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Patient rights & responsibilities
Access to care
You have the right to medical care needed within the scope of services
provided at the Medical Center without regard to race, color, religion, national
origin, handicap or disability, financial status, age or sex. If you have a
disability or handicap that requires modifications or accommodations to
policies, programs and practices at the Medical Center in order to receive the
same services, privileges, goods, accommodations or advantages as a non-disabled
patient, we will make those provisions unless the request would:
- Fundamentally alter the Medical Center programs, services, goods,
privileges, advantages or accommodations;
- Involve issues of medical treatment; or
- Compromise patient care.
Care is also not conditional based on the existence of a medical record.
If you should require care that is beyond the Medical Center’s scope of
service, you will be transferred in accordance with our policies.
Care complaints
We strive to continuously improve the quality of care delivered to our
patients. If you have a question or concern, you have the right, without
recrimination, to voice complaints regarding the care received. You may share
your concern with any caregiver, including but not limited to your nurse, the
department manager/director, any of the Medical Center’s continuing Care
Facilitators, and/or with Medical Center Administration. The complaint will be
reviewed and, when possible, immediately resolved. Communication with the person
presenting the complaint will be done in person, whenever possible, or by phone
and/or in writing. In the event you are not satisfied with the Medical Center’s
resolution of your complaint, you may contact the Wisconsin Bureau of Quality
Assurance:
Wisconsin Bureau of Quality Assurance
1 West Wilson Street
P.O. Box 2969
Madison, WI 53701-2969
(608) 266-8084
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Aurora BayCare Medical Center is accredited by the Joint Commission of
Healthcare Organizations (JCAHO). If you have issues concerning the quality or
safety of patient care, you may contact JCAHO directly at 1-800-994-6610 or
www.jcaho.org.
Patient/family involvement in decision-making
(Advance Directive and Informed Consent)
You or your designated representative has the right and responsibility to be
involved in decision-making about your care. This includes acceptance or refusal
of care.
Advance Directive documentation detailing any withholding or withdrawal of
resuscitation or life-sustaining measures will be used by the medical staff in
treatment plans and orders for patient care.
Any conflicts in your needs and wishes by family members or designated
representatives may be addressed informally through a social worker, or
formally, through the Medical Ethics Committee.
Although you have the right to accept or refuse any treatment or procedure,
our medical staff will detail the benefits, significant risks, and recognized
alternatives to treatments and procedures. Expectations for recuperation and
consequences of refusal will be discussed with you as well.
Respect and dignity
You have the right to considerate, respectful care at all times and under all
circumstances with recognition of your personal dignity.
Privacy and confidentiality
You have the right, within the law, to personal and information privacy as
manifested by the following rights:
- To refuse to talk with or see anyone not officially connected with the
Medical Center, including visitors or persons officially connected with the
Medical Center, but not directly involved in your care.
- To wear appropriate personal clothing and religious or other symbolic
items as long as they do not interfere with diagnostic procedures or
treatments.
- To be interviewed and examined in surroundings designated to ensure
reasonable visual and auditory privacy. This includes the right to have a
person of your same sex be present during certain parts of a physical
examination, treatment or procedure performed by a health care professional
of the opposite sex. You also have the right not to remain disrobed any
longer than is required for completing the examination, treatment or
procedure for which you were asked to disrobe.
- To expect that any consultation or discussion involving your case be
conducted discreetly and that individuals not directly involved with your
care not be allowed to be present without your consent.
- To have your medical record read only by individuals directly involved
in your treatment or the monitoring of its quality. Other individuals can
only read your medical records with your written authorization or that of
your legally authorized representative.
- To expect that all communication and other records pertaining to your
care, including the source of payment for treatment, be confidential.
- To request a transfer to another room if another patient or visitor in
the room is unreasonable and is disturbing you.
- To be placed in a protective environment when considered necessary for
personal safety.
- To ensure privacy for visits by your spouse and, if you both are
inpatients, to share a room unless medically contraindicated by your
attending physician.
Psychosocial, spiritual and cultural values
You are free to express spiritual beliefs and cultural practices that do not
harm others or interfere with your medical treatment.
We will ensure that your psychosocial and spiritual needs are met through
Medical Center resources and through the Pastoral Care Team.
