Care Management Service Agreement

This Agreement is entered into on this day of:

by and between (hereinafter the “Client”)

and Pathways in Aging, LLC (hereinafter “Pathways”), wherein Pathways agrees to provide Services, as defined more fully below, to the Client or to

(hereinafter the “Care Recipient”), if different from the Client. Pathways, the Client, and the Care Recipient are collectively referred to herein as the “Parties.”

*The Services are described more fully in the applicable Addendum, attached hereto and made part of this Agreement.

 

Financial Responsibility

Client agrees to pay to Pathways the professional fees and all reasonable out-of-pocket expenses incurred in carrying out the Services for the Client or for the Care Recipient in accordance with the Fee Schedule attached hereto as Addendum D and made part of this Agreement.

 

Service Area

Services are provided throughout Northern Virginia and the Greater Seattle Area in Washington State. Client agrees that Pathways has no obligation under this Agreement to provide Services outside of these defined areas.

Driver’s Release

In the event that the Care Recipient requires transportation services by Pathways, the Care Recipient and/or the Client understands and acknowledges that Pathways, its employees and agents, are not liable for any injuries, damages, loss, or suffering (“injuries”) to the Client or the Care Recipient which result from the use of a vehicle by a Pathways employee, unless the injuries were the direct result of the Pathways employee’s intentional or negligent act or failure to act. This limitation on Pathways’ liability shall apply regardless of whether the vehicle is owned by the Care Recipient, the Client, a third party, or by Pathways, its employees or agents.

 

Service Hours

Pathways does not provide 24-hour emergency coverage. Although Pathways monitors its telephones and email after hours, and utilizes an answering service on weekends and holidays, Pathways does not guarantee a timely response outside of business hours Monday through Friday, excluding recognized public holidays. We encourage Client, Care Recipient and their families to maintain telephone or other contact information for emergency responders and other service providers.

Confidentiality and Liability

Pathways understands that any and all private information obtained about the Client and the Care Recipient and their family during the course of this Agreement (including but not limited to medical, financial, legal, or career) are strictly confidential and may not be disclosed except as required for purposes of carrying out the Services. By executing this Agreement, the Client and the Care Recipient consent to the release of information by Pathways so that Pathways, where necessary and appropriate, may act as an advocate for the Client and the Care Recipient to persons acting in official capacities, including but not limited to third party payers, law enforcement, or other health care or service providers involved in Client/Care Recipient’s care.


Pathways utilizes technology, including but not limited to, email, AI transcription, medical charting software, healthcare system portals, applications, HIPAA compliant fax, and cell phones, while providing the Services. Technology increases our efficiency and is a necessity in the modern health care profession. Although Pathways complies with best practices to minimize breaches of privacy, the use of such technology also comes with some risk. Client and Care Recipient agree that, in order to provide the best care possible in the most efficient manner available, Pathways may utilize the method of communication best suited to the task in any given circumstance. Client and Care Recipient agree to indemnify and hold harmless Pathways, its employees and agents, from any damage or injury caused by the necessary use of this technology.

Client agrees and understands that as part of the Services provided, Pathways may refer the Client and/or the Care Recipient to third-party service providers. While Pathways strives to refer to the highest quality providers, it cannot guarantee, and expressly does not assume liability for, the actions of third-party service providers. The Client/Care Recipient is responsible for independently investigating and evaluating programs and providers, and is solely responsible for fees or charges imposed by third parties. The Client, the Care Recipient, and their heirs,
successors and assigns, collectively and individually, indemnify and hold harmless Pathways, its employees and agents, from and against all claims, damages, suits, charges, liabilities, costs and expenses (including legal fees and expenses) arising as a result of negligent, intentional, or other acts of independent contractors or their representatives. Any person signing this agreement as a Client will be bound by its terms, and is jointly and severally liable with the Care Recipient to Pathways.

 

Email Newsletter

Pathways includes clients, care recipients, and designated family care team members on email newsletters. Client and Care Recipient consent to the distribution of email newsletters to themselves and designated family members. Client, Care Recipient, and designated family members may unsubscribe from

Term and Termination

The term of this Agreement is one year from execution of the Agreement. This Agreement shall renew automatically for additional one-year terms unless terminated. Client/Care Recipient may terminate this Agreement by giving written notice 30 days in advance of the end of a term year.

