2019-12-16_jpatchett_Client Intake Kit 2.1.H - Updated.docx

HC of Virginia, Inc. Client Agreement Version 2.1.H

CLIENT NAME: _______________________________________________________________

This Client Agreement (“Agreement”) is entered on ____________________, 20______ (the “Effective Date”) by and between the Client(s), the Client’s Authorized Agent(s) (as defined below, if applicable) and HC of Virginia, Inc. (“Company” or “HCVA”).

CONSENT TO RECEIVE SERVICES:

Company has been engaged and authorized by Client to dispatch home attendants (“Attendant(s)”) to the Client’s residence or other facility identified by Client for the provision of personal care services.  Client understands that HCVA is a non-medical home care organization that does not provide medical services or treatments; and that Attendant(s) cannot provide medical services.  Client waives any issues of medical liability on the Company’s part for the provision of non-skilled personal care services. A general description of services to be performed is outlined as a part of the initial assessment and updated as modifications become necessary.

HOURLY RATES:		_______

The rate for Client’s hourly care is $26 per hour.  If Client and Company mutually agree that a change in their rate is required due to significant change in Client’s care needs, type or level of care, the new rate will become effective on the date of the mutual agreement.  For all other rate increases not associated with the type or level of care, Client will receive 30 days written note from the Company before rate increase is implemented.

INITIAL CARE SCHEDULE:

Personal care services by Attendant(s) will tentatively start on __________________________

Proposed initial weekly schedule: ______________________________________________________________________________

RECORD KEEPING:

Client’s ongoing schedule will be adjusted based on the client’s care needs and preferences of the Client.  Attendant(s) are required to clock in and review their daily tasks on the phone when they start their shift, and again when they end their shift.  Client agrees that enough time to complete these activities shall be provided during each shift worked and authorizes Attendant to use Client’s home phone if needed for these tasks.

CHANGES TO SCHEDULES:

Notice of schedule or changes in the amount of care may be conveyed by either party by phone, email, or in writing.  All schedules for personal care services must be arranged between the Client and HCVA, not directly with the assigned Attendant(s).  Client agrees not to not alter, eliminate, or add schedules directly with their Attendant(s).  Failure to observe HCVA’s scheduling requirements may result in overtime rates charged to the Client and/or missed shifts due to miscommunication.

PAYMENT OF INVOICES:  Invoices are sent to Client or Client’s Authorized Agent weekly and are due upon receipt.  Client agrees invoices not paid within four weeks shall be considered past due and in default, and a penalty of 10% shall be added each invoice. Invoices in default will also be subject to collections procedures and legal action by the Company.  Collection or legal expenses incurred on invoices in default by the Company shall be paid for by the Client and Client hereby accepts responsibility for same.  If services are terminated by either party payment for all services will immediately become due.  Company reserves the right to draft the Client’s account or credit card for all payments due on the date of notice of termination.  After the termination of services, by either party, the Client and the Company agree to a limit of a six-month period to identify and resolve any and all billing, payment or deposit discrepancies.

LONG TERM CARE INSURANCE:  Most long-term care (“LTC”) insurance companies will pay for the Company’s services; however, their contract is with the Client and not the Company so HCVA cannot guarantee this.  Upon request, the Company will assist the Client in processing LTC claims. This offer of this assistance does not relinquish the Client of their responsibility to personally pay their invoices in a timely manner.

OBSERVED HOLIDAYS:  Current HCVA Observed Holidays at the time of this agreement are Easter, President’s Day, Martin Luther King Day, Memorial Day, President’s Day, Independence Day, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day, New Year’s Eve, and New Year’s Day.  Company reserves the right to adjust observed Holidays on an annual basis. The Company will pay Attendants and charge Client one and one-half times the normal rate for services rendered on observed holidays.   Client can decline holiday service by notifying Company at least seventy-two (72) hours in advance

MILEAGE CHARGES:

Client agrees to pay the Company (for reimbursing Attendant(s)) for the automobile traveling expenses incurred by Attendant(s) in the performance of their duties.  HCVA will invoice Client for these expenses.  If the Client’s automobile is used, there will be no additional mileage charge.  The current mileage reimbursement rate is .45 cents per mile. This amount shall be adjusted annually and communicated to Client.

