Primary client
Secondary client (if applicable)
Introduction
The Client wishes to engage North Shore Home Care Service Inc. doing business as Hero Home Care ("Hero Home Care") to place a healthcare worker (the "Caregiver") in his or her home to provide the Services. Hero Home Care wishes to place the Caregiver in the Client's home to provide the Services in accordance with the terms and conditions of this Agreement.
Services and rates
Based upon the Client's unique circumstances, Hero Home Care will ensure that the Caregiver provides to the Client those of the following Services that are required by the Client in the sole discretion of Hero Home Care and defined in the Client's Care Plan ("Services"). In consideration for the Services, the Client will pay Hero Home Care as per Schedule A: Rates & Services of the Client Service Agreement.
Agreement and rate changes
Due to periodic assessments resulting in a change of the Client's Caregiver's work status and the Client's developing healthcare needs, the Client acknowledges and agrees that Hero Home Care may make changes to this Agreement and the rates set out herein upon giving the Client at least 14 days' prior written notice.
Cancellation of service
Hero Home Care requires a minimum of one (1) week's notice to cancel service, except for medical emergencies (see below). If less than 1 week's notice is given, Hero Home Care will bill the Client for their regular scheduled daily hours. If the Client's cancellation is due to a medical emergency (e.g. unexpected hospitalisation, death) the Client will only be billed one (1) day of service. For any of our monthly service fees (e.g. Management Fee, CuePath), Hero Home Care requires a minimum of one (1) month's notice to cancel.
Consent to treatment
The Client consents to treatment from Hero Home Care consistent with the agreed upon and established Services. The Client confirms that they have been informed and have participated in planning the care and procedure(s) to be carried out by Hero Home Care and signs this consent willingly and voluntarily. The Client understands that this consent is valid from the date of this Agreement and that they may withdraw their consent at any time by written notice to Hero Home Care. If they do withdraw their consent, the Services will not thereafter be provided. Hero Home Care may terminate this Agreement and stop providing the Services by providing the Client with 14 days' written notice.
Confidentiality/release of information
The Client gives consent for Hero Home Care to obtain/share medical information from/with their Physician and other healthcare professionals and to discuss a treatment plan only if needed as it pertains to the Services. All information obtained will be kept confidential and secure.
Caregiver reimbursements, gifts, and gratuities
The Client agrees to reimburse the Caregiver for any out-of-pocket expenses related to the care of the Client, including but not limited to, parking fees, tolls, groceries, and medication. These charges will be shown on the Client's invoice and are payable as part of the regular billing. The Client agrees to not reimburse caregivers directly for any of these expenses. The Client also agrees to not provide Caregivers with any gifts or gratuities. If the Client is pleased with the service, let both the Caregiver and Hero Home Care know and Hero Home Care will reward the Caregiver accordingly.
Third party invoicing
If you are approved for any type of third party benefits, Hero Home Care agrees to provide services as stipulated in those benefits and, depending on your third party benefit agreement, can submit invoices directly to the third party payer for processing. If you are beginning services prior to approval or if approval for third party benefits is denied, you are responsible to pay for services provided by Hero Home Care. We have the absolute right, without limitation or penalty, to stop all work in the event there are billing disputes and or delinquent charges due to us. Any deductibles owing by you to a third party payer that result in a deduction from Hero Home Care invoices will be invoiced to you directly and are then payable by you to Hero Home Care.
Non-solicitation of employees
The Client hereby agrees to not hire any Hero Home Care employees on a direct basis instead of obtaining their services through Hero Home Care (where these individuals are bonded and insured). Notwithstanding the foregoing, if you decide to forgo the security provided by Hero Home Care and use the services of a Hero Home Care employee of whom you have been introduced to by Hero Home Care, you agree to pay the sum of $7,500.00 per individual used to Hero Home Care as liquidated damages. Damages are payable immediately as compensation for our lost income and as reimbursement for our cost of screening and training our employees.
Indemnification clause
In no event shall Hero Home Care be liable under this agreement to you or any third party for any claim or damages including, without limitation, any consequential, indirect, incidental, exemplary, special, punitive or other damages, whether arising out of breach of contract, tort (including negligence), any other theory of liability or otherwise, regardless of whether such claim or damages were foreseeable and whether or not North Shore Home Care Services Inc. was advised of the possibility of such claim or damages arising out of or relating to a contagious disease including, without limitation to, the 2019 Novel Coronavirus (COVID-19), Middle East Respiratory Syndrome, Severe Acute Respiratory Syndrome, H1N1 influenza Virus, Avian Flu or any other similar illness or the transmission thereof.
Billing and payments
Hero Home Care will invoice the Client twice per month and will process payments via Pre-Authorised Debit (PAD) (see Schedule B). Hero Home Care assumes all responsibility with respect to the management of all remuneration for its Caregivers, including all customary and statutory withholdings including but not limited to all taxes, benefits and vacation pay. The Client's payments for Services are fully inclusive and you will be charged no additional fees except as expressly set out in this Agreement. Interest of 1.5% per month will be charged on accounts with unpaid balances over 30 days. Hero Home Care has the absolute right, without limitation or penalty, to stop all work in the event of billing disputes and/or where delinquent charges are due to Hero Home Care.
I have read this Agreement and agree to the above terms and conditions.
Hero Home Care representative
Client / responsible party
| ✓ | Service | Rate | Services included |
|---|---|---|---|
| Hero Support | $95.00 / month | Virtual Care Platform (Care2Talk), In-home reassessments, Dedicated Care Manager, Supervised training visits, Care Plan development & coordination, 24/7/365 emergency on-call, Scheduling & care coordination, Real-time caregiver tracking, Virtual Family Room access, Care updates & progress reports, Interdisciplinary medical team communication | |
| Caregiver | $55.00 / hour (3 hr min) |
Companionship care, Dementia support & Alzheimer's care, Grocery shopping, cooking & meal support, Homemaking, Personal care, Medication monitoring, Transportation & accompaniment, Overnight care (12 hour visits) | |
| Licenced Practice Nurse | $75.00 / hour (2 hr min) |
Wound care, Medication administration, Post-operative care, Wellness assessment, Medical reports, Family education & training, Medical equipment & supply coordination | |
| Registered Nurse | $100.00 / hour (2 hr min) |
||
| Advanced Care Management | $75.00 / hour (2 hr min) |
* Rates (except nursing services) are subject to GST
* Services provided on Statutory Holidays are billed at 1.5x
* Any travel using the caregiver's vehicle while on shift is billed at $0.75 per km
* Travel time and/or taxi service may be required for locations outside of regular public transit service
Bank account information
You (the "Payer") authorise North Shore Home Care Services Inc. doing business as Hero Home Care ("Hero Home Care") to debit the bank account identified above as required on the 22nd and the 7th of the month for Services provided by Hero Home Care, including all applicable taxes and fees and any amounts in arrears. If the 22nd or 7th falls on a weekend or a holiday, Hero Home Care will debit the Payer's account on the following business day. Hero Home Care must obtain authorisation for any other one-time or sporadic debits.
This authority is to remain in effect until Hero Home Care has received written notification from the Payer of its change or termination. This notification must be received at least ten (10) business days before the next debit is scheduled. The Payer has certain recourse rights if any debit does not comply with this agreement. To obtain more information on recourse rights, to obtain a sample cancellation form, or for more information on your right to cancel a PAD Agreement, the Payer can contact their financial institution or visit www.cdnpay.ca.
I have read this Agreement and agree to the above terms and conditions.
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