Pathways may terminate this Agreement at any time by giving written notice to the Client and/or the Care Recipient. Pathways may terminate this Agreement for any reason, including but not limited to the following, which shall constitute termination for cause:

-Pathways is unable to provide appropriate Services that meet the needs of the Client and/or the Care Recipient;

-The Client/Care Recipient has achieved his or her goals and the Services are no longer needed;

-The Client/Care Recipient is unwilling to participate appropriately in the Care Plan;

-The Client/Care Recipient has created an unsafe living environment or an unsafe environment for Pathways to provide the Services;

-The Client/Care Recipient is unwilling or unable to pay Pathways the fees for the
Services required for his or her care.

In the event Pathways terminates this Agreement for cause, Pathways will allow sufficient time and support to transition the Client/Care Recipient to alternate services.

 

Entire Agreement

This Agreement constitutes the entire agreement of the Parties, and supersedes any and all previous understanding, agreements, arrangements, or discussions, whether written or oral, between the Parties relating to the matters pertaining hereto. There are no collateral agreements, representations, or guarantees, whether oral or written, unless attached hereto and specifically made part of this Agreement.

Arbitration

Any and all disputes, claims or controversies arising out of or relating to this Agreement, and any and all other disputes, claims or controversies by and between the Client and Care Recipient, on the one hand, and Pathways and/or its employees, agents, clients, customers, and vendors (collectively, the “Pathways Parties”) on the other hand, shall be resolved exclusively through final and binding arbitration, and not by way of a court or jury trial. This agreement to arbitrate shall be governed, construed and enforced pursuant to the Federal Arbitration Act; however, any
claims submitted to arbitration regarding other terms of this Agreement shall be governed by the laws of the Commonwealth of Virginia or the State of Washington, depending on the place in which the Services were performed, respectively. In arbitration, each party shall pay the fees for his, her or its own attorneys, subject to applicable law and/or any remedies to which that party may later be entitled under applicable law. By signing this Agreement, Pathways Parties, the Client and the Care Recipient waive any rights to have such dispute tried by a judge or jury, or to
appeal any findings of the arbitrator except as may be vacated under the Federal Arbitration Act.

 

Severability

If any part of this Agreement is determined to be void or invalid, the remaining provisions will continue in full force and effect.

 

Governing Law

The validity and construction of this Agreement will be governed by and determined under the laws of Commonwealth of Virginia or the State of Washington, depending on the place in which the Services were performed, respectively.

The Parties acknowledge that they have read, understand and accept the terms of Service contained within this Agreement, and that the Client assumes all financial responsibility for payment of Services on behalf of the Client or the Care Recipient. This Agreement may be signed by any Party by use of an electronic signature, and the entered name of the Party, or any other electronic sound, symbol, or process attached to or logically associated with a record and executed or adopted by a person with the intent to sign the record, shall constitute a valid signature.

 

ADDENDUM A
CARE MANAGEMENT SERVICES

Care Management Services include all necessary and appropriate medical and non-medical services that promote the care and well-being of our Care Recipients. The needs of each Care Recipient are individual to them, and the Services provided by Pathways will vary depending on each individual’s needs. The Care Management Services described in this Addendum are examples of the Services Pathways provides, but are not intended to be an exhaustive list.

 

Information Gathering and Research. Time spent researching potential resources, as well as contact with current care providers. This includes gathering information from doctors, lawyers, non-family caregivers, home care agencies, community agencies, residential facilities, and other community resources. Information gathering and research may be conducted both at the outset and during the course of care management for the Client/Care Recipient.

Assessment and Care Coordination. Providing direct care to the Client/Care Recipient, to include: conducting assessments of the Client/Care Recipient’s health and living conditions; providing recommendations for appropriate services by Pathways and other health care providers; arranging for and monitoring the services to assure appropriate care for the Client/Care Recipient; assisting with the filing of applications for programs identified to be beneficial to the Client/Care Recipient, and to assist in re-applying for identified programs to provide for continuing eligibility; maintain contact with the Client, the Care Recipient, and any
designated family members, through in-person meetings, telephone, text, email, and written correspondence; undertaking errands for or with the Client/Care Recipient, including shopping; travel time to conduct all Care Management Services; provide reports to all parties involved in the care of the Client/Care Recipient; and provide all administrative support in connection with the Care Management Services.

