.S. Mail to 3165 Sweeten Creek Rd, Asheville, NC 28803-2115. Aeroflow will send its Notices to your last known account or purchase address.

5. How to Reject Changes to This Provision.

   If Aeroflow changes this arbitration provision after the date you first accepted these Terms or any subsequent changes, you may reject the new changes by sending Aeroflow a written notice, personally signed by you, by certified mail to 3165 Sweeten Creek Rd, Asheville, NC 28803-2115 within 30 days of the effective date of the change. The date is indicated by the earlier of (1) the "Last Updated" date of the Terms or (2) the date of Aeroflow’s email notifying you of the change.

   If you reject a change, the prior arbitration provision you accepted will still apply.

6. Severability.

   If any part of this Section 20 is found void, invalid, or unenforceable, the remaining portions remain effective. However, if a court determines a public injunctive relief claim may proceed despite the “No Class Actions” clause, that claim will be decided in court, and all other claims will be arbitrated. The parties will ask the court to stay the injunctive claim until the arbitration concludes.

The formation, existence, construction, performance, and validity of this agreement shall be governed by the laws of the State of North Carolina and the United States, without reference to choice or conflict of law principles.

You agree that, for any disputes or issues not subject to arbitration (including because of your exercise of the opt-out right specified in Section 20 above or because an issue is for the court, not the arbitrator, to resolve) or that have been determined by a court of law or an arbitrator as not being subject to arbitration and are not brought in small claims court, this Agreement, for all purposes, shall be governed and construed in accordance with the laws of the State of North Carolina and any such dispute must be brought in a state or federal court located in the Western District of North Carolina, United States District Court. In addition, both parties agree to submit to the exclusive personal jurisdiction and venue of such courts. As detailed above, however, no such dispute may be brought on a class or representative basis.

Last update July 1, 2025

Appendix A

Advanced Directives

What is an Advance Directive? An advance directive is a set of directions you give about the medical and mental health care you want if you ever lose the ability to make decisions for yourself. There are two ways for you to make a formal advance directive. These include: Living Wills and Healthcare Powers of Attorney. Forms & additional information may be obtained from the Secretary of State website.

Do I have to have an Advance Directive and what happens if I don't? Making an advance directive is your choice. If you become unable to make your own decisions, and you have no advance directive, your physician or mental health care provider will consult with someone close to you about your care. Discussing your wishes with your family and friends now will help ensure that you get the level of treatment you want when you can no longer tell your health providers what you want.

What is a Living Will? A Living Will is a legal document that tells others that you want to die a natural death if you: become incurably sick with an irreversible condition that will result in your death within a short period of time; are unconscious and your physician determines that it is highly unlikely you will regain consciousness; or have advanced dementia or a similar condition which results In a substantial cognitive loss and it is highly unlikely the condition can be reversed. You can direct your physician not to use certain life-prolonging treatments such as a breathing machine ("respirator" or "ventilator"), or to stop giving you food and water through a tube ("artificial nutrition or hydration" through feeding tubes and IVs). The document goes into effect only when your physician and one other physician determine that you meet one of the conditions specified in
the Living Will. You can cancel anytime by communicating your intent to cancel it in any way.

What is a Healthcare Power of Attorney? A Healthcare Power of Attorney is a legal document in which you can name a person(s) as your health care agent(s) to make medical and mental health decisions for you if you become unable to decide for yourself. You can say which treatments you would want and not want. You should choose an adult you trust to be your health care agent.
Discuss your wishes with that person(s) before you put them in writing. The document will go into effect when a physician states in writing that you are not able to make or to communicate your health care choices. You can cancel or change while you are able to make and communicate your decisions.

How do I make an Advance Directive? There are several rules to protect you and ensure your wishes are clear to the physician who may be asked to carry them out. An advanced directive must be: (1) written; (2) signed by you while you are still able to make and communicate health care decisions; (3) witnessed by two qualified adults; and (4) notarized. A qualified witness is a competent adult who sees you sign, is not a relative, and will not inherit anything from you upon your death. The witness cannot be your physician, a licensed employee of your physician or any paid employee of a healthcare facility where you live or that is treating you.

