You have the right to:
• Impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical or mental disability, age, culture, language, socioeconomic status, sex, sexual orientation, and gender identity or expression.
• Be treated with courtesy and respect, with appreciation of individual dignity, and with protection of need for privacy.
• Effective communication that provides information in a manner you understand, in your preferred language with provisions of interpreting or translation services, at no cost, and in a manner that meets your needs in the event of vision, speech, hearing or cognitive impairments. Information should be provided in easy to understand terms that will allow you to formulate informed consent.
• Respect for your cultural and personal values, beliefs and preferences.
• Personal privacy, privacy of your health information
• Have your pain managed as individually and effectively as possible.
• Access and request copies of part or all of your medical record in accordance with law and regulation within a reasonable time.
• Access, request amendment to and obtain information on disclosures of your health information in accordance with law and regulation within a reasonable time frame.
• Have a family member, friend or other support individual notified of your admission and/or be present with you during the course of your stay, unless that person’s presence infringes on others’ rights, safety or is medically contraindicated.
• Receive prompt life-saving treatment in an emergency
• Refuse care, treatment or services in accordance with law and regulation and to leave the facility against advice of the physician and to be informed of the medical consequences of the consequences of such refusal.
• Have a surrogate decision-maker participate in care, treatment and services decisions when you are unable to make your own decisions.
• Receive information about the outcomes of your care, treatment and services, including unanticipated outcomes.
• Receive information about the nature and purpose of, and the benefits, risks, and side effects to your proposed care, treatment and services; the likelihood of achieving your goals and any potential problems that might occur during recuperation from proposed care, treatment and service and any reasonable alternatives to the care, treatment and services proposed.
• Give or withhold informed consent to recordings, filming or obtaining images of you for any purpose other than your care.
• Participate in or refuse to participate in research, investigation or clinical trials without jeopardizing your access to care and services unrelated to the research.
• Know the names and specialty of the practitioner who has primary responsibility for your care, treatment or services and the names and functions of other practitioners providing your care.
• Formulate advance directives concerning care to be received at end-of-life and to have those advance directives honored to the extent of the facility’s ability to do so in accordance with law and regulation. You also have the right to review or revise any advance directives.
• Be free from neglect; exploitation; and verbal, mental, physical and sexual abuse.
• To retain and use personal clothing or possessions, unless it is deemed to not be in your best interest.
• Be free from any forms of restraint or seclusion used as a means of convenience, discipline, coercion or retaliation; and to have the least restrictive method of restraint or seclusion used only when necessary to ensure patient safety.
• Access protective and advocacy services and to receive a list of such groups upon your request.
• Receive the visitors whom you designate, including but not limited to a spouse, a domestic partner (including same-sex domestic partner), another family member, or a friend, unless your visitor’s presence compromises your or other’s rights, safety or health. You have the right to deny visitation at any time. You may deny or withdraw your consent to receive any visitor at any time. To the extent this facility places limitations or restrictions on visitation; you have the right to set any preference of order or priority for your visitors to satisfy those limitations or restrictions.
• Examine and receive an explanation of the bill for services, regardless of the source of payment.
• A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate. A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
• Obtain a copy of any rules and regulations of the Hospital which apply to a person’s conduct as a patient.
• A reasonable response to his/her questions, requests and needs for treatment or services within the hospital’s capacity.
• Be given full information and necessary counseling on the availability of known financial resources for care.
• Be informed upon discharge of his continuing health care requirements following discharge and the means for meeting them.
• To provide, to the best of your knowledge, accurate and complete information about present symptoms, past illnesses, hospitalizations, medications, and other matters relating to your health.
• To report unexpected changes in your condition to those responsible for your care.
• To understand your health care. If you are unclear about either your condition or medical treatment, please ask your physician or other staff member to discuss them with you.
• To follow the treatment plan recommended by the practitioner primarily responsible for your care.
• To accept full responsibility for your decision and your health care if you refuse treatment.
• To pay your Hospital bill promptly and to supply us with necessary health insurance information.
• To follow the Hospital’s rules and regulations affecting patient care and conduct, including the “smoking” policy.
• To be considerate of the rights of other patients and the Hospital personnel by assisting in the control of the noise and the number of your visitors and allowing your roommates and other patients privacy and quiet.
• To respect the property of others and of the Hospital.
• To respect the individuality of others including racial, ethnic and cultural differences.
• To report your pain and to discuss with the doctors/nurses any concerns you may have about pain.
• To take reasonable care of your own valuables and other possessions.
• To understand that physicians (includes persons employed by physicians such as mid-level providers) on the staff at this hospital, including my attending physician, may not be an employee or agent of the hospital and that the hospital cannot be held responsible for any actions related to a physician’s medical decision making specific to my care while at the hospital.
Power of Attorney for Healthcare (agent)
The Power of Attorney for Health Care (agent) is a simple legal document that allows you to name someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate those decisions. For more information or assistance, call the Hospital’s Patient Advocate or a member of Care Management.
State and Federal regulations require all acute care hospitals to offer patients and families the opportunity for organ and tissue donation.
You, your family, your significant other or your guardian have the right to tell us when something is wrong. This is called presenting a complaint. If you present a complaint, your care will not be affected in any way. If you have a problem that you cannot solve with your doctor, nurse or other caregiver, please call the Patient Advocate’s Office or the President’s Office.
If you send a complaint by fax, e-mail or written letter, the Patient Advocate will acknowledge your communication within two business days.
The Patient Advocate will contact you, review your complaint, and make every effort to resolve your concerns at that time. The Patient Advocate will work with other members of the Hospital to review and resolve your complaint in a timely manner. Usually this is completed within seven days but if it is not resolved, the Patient Advocate will contact you directly to discuss current status of your complaint. A letter will be sent to you that will include the name of the hospital contact, steps taken for the review, results of the review, and the completion date.
Patient Advocate’s Office
In addition, you have the right to discuss your concerns with any of the following agencies:
Ohio Department of Health
Mail: Ohio Department of Health
246 North High Street
Columbus, OH 43215
Email: [email protected]
The Joint Commission
Directs one to the "Report a Patient Safety" event page
Email: [email protected]
Mail: Office of Quality and Patient Safety
The Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
In addition, each Medicare beneficiary who is an inpatient will be provided a standardized notice, “An Important Message from Medicare” upon admission and within two days of discharge. This document should be reviewed, signed and dated by the Medicare beneficiary. As a Medicare recipient, you have the right to discuss any concerns around quality of care of services to the patient representative. Additionally, if you are not satisfied, you have the right to contact the Medicare Quality Improvement Organization:
Quality lmprovement Organization
Toll Free 855-408-8557
TTY for all areas: 855-843-4776
5201 W. Kennedy Boulevard, Suite 900
Tampa, FL 33609
Email: [email protected]