Medical or Behavioral Health Visits. Attending Client/Care Recipient medical and
non-medical professional appointments; communicating with the provider of medical and non-medical services; conducting any tasks necessary as a follow-up to such appointments.

Consulting Specialists and Advocates. When necessary, consult with and refer to medical and non-medical professionals to assist Client/Care Recipient with complex biopsychosocial needs and legal and financial issues that arise in the course of care, and to advocate for them concerning the proper course of action.

Coaching and Counseling. Provide education and support for caregivers, family members andfriends about effective communication, disease specific care, preventing caregiver burnout, conflict management, and other topics as needed.

 

ADDENDUM B
HEALTH CARE AGENT SERVICES

Nomination. Pathways in Aging agrees that Heather Suri, Founder and CEO, and a
designated Pathways employee, may be named as primary and secondary Health Care Agents under a Health Care Power of Attorney/Advance Medical Directive. Client/Care Recipient agrees to provide Pathways with any originals or copies of the appropriate document, including any amendments thereto, and to inform Pathways of any amendments to or revocation of the appropriate document as soon as is practicable. NOTE: The appointment of Heather Suri and Pathways as Health Care Agent must be effective immediately. Pathways does not agree to be named Health Care Agent under a “springing” power of attorney or any document in which the appointment becomes effective only upon proof of incapacity.

Clients/Care Recipients receiving Health Care Agent Services must be enrolled for Care Management Services by Pathways or in the Plan Ahead with Pathways program.

Unless otherwise specifically provided for in the Health Care Power of Attorney/Advance Medical Directive, Pathways may provide the following Services:

Primary Responsibilities. Determine and implement all actions necessary for the
Client/Care Recipient’s personal care, residential placement, and medical treatment, including the items specifically mentioned in the applicable document in accordance with the wishes of the Client/Care Recipient; communicate with the Client/Care Recipient to understand their wishes and preferences regarding health care matters; abide by all applicable federal and state statutory and regulatory requirements governing health care powers of attorney/health care directives and health care agents.

Medical Records. Client/Care Recipient agrees that Pathways will have access to all medical information and records maintained by Client/Care Recipient’s health care providers. Client/Care Recipient agrees that Pathways may disclose medical and related information concerning Client/Care Recipient’s treatment to appropriate health care providers, and may admit or transfer Client/Care Recipient to such hospitals, hospices, or treatment facilities as Pathways determines to be in Client/Care Recipient’s best interests.

Releases. Client/Care Recipient agrees that Pathways may grant releases to health care providers from all liability for damages suffered by Client/Care Recipient by such health care providers who act in reliance on instructions given by Pathways. Client/Care Recipient agrees that Pathways may sign Refusal to Permit Treatment and Leaving Hospital Against Medical Advice, or similar documents, as well as any necessary waivers of or releases from liability required by any hospital or physician to implement my wishes regarding medical treatment or nontreatment.

Anatomical Gifts. Client/Care Recipient agrees that Pathways may make anatomical gifts on behalf of Client/Care Recipient for any purpose, including transplantation and medical research. Pathways may execute the papers necessary to carry out these gifts.

Autopsy and Disposition of Remains. Client/Care Recipient agrees that Pathways may authorize an autopsy and direct the disposition of my remains in accordance with any instructions provided by Client/Care Recipient either orally or in writing.

Enforcement by Pathways. Client/Care Recipient agrees that Pathways may, at the expense of the Client/Care Recipient, take all actions necessary to enforce the Health Care Power of Attorney/Advance Medical Directive in any court of competent jurisdiction, including actions seeking a declaratory judgment, a preliminary or permanent injunction, and actual and punitive damages, for any matter associated with the application or enforcement of the document or Pathways ability to act in accordance therewith.

 

ADDENDUM C
GUARDIANSHIP SERVICES

Nomination. Pathways in Aging agrees that Heather Suri, Pathways’ Founder and CEO, and a designated Pathways employee, may be named as primary and secondary Guardians, respectively, for the Client/Care Recipient, in accordance with applicable state laws governing the appointment of guardians for incapacitated adults.