Access to protective services
When the Medical Center requires protective services, for example, in the
case of guardianship and advocacy services, conservatorship, and child or adult
protective services, a social worker will be assigned to assist with the
process.
You and/or a family member may request a list of names, addresses, and
telephone numbers of pertinent state client advocacy groups.
You have the right to file a complaint with the state survey and
certification agency if there is a concern about patient abuse, neglect or
misappropriation of patient property at the Medical Center.
Personal safety
You have the right to expect reasonable safety insofar as Medical Center
practices and its environment are concerned. This includes the right to expect
an environment free from mental and physical abuse; free from chemical, and
except in emergencies, physical restraints, except as authorized in writing by a
physician for a specified and limited period of time, or when necessary to
protect you from injuring yourself or others.
Identity
You have the right to know the identity and professional status of
individuals providing care to you and to know which physician or other
practitioner is primarily responsible for your care. This includes your right to
know the existence of any professional relationship among individuals treating
you as well as the relationship to any other health care or educational
institution involved in your care. Your participation in any clinical training
program or in the gathering of data for research purposes is voluntary.
Information
You have the right to obtain complete and current information concerning your
diagnosis, treatment and any known prognosis from the practitioner responsible
for your care. This information should be communicated to you in terms you can
understand. When necessary, this information may be made available to a
legally-authorized individual. When practical, you will have the opportunity to
participate in the planning of your medical treatment.
You and/or your legally-designated representative have access to the
information contained in your medical record within the limits of the law.
Communication
You have the right of access to people outside of the Medical Center through
visitors and through verbal or written communication. Assistance will be
provided to those individuals with impaired visual, hearing or speaking skills.
An interpreter will also be provided if you do not speak or understand English.
In general, you have the right to unrestricted access to communication.
Sometimes, it may become necessary to restrict visitors, mail, telephone calls,
or other forms of communication as part of your medical care. Should this occur,
you will be included in making that decision and restrictions will be explained
in a language that you understand. If you are an emancipated minor or under
guardianship, applicable law determines who is legally entrusted to act in your
best interest. Clinical justification of any communication restrictions will be
documented in your medical record.
Consent
You have the right to reasonable informed participation in decisions about
your health care. This should be based on a clear, concise explanation of your
condition and of all proposed technical procedures, including the possibilities
of any risk of serious side effects or death, problems related to recuperation
and probable success of treatment. You should not be subjected to any procedure
without your voluntary competent consent, complete understanding of the consent,
or the consent of your legally-authorized representative. If medically
significant alternatives to your proposed care or treatment exist, you will be
informed of those alternatives. You have the right to know who is responsible
for authorizing and performing procedures or medical treatment.
You also have the right to know if the Medical Center or your physician
proposes to participate in research, investigational studies or clinical trials
which may affect the care or treatment you receive. You have the right to refuse
to participate in any such activity.
Consultation
You may, at your request and expense, consult with a specialist concerning
your condition and treatment.
Refusal of treatment
You have the right to refuse or accept treatment to the extent permitted by
law and to be informed of the medical consequences of such refusal. Should you
or your legally-authorized representative refuse treatment which prevents the
provision of appropriate care in accordance with professional standards, our
relationship may be terminated. Arrangements will be made to ensure
uninterrupted provision of care through another physician or through a transfer
agreement with another facility.
Continuity of care
(Admissions/Transfers)
Admissions to and transfers from the Medical Center are based on your needs
for services and the organization’s capability to provide those services.
You may be transferred or discharged only for medical reasons, for your
overall welfare or that of other patients, or for non-payment as allowed by
Titles XVIII or XIX of the Social Security Act.
If required, you will be given reasonable advance notice as to the need for
the transfer or discharge and of any alternatives. If a transfer is warranted,
you will not be transferred unless accepted to another facility. All actions
will be documented in your medical record.
You have the right to be informed by the practitioner responsible for your
care or by his/her delegate, of any continuing health care requirements needed
following discharge from the Medical Center.
Medical Center charges
Regardless of the source for payment of your care, you have the right to
request and receive an itemized and detailed explanation of the total bill for
services received while a patient at the Medical Center. You have the right to
timely notice of any change concerning your eligibility for reimbursement by a
third-party payor that has indicated such a change to the Medical Center.