REGULATORY SURCHARGE:

The home health care industry has faced numerous regulatory challenges and burdens, most importantly the Affordable Care Act Employer Mandate and Employer Shared Responsibility Payment, the repeal of the Home Care Companionship Exemption under the Fair Labor Standards Act, and significant expansion of the administrative requirements of timekeeping rules for home care workers. The net effect of these changes has been a significant increase in the Company’s tax, labor, health insurance and administrative costs.   HCVA has absorbed most of these costs, but we ask all HCVA Clients to help the Company offset these costs by paying a 1.5% Regulatory Surcharge on each weekly invoice.

SECURITY OF ATTENDANTS:

Client and Client’s Authorized Agent always agree to treat HCVA Attendant(s) with respect and professionalism, and not to threaten any act of violence or physical harm to any Attendant or to intentionally place any Attendant at risk of bodily harm or injury.  Attendants are instructed by HCVA not to put themselves at risk of bodily harm or injury in the provision of personal care services for the Client.  Thus, Client understands and acknowledges that, if an Attendant reasonably feels threatened and/or in physical danger while performing personal care services, the Attendant is entitled to leave Client’s premises without exposing the Company to any liability.

AGREEMENT NOT TO HIRE ATTENDANTS:

Client understands that HCVA invests a significant amount in the process of recruiting, screening, hiring and training each Attendant, and that each Attendant is a significant asset of the Company.  Client further understands that each Attendant working for the Company is prohibited from accepting private employment from Client directly (or through another organization/agency) while said Attendant is employed by the Company, as well as for a period of three (3) years following the Attendant’s end of employment with Company (for any reason).  Accordingly, should Client attempt to employ any of Company’s Attendants directly, such employment will be deemed in violation of this agreement and shall pay Company a one-time placement fee of FIFTEEN THOUSAND DOLLARS ($15,000) for each Attendant client employs.  This provision applies regardless if Client, Client’s Agent, Client’s Power of Attorney, another Home Care Organization or any other person employs Attendant to provide services for the Client.

SECURITY OF MONEY AND VALUABLES:

Client agrees to secure all valuables, jewelry, money, credit cards, ATM/Debit cards, checks, online accounts such as PayPal, and financial instruments (“Money and Valuables”) that must be kept in the Client’s residence (or other location where personal care services are provided) during any time that HCVA Attendant(s) are providing care to Client.  Client agrees not to provide any Attendant with possession of Client’s Money and Valuables, or to grant access or disclose to any Attendant, Client’s social security number, bank / online / ATM/Debit/credit card account information or passwords for any reason, unless specifically agreed to and directed by HCVA.

LIMITATION OF LIABILITY:

In recognition of the relative risks and benefits of services provided by the Company, Client agrees to the fullest extent of the law, to limit the liability of Company and hold the Company harmless for any and all claims, losses, costs, damages of any nature whatsoever or expense in any manner related to or arising out of the provision of personal care services by the Company.  This includes all attorneys’ fees, expert witness fees, and all costs, so that the total aggregate liability of the Company to the Client shall not exceed the total fees payable to the Company by the Client for services rendered. Further, Client releases Company from all claims and liability which the Client may acquire by reason of damage, loss, injury and/or suffering which arises from the operation and/or use of a vehicle by an Attendant, regardless of the ownership of the vehicle.  Client also agrees to hold the Company harmless for any intentional acts of HCVA Attendants that are outside the course and scope of their duties to provide personal care services to Client.  This limitation does not relieve the Company of any responsibilities, obligations, and liability insurance/bonding insurance mandated by the Virginia Department of Health for Licensed Virginia Home Care Organizations.

FALL RISK:

Client understands that with any level of care Client may potentially experience a fall. Client understands that if Client has dementia, Alzheimer’s or any condition that causes mental confusion, Client is at high risk for experiencing falls and related physical injuries.  The Company will take reasonable precautions to minimize fall risks, especially if the Client has dementia or Alzheimer’s, but the Company cannot guarantee that falls or related injuries will not occur.  Client agrees to limit the liability of the Company and hold the Company harmless for all claims, losses, costs, damages or expense of any nature whatsoever in the event of a fall.