Who should I talk to about an Advance Directive? You should talk to those closest to you about an advance directive and your feelings about the health care you would like to receive. Your physician or health care provider can answer medical questions. A lawyer can answer questions about the law. Give copies to your family, your physician or mental health providers, your health care agent(s), and any family members or close friends who might be asked about your care should you become unable to make decisions. Please furnish Aeroflow with a copy of your advance directives.

Appendix A

Advanced Directives

What is an Advance Directive? An advance directive is a set of directions you give about the medical and mental health care you want if you ever lose the ability to make decisions for yourself. There are two ways for you to make a formal advance directive. These include: Living Wills and Healthcare Powers of Attorney. Forms & additional information may be obtained from the Secretary of State website.

Do I have to have an Advance Directive and what happens if I don't? Making an advance directive is your choice. If you become unable to make your own decisions, and you have no advance directive, your physician or mental health care provider will consult with someone close to you about your care. Discussing your wishes with your family and friends now will help ensure that you get the level of treatment you want when you can no longer tell your health providers what you want.

What is a Living Will? A Living Will is a legal document that tells others that you want to die a natural death if you: become incurably sick with an irreversible condition that will result in your death within a short period of time; are unconscious and your physician determines that it is highly unlikely you will regain consciousness; or have advanced dementia or a similar condition which results In a substantial cognitive loss and it is highly unlikely the condition can be reversed. You can direct your physician not to use certain life-prolonging treatments such as a breathing machine ("respirator" or "ventilator"), or to stop giving you food and water through a tube ("artificial nutrition or hydration" through feeding tubes and IVs). The document goes into effect only when your physician and one other physician determine that you meet one of the conditions specified in
the Living Will. You can cancel anytime by communicating your intent to cancel it in any way.

What is a Healthcare Power of Attorney? A Healthcare Power of Attorney is a legal document in which you can name a person(s) as your health care agent(s) to make medical and mental health decisions for you if you become unable to decide for yourself. You can say which treatments you would want and not want. You should choose an adult you trust to be your health care agent.
Discuss your wishes with that person(s) before you put them in writing. The document will go into effect when a physician states in writing that you are not able to make or to communicate your health care choices. You can cancel or change while you are able to make and communicate your decisions.

How do I make an Advance Directive? There are several rules to protect you and ensure your wishes are clear to the physician who may be asked to carry them out. An advanced directive must be: (1) written; (2) signed by you while you are still able to make and communicate health care decisions; (3) witnessed by two qualified adults; and (4) notarized. A qualified witness is a competent adult who sees you sign, is not a relative, and will not inherit anything from you upon your death. The witness cannot be your physician, a licensed employee of your physician or any paid employee of a healthcare facility where you live or that is treating you.

Who should I talk to about an Advance Directive? You should talk to those closest to you about an advance directive and your feelings about the health care you would like to receive. Your physician or health care provider can answer medical questions. A lawyer can answer questions about the law. Give copies to your family, your physician or mental health providers, your health care agent(s), and any family members or close friends who might be asked about your care should you become unable to make decisions. Please furnish Aeroflow with a copy of your advance directives.

Appendix B

Infection Control

It is the policy of Aeroflow to conform to the acceptable standards of infection control pertaining to equipment and home health services issued by the Centers for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA), in order to ensure the safety of clients/patients and employees, and also to ensure quality client/patient service

How infections occur and are spread: An infection occurs when germs enter the body, increase in number, and cause a reaction of the body.

Three things are necessary for an infection to occur:

1. Source: Places where infectious agents (germs) live (e.g., sinks, surfaces, human skin)
2. Susceptible Person: A person with a way for germs to enter the body
3. Transmission: A way germs are moved to the susceptible person 

There are a few general ways that germs travel in healthcare settings:

• Through contact (i.e., touching)
• Sprays and splashes (when an infected person coughs or sneezes)
• Inhalation (when germs are aerosolized in tiny particle)
• Sharp injuries (i.e., when someone is accidentally stuck with a used needle or sharp instrument)

How to prevent infection:

• Wash your hands often
• Get vaccinated
• Get vaccinated and use antibiotics sensibly
• Stay at home if you have signs and symptoms of an infection.
• Cover your mouth and nose
• Disinfect the 'hot zones' in your residence - the kitchen and bathroom
• Don't share personal items
• Make sure health care providers clean their hands or wear gloves
• Clean equipment and supplies regularly
• Replace equipment on a regular schedule. Contact Aeroflow (888-345-1780) when your supplies are to be thrown out.