Medical Center rules and regulations
You will be informed of any Medical Center rules and regulations applicable
to your conduct as a patient. You are entitled to information about the Medical
Center’s policy for the initiation, review and resolution of patient complaints.
Conflict of care concerning adolescents/neonates
In case of a conflict between a parent(s) or guardian(s) and/or the physician
regarding the care of adolescent or neonate patients, legal action will be
sought to protect patient rights.
Ethical issues
You have the right to participate in the consideration of any ethical issues
that may arise during the provision of your care. The Medical Center provides
this support through staff members and the Medical Ethics Committee. A request
may be made to any staff person or physician, by yourself or a family member
with ethical issues, to access support.
Rights or authorized responsible person
(patient representative)
The Medical Center recognizes the right of your guardian, next of kin, or
legally-authorized responsible person to exercise, to the extent permitted by
law, rights on your behalf. Your representative may exercise this right if, and
only if, you have been found incompetent in accordance with the law, and are
found to be medically incapable of understanding the proposed treatment or
procedure, are unable to communicate your wishes regarding treatment or if you
are a minor.
Valuables
The Medical Center encourages all patients to send valuables home with family
members and to keep only small amounts of money in their possession.
When this is not possible, valuables may be placed in the Medical Center’s
safe until requested for return or upon discharge. The Medical Center is not
responsible for the loss of personal items.
Organ donation
Although you may have identified yourself as a potential organ and/or tissue
donor on the back of your driver’s license or on a uniform donor card,
signatures on these documents do not ensure that your wishes will be followed.
Therefore, the Medical Center encourages all patients wishing to become organ
and/or tissue donors to discuss donation plans with their physician and family
members. Questions may also be directed to any Medical Center staff person.
The potential for organ donation will be addressed following any death at the
Medical Center.
Research studies involving medical investigation
If you are asked to participate in a research study involving a medical
investigation or are requested to consent on behalf of another, you have the
right to:
- Be informed of the nature and purpose of the investigation.
- Be given an explanation of the procedure to be followed in the medical
investigation, and the name of any drug or device to be used.
- Be given a description of any accompanying discomforts and risks to be
reasonably expected form the investigation, if applicable.
- Be given a disclosure of any appropriate alternative procedure, drugs,
or devices that might be advantageous, along with the risks and benefits.
- Be informed of medical treatment available after the investigation (if
any) should complications arise.
- Be given an opportunity to ask questions concerning the investigation or
the procedure involved.
- Be instructed that consent to participate in the medical investigation
may be withdrawn at any time and your participation in the medical
investigation may discontinue without prejudice to your care.
- Be given a copy of a signed and dated written consent form when one is
required.
- Be given the choice to consent or not to consent to a medical
investigation without the intervention of any element of force, fraud,
deceit, duress, coercion, or undue influence on your decision.
Pain
Patients have a right to appropriate assessment and management of pain. This
will include assessment/reassessment of pain and education of patient and
significant others regarding roles in managing pain as well as potential
limitations and effects of pain management. This is done based on assessment of
the patient’s personal culture, spiritual and ethnic beliefs. The discharge
process will include continuing care based on needs of the patient at time of
discharge.
Terminally ill patients
Pain management and grief counseling services are available for you and your
family members should you become terminally ill. Services are available as part
of the integrated health care plan through Nursing Services, Social Services and
the Pastoral Care Team.
Violation of rights
Suspected violations of patient rights will be investigated by the
appropriate department director. Disciplinary action for employees or referral
to the Medical Staff Credentials Committee for Medical Staff and/or Allied
Health staff may result.
Patient responsibilities
Provision of information
You have the responsibility, to the best of your knowledge, to provide
accurate and complete information about present complaints, past illnesses,
hospitalizations, medications, and other matters relating to your health. You
have the responsibility to report unexpected changes in your condition to the
responsible practitioner. You are also responsible for reporting whether you
clearly comprehend a contemplated course of medical action and what is expected
of you as a result of that action.
Compliance with instructions
You are responsible for following the treatment plan recommended by your
practitioner primarily responsible for your care