CLIENT TERMINATION OF SHIFTS OR AGREEMENT:

Client can terminate service with Company at any time by providing at least 24 hours’ notice for hourly shifts and 48 hours for 24-hour live-in shifts.  The notice must be provided to Company Management in writing, through email or by calling the 24 hour on-call number speaking directly to the on-call manager.  If Client dismisses Attendants prior to the end of their scheduled shifts, or if Client fails to cancel scheduled Attendant’s shifts less than the required 24- or 48-hours’ notice, Client will be required to pay a cancellation charge equivalent to the hourly rate for the entire scheduled canceled shift.

HCVA TERMINATION OF SERVICES:

HCVA has the right to terminate services in its sole discretion without cause by providing 5 days’ notice to Client or Client’s Authorized Agent. Additionally, HCVA reserves the right to terminate services immediately for: failure of Client to pay invoices timely; failure of Client check, ACH or credit card to clear when applied to invoices by HCVA, engaging in conduct or any act of violence, physical harm toward an Attendant or intentionally placing any Attendant at risk of bodily harm or injury,  verbal harassment by Client towards HCVA employees or violation of Client’s Agreement Not to Hire Attendants.

ENTIRE AGREEMENT:

This Agreement (including all pages and addendums) constitutes the entire agreement between the parties and supersedes all prior oral and/or written agreements between the parties with respect to the subjects covered in this Agreement.

ELECTRONIC SIGNATURES:

Client agrees and acknowledges that his or her electronic signature, along with electronic signatures by Company employees, is the legal equivalent of a manual signature by either party to this Agreement.  Client expressly authorizes either party to utilize electronic signatures for validation of Client agreements, validation of care logs, and for daily timesheets by Company employees, along with other forms which require a signature by either party.

CERTIFICATION OF AUTHORITY:

If someone other than Client(s) (hereafter referred to as an “Authorized Agent”) shall be designated to direct the care activities, pay bills, accept notices or make decisions on behalf of the Client, that Authorized Agent shall sign this Agreement on behalf of Client(s).  Said Authorized Agent hereby certifies that he/she has the authority to enter into this Agreement on behalf of said Client(s) and bind Client(s) to the terms hereof. Authorized Agent agrees to provide, promptly on request, the Company with documentation or other information reasonably necessary for the Company to ascertain the extent of the Authorized Agent’s authority.   Furthermore, said Authorized Agent accepts full responsibility for the payment of all fees incurred for services rendered by HCVA to Client(s).

Client or Authorized Agent   - Printed Name: _____________________________________________

Capacity of Authorized Agent in Relation to Client: _________________________________________

Client or Authorized Agent – Signature:   __________________________________________________

HCVA Representative – Signature:  _________________________________________________

Date Signed: _________________________________

Client Consent to Provide Medical Information

I,  ________________________________________(Client or Client’s Authorized Agent) authorize any medical provider or insurance company to provide information about ___________________________________________________(Client’s) medical condition and status to managers and employees of HC of Virginia, Inc., who are designated to provide personal care services on my behalf.

Other Individuals authorized by Client or Client’s Authorized Agent to receive information or make decisions in relation to Client’s care, home, schedule, or invoices:

___________________________________________________     ________________________

Signature of Client/Authorized Agent                                               Date

Responsible Party Information

Name: ________________________________________________________________________

Address: ______________________________________________________________________

Home Phone: ______________________________       Cell Phone: _______________________

E-Mail Address: ________________________________________________________________

Long Term Care Insurance

Insurance Carrier: _______________________________________________________________

Policy#: __________________________________________     Claim #: __________________

SSN: ____________________________________________     DOB: _____________________

Address listed on policy: _________________________________________________________

Svc. Center Phone #: ______________________ Svc. Center Fax #: ______________________

Notice of Client’s Bill of Rights and Confidentiality

The right to be treated with courtesy, consideration and respect, and is assured the right to privacy;

The right to be assured confidential treatment of his/her medical and financial records as proved by law;

The right to be free from mental/physical abuse, neglect, and property exploitation;

To be assured the right to participate in the planning of the Client’s home care, including the right to refuse service;

The right to be served by individuals who are properly trained and competent to perform their duties;

The right to voice grievances and complaints related to organizational services without fear of reprisal;

The right to be advised, before care is initiated, to the extent to which payment for the home care organization services may be expected from federal and state programs, and the extent to which payment may be required from the Client;

The right to be advised orally and in writing of any changes in fees for services that are the Client’s responsibility. HCVA shall advise the Client of these changes as soon as possible, but no later than 30 calendar days from the date it became aware of the change;

The right to be provided with advance directive information prior to start of service; and

The right to be given at least five days written notice if HCVA decides to terminate services.