Symptoms of Hepatitis infection: Extreme fatigue, mild fever, headache, loss of appetite, nausea, and vomiting. Symptoms of Tuberculosis (TB) infection: fatigue, anorexia, productive cough, coughing up blood, weight loss, loss of appetite, lethargy, weakness, night sweats, chills, flu-like symptoms and fever. Some people with TB may show no symptoms. NOTIFY YOUR HEALTHCARE PROVIDER IF YOU FEEL YOU HAVE BECOME INFECTED.

.

Appendix C

How to Make Your Home Safe for Medical Care

At Aeroflow, we want to make sure that your home medical treatment is done conveniently and safely. Many of our clients/patients are limited in strength or unsteady on their feet. Some are wheelchair- or bed-bound. These pages are written to give our clients/patients some easy and helpful tips on how to make the home safe for home care. Discuss these plans with your family members.

Fire Safety and Prevention

• Smoke detectors should be installed in your home: make sure you check the batteries at least once a year. If appropriate, you may consider carbon monoxide detectors as well. Ask your local fire department if you should have one in your home.
• Have a fire extinguisher in your home, and have it tested regularly to make sure it is still charged and in working order.
• Have a plan for escape in the event of a fire.
• If you are using electrical medical equipment, make sure to review the instruction sheets for that equipment. Read the section on electrical safety.

Electrical Safety

• Make sure that all medical equipment is plugged into a properly grounded electrical outlet.
• If you must use a three-prong adapter, make sure it is properly installed by attaching the ground wire to the plug outlet screw.
• Use only good quality outlet "extenders" or "power strips" with internal circuit breakers. Don't use cheap extension cords.

Safety in the Bathroom

• Use non-slip rugs on the floor to prevent slipping.
• Install a grab-bar on the shower wall and non-slip footing strips in the tub or shower.
• Ask your medical equipment provider about a shower bench you can sit on in the shower.
• If you have difficulty sitting and getting up, ask about a raised toilet seat with arm supports to make it easier to get on and off the commode.
• If you have problems sensing hot and cold, you should consider lowering the temperature setting of your water heater, so you don't accidentally scald yourself without realizing it.
  

Safety in the Bedroom

• It's important to arrange a safe, well-planned and comfortable bedroom since a lot of your recuperation and home therapy may occur there.
• Ask your home medical provider about a hospital bed. These beds raise and lower so you can sit up, recline, and adjust your knees. A variety of tables and supports are also available so you can eat, exercise and read in bed.
• Bed rails may be a good idea, especially if you have a tendency to roll in bed at night.
• If you have difficulty walking, inquire about a bedside commode so you don’t have to walk to that bathroom to use the toilet.
• Make sure you can easily reach the light switches, and other important things you might need throughout the day or night.
• Install night-lights to help you find your way in the dark at night.
• If you are using an IV pole for your IV or enteral therapy, make sure that all furniture, loose carpets, and electrical cords are out of the way so you do not trip and fall while walking with the pole.

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Appendix D

Emergency Planning

Every client/patient receiving care or services in the home should think about what they would do in the event of an emergency. Our goal is to help you plan your actions in case there is a natural disaster where you live and to try to provide you with the best, most consistent service we can during an emergency.

Know what to expect: If you have recently moved to this area, take the time to find out what types of natural emergencies have occurred in the past, and what types might be expected. Find out what, if any, times of year these emergencies are most prevalent. Find out when you
should evacuate, and when you shouldn't. Your local Red Cross, local law enforcement agencies, local news and radio stations provide excellent information and tips for planning.