Primary Responsibilities. Act in a fiduciary capacity on behalf of the Client/Care Recipient in accordance with a court order naming Pathways/Heather Suri as guardian. Pathways/Heather Suri agrees to act in the Client/Care Recipient’s best interests, and will abide by all applicable state laws and regulations governing the duties and responsibilities of guardians. Such responsibilities include, but are not limited to: maintaining contact with the Client/Care Recipient to stay informed regarding the Client/Care Recipient’s needs; visits to Client/Care Recipient by the Guardian or an employee designated by Pathways; and obtaining the services of attorneys, health care providers, advisors, or other skilled professionals to provide Client/Care Recipient with appropriate care.

Consent to Petition. The Client/Care Recipient agrees that Pathways may file a petition with a court of competent jurisdiction to name Pathways/Heather Suri as the Client/Care Recipient’s guardian. Client/Care Recipient agrees that Pathways/Heather Suri may hire and employ attorneys or other professionals, and Client/Care Recipient’s expense, to file such petition and manage the petition to a successful conclusion.

Conservatorship Not Applicable. The Client/Care Recipient agrees that Pathways/Heather Suri will not be named, and will not act as, Client/Care Recipient’s conservator. As such, Pathways/Heather Suri will not control or have any fiduciary responsibility over Client/Care Recipient’s estate or financial affairs. Pathways/Heather Suri agrees, however, to use their best efforts to work in conjunction with any conservator named for Client/Care Recipient, or any other persons who have control or fiduciary responsibility over Client/Care Recipient’s estate and finances.

 

ADDENDUM D
FEE SCHEDULE

Monthly Administrative Fee: $69 Billed monthly to all Clients/Care Recipients.

Consultation: $150 This fee covers up to one hour of consultation in the office, by phone, video conference, or other virtual communication.

Care Management Services: $195 per hour (billed in 6-minute increments) Billable time for Care Management Services includes all time spent by the Care Manager on behalf of the Client and Care Recipient. During the first month of service, an assessment and care plan are developed. Client and Care Recipient understand that a minimum of one hour per month of personal contact with the Client and/or Care Recipient is necessary in the months following the initial assessment to have current information allowing the Care Manager to provide quality Care Management Services and to reduce the likelihood of a crisis.

Assistant Care Manager Services: $80 per hour (billed in 6-minute increments) Based on availability and need.

Plan Ahead with Pathways: $500 This fee covers the initial interview for Plan Ahead with Pathways Services. NOTE: This program includes virtual interviews. Biannual or quarterly interviews to maintain our records are required for this service, and those interviews are billed at the Care Management Rate. Any Care Management Services requested between biannual or quarterly interviews are also billed at the Care Management Rate.

Health Care Agent Services: $195 per hour (billed in 6-minute increments). Pathways will specify at the time of billing whether hourly services were performed for Care Management or Health Care Agent Services; clients will not be double-billed.

Guardianship Services: $195 per hour Fees for guardianship services may be subject to a fee schedule approved by the Commissioner of Accounts or other presiding court official of the governing jurisdiction.

After Hours Services: $250 per hour (billed in 15-minute increments) Service hours are Mon-Fri, 8:30am-5:30pm. All Services, including but not limited to unplanned phone calls, crisis intervention, and other Client/Care Recipient contact, which are provided on weekends, holidays or between the hours of 5:30pm and 8:30am the following day, are billed at the After Hour Services rate, and will be charged for a minimum of 15 minutes of billable time.

Mileage: The amount per mile allowed in the Internal Revenue Service’s standard mileage rate for business transportation, as adjusted by the IRS from time to time, assessed for all travel associated with providing the Services.

Invoicing and Payment Terms

Monthly invoices will include all reasonable out-of-pocket expenses incurred on behalf of the Client/Care Recipient.

Services are billed monthly, with payment due and payable upon receipt. Pathways accepts payment be check or credit card only.

Invoices not paid within thirty (30) days are subject to a late fee of 1.5% per month for every month an invoice remains unpaid, and may result in cessation of all Services.

Client/Care Recipient will be charged for a canceled appointment unless Pathways is given a minimum of 24 hours notice prior to cancellation.

Upon termination of this Agreement by either Party, all outstanding invoices and fees billed for work performed prior to termination are due immediately.

Fees may be revised from time to time by Pathways at its sole discretion. Clients/Care Recipients will be provided notice of any fee changes thirty (30) days prior to changes in the Fee Schedule, and a revised Fee Schedule will be provided to the Client/Care Recipient. The Client and the Care Recipient agree that any revised Fee Schedule will be deemed agreed to and made part of this Agreement at the time the Fee Schedule is revised.