CLIENT RESPONSIBILITIES

To provide accurate and complete medical and financial information at all times;

Notify HCVA of any change in situation that will impact the agreed upon services Client is receiving. Notice must be made at least 24 hours in advance of scheduled service; otherwise Client will be subject to a fee equivalent to the previously scheduled shift.

Notify HCVA of any problems, concerns or complaints with services and call the Virginia Department of Health Hotline with any unresolved complaints.

Comply with care that was jointly developed for Client.

Notify HCVA of any Advance Directives or changes to these documents.

Request information and ask questions.

Provide and maintain a safe home environment for all Attendants.

STATEMENT OF CONFIDENTIALITY

At HCVA, all Client materials are kept confidential. Information will not be released without Client consent. Exceptions to this are as follows:

Subpoenaed by a court of law to testify in a matter.

Revelation that a Client has intent to harm oneself or someone else.

Reason to suspect that a Client or another person will harm oneself or someone else.

If Company representatives or employees must testify in court, HCVA will make reasonable efforts to disclose to Client, in advance, their expected testimony.  All staff members of HCVA are required to comply with this same policy and if it is violated, appropriate corrective action will be taken.

I HAVE READ THE ABOVE, ASKED ALL THE QUESTIONS DESIRED, AND UNDERSTAND AND AGREE.

Client or Authorized Agent   	Date      	Capacity of Authorized Agent in Relation to Client

Medication Management

HC of Virginia, Inc. is a non-medical home health care organization. Our home care license is issued through the Virginia Department of Health. Per our license, our Attendants are permitted to administer medications a client would typically self-administer in their own home. For Attendants to assist with administration, a responsible party must first organize the medications and provide administration instructions.   Please choose one of the following options for organization of medications:

___	Client does not need assistance with managing their medications and will administer and manage their own medications.

___	Client needs assistance with managing and their medications. A family member or other medical professional will manage and organize the medications on behalf of the senior/client. HCVA will administer medications based on the management and instructions of Designated Person:

Designated Person Organizing Medications:

Name: __________________________________________________

Phone Numbers: __________________________________________

Relationship to the client: ___________________________________

___	Client/Authorized Agent will contract with HCVA Manage Staff to organize/manage their medications for a rate of $__________ per visit. The number of charged visits will be determined by HCVA based on the requirements to accurately and consistently organize Client’s medications.

________________________________________              ______________

Signature			                                 Date

_________________________________________

Capacity of Authorized Agent in Relation to Client

Payment for Services

The services offered through HC of Virginia, Inc. (“HCVA” or the “Company”) are will be billed on a weekly basis.  Please select your method of payment:

I hereby authorize HC of Virginia, Inc. hereinafter called HCVA, to initiate debit entries to my account as indicated above at the depository, financial institution or credit card named above, and to debit the same to such account.  I understand the amount charged to my account will be reflected on my bank or credit card statement. The amount charged is based on services requested by me and prices stated by HCVA. I acknowledge that the origination of transactions to my account must comply with the provisions of U.S. law.  I authorize the above method of payment to be electronically credited and debited by HCA Virginia on a recurring weekly basis. This authorization is to remain in full force and effect until HCVA has received verbal or written notification from me of its termination in such time and in such manner as to afford HCVA and Depository a reasonable opportunity to act on it. This authorization may only be modified by contacting HCVA at (804) 741-0009 or (757) 220-3151 Monday – Friday between the hours of 9:00am and 4:00pm.

Signature of Client or Authorized Agent: _______________________________________________

E-mail		__________________________________________________________________________                         (Please Print)

New Client Information

SCHEDULING, BILLING, AND AFTER-HOURS CALLS

All matters concerning your billing and schedule should be communicated directly with our office. Our telephone number is (757) 220-3151 or (804) 741-0009. We are on call 24 hours a day. If it is after business hours, please dial option 0 to immediately reach the on-call manager.

ATTENDANT CHECK-IN/CHECK-OUT

We use an automated check-in/check-out system that is based upon recognition of your home phone number or the Attendant’s cell phone number. Your Attendant(s) will ask you to use your phone to call a toll-free number when they arrive and whey they depart.

The Attendant(s) will also report any mileage for transportation they have provided on your behalf using their personal vehicle during the check-out process. Mileage charges will be added as a separate line item on your weekly invoices.

MONEY AND VALUABLES

Never give your Attendant cash, credit cards, ATM/Debit cards, PIN numbers, passwords, checks, bank account, online payment or credit card account information, or other monetary sources.

Please make prior arrangements with the office if there is an important need to have your Attendant make a purchase on your behalf. We will provide the Attendant with instructions on how to make the purchase.

Never share your social security number, insurance policies, banking or credit card information, or related financial information with your Attendant(s).

Make sure that all your valuables and personal information are in an easy to remember, discreet and safe location. If you have anything of exceptional or sentimental value, please put it in a safe location (preferably locked) or give it to a family member. If there are no other options and the item must be prominently displayed in your home, please instruct your Attendant not to touch it.

Make sure you have an agreed upon location to store hearing aids, glasses, dentures or anything else of value in daily use.

We value our relationship and want to ensure that you are completely satisfied with the services we provide. If at any time you feel there, we can do to improve our service, please do not hesitate to call our management team at (757) 220-3151 or (804) 741-0009.

Local Area Ombudsman:

Counties: Charles City, Chesterfield, Goochland, Hanover, Henrico, New Kent, & Powhatan 
City: Richmond

Senior Connections - The Capital Area Agency on Aging, Inc
Long-Term Care Ombudsman Program 
24 East Cary Street 
Richmond, Virginia 23219-3796
Phone: 804-343-3000 
FAX: 804-649-2258
Toll Free: 1-800-989-2286

Gretchen Francis - gfrancis@youraaa.org
Laurie Hunter - Lhunter@youraaa.org 
Michelle Williams - mwilliams@youraaa.org 
 http://www.seniorconnections-va.org/ (External Site)

Counties: Nelson, Albemarle, Louisa, Fluvanna, & Greene
City: Charlottesville

JABA
Long-Term Care Ombudsman Program 
674 Hillsdale Drive, Suite 9 
Charlottesville, Virginia 22901
Phone: 434-817-5222 
FAX: 434-817-5230

Sue Drumm & Tamar Goodale 
Sue Drumm - sdrumm@jabacares.org 
Tamar Goodale - tgoodale@jabacares.org 
http://www.jabacares.org/ (External Site)

Counties: Westmoreland, Northumberland, Richmond, Lancaster, Essex, Middlesex, Mathews, King & Queen, King William, & Gloucester

Bay Aging Long-Term Care Ombudsman Program 
P.O. Box 610 
Urbanna, Virginia 23175-06410
Phone: 804-758-2386 x 44
FAX: 804-758-5773

Ombudsman: Lisa Walker
Lisa Walker- lwalker@bayaging.org
 http://www.bayaging.org/ (External Site)

Counties: James City& York 
Cities: Williamsburg, Newport News, Hampton, & Poquoson

100 Parker View Court 
Williamsburg, Virginia 23188
Phone: 757-220-1577
FAX: 757-220-1577

Ombudsman: Carol Turner 
 bayaging_ombudsman@yahoo.com

www.bayaging.org (External Site)
http://www.paainc.org/ (External Site)

Counties: Southampton & Isle of Wight 
Cities: Franklin, Suffolk, Portsmouth, Chesapeake, Virginia Beach, & Norfolk

Hampton Roads Long-Term Care Ombudsman Program

Ombudsman & Volunteer Coordinator: Willie Alston
Willie Alston -  walston@ssseva.org (E-Mail)
Telephone: 757-222-4542

Counties: Dinwiddie, Sussex, Greensville, Surry, & Prince George 
Cities: Petersburg, Hopewell, Emporia, & Colonial Heights

Crater District Area Agency on Aging 
23 Seyler Drive 
Petersburg, Virginia 23805
Phone: 804-732-7020 
FAX: 804-732-7232

Ombudsmen: Carol Driskill & Fletcher Cooke
Carol Driskill -  cdriskill@cdaaa.org

Fletcher Cooke - fcooke@cdaaa.org
 http://www.cdaaa.org/ (External Site)

Complaint Unit Office of Licensure and Certification Virginia Department of Health

9960 Mayland Drive, Ste. 401

Henrico, VA 23233-1463

Fax Number: 1-804-527-4503

Hot Line Number: 1-800-955-1819

OLC-Complaints@vdh.virginia.gov

Name | Relationship | Access To Home | Care Directions | Medical Info | Schedule | Other

______ ACH Weekly Direct Billing – NO DEPOSIT OR FEE REQUIRED. | ______ ACH Weekly Direct Billing – NO DEPOSIT OR FEE REQUIRED. | ______ ACH Weekly Direct Billing – NO DEPOSIT OR FEE REQUIRED. | ______ ACH Weekly Direct Billing – NO DEPOSIT OR FEE REQUIRED. | ______ ACH Weekly Direct Billing – NO DEPOSIT OR FEE REQUIRED.

Depository Name (Financial Institution): | Depository Name (Financial Institution):

Branch: | Branch: | Branch: | Branch: | Branch:

City, State, Zip: | City, State, Zip: | City, State, Zip: | City, State, Zip: | City, State, Zip:

Routing Number: | Routing Number: | Routing Number: | Routing Number: | Routing Number:

Account Number: | Account Number: | Account Number: | Account Number: | Account Number:

_______ Credit Card Billing – NO DEPOSIT.  2% BANK FEE ADDED TO EACH INVOICE. | _______ Credit Card Billing – NO DEPOSIT.  2% BANK FEE ADDED TO EACH INVOICE. | _______ Credit Card Billing – NO DEPOSIT.  2% BANK FEE ADDED TO EACH INVOICE. | _______ Credit Card Billing – NO DEPOSIT.  2% BANK FEE ADDED TO EACH INVOICE. | _______ Credit Card Billing – NO DEPOSIT.  2% BANK FEE ADDED TO EACH INVOICE.

Payer Name:

Billing Address:

Billing Address:

Billing Address:

Credit Card Type:

Credit Card #:

Expiration Date: | CVV#

_____ Direct Payment via Manual Check – 2 WEEK DEPOSIT REQUIRED. | _____ Direct Payment via Manual Check – 2 WEEK DEPOSIT REQUIRED. | _____ Direct Payment via Manual Check – 2 WEEK DEPOSIT REQUIRED. | _____ Direct Payment via Manual Check – 2 WEEK DEPOSIT REQUIRED. | _____ Direct Payment via Manual Check – 2 WEEK DEPOSIT REQUIRED.

Client agrees to pay a refundable deposit of $_______________   at the time of signing this Agreement, which shall be applied to the final invoice and any outstanding invoices or fees at the end of services between Company and Client. In the case that Client has any outstanding balance for personal care related services rendered by the Company, but not limited to, outstanding cancellation charges, or Client directly employs an HCVA Attendant in violation of this Agreement, Client’s deposit may be withheld and applied against any such outstanding invoices or penalties. | Client agrees to pay a refundable deposit of $_______________   at the time of signing this Agreement, which shall be applied to the final invoice and any outstanding invoices or fees at the end of services between Company and Client. In the case that Client has any outstanding balance for personal care related services rendered by the Company, but not limited to, outstanding cancellation charges, or Client directly employs an HCVA Attendant in violation of this Agreement, Client’s deposit may be withheld and applied against any such outstanding invoices or penalties. | Client agrees to pay a refundable deposit of $_______________   at the time of signing this Agreement, which shall be applied to the final invoice and any outstanding invoices or fees at the end of services between Company and Client. In the case that Client has any outstanding balance for personal care related services rendered by the Company, but not limited to, outstanding cancellation charges, or Client directly employs an HCVA Attendant in violation of this Agreement, Client’s deposit may be withheld and applied against any such outstanding invoices or penalties. | Client agrees to pay a refundable deposit of $_______________   at the time of signing this Agreement, which shall be applied to the final invoice and any outstanding invoices or fees at the end of services between Company and Client. In the case that Client has any outstanding balance for personal care related services rendered by the Company, but not limited to, outstanding cancellation charges, or Client directly employs an HCVA Attendant in violation of this Agreement, Client’s deposit may be withheld and applied against any such outstanding invoices or penalties. | Client agrees to pay a refundable deposit of $_______________   at the time of signing this Agreement, which shall be applied to the final invoice and any outstanding invoices or fees at the end of services between Company and Client. In the case that Client has any outstanding balance for personal care related services rendered by the Company, but not limited to, outstanding cancellation charges, or Client directly employs an HCVA Attendant in violation of this Agreement, Client’s deposit may be withheld and applied against any such outstanding invoices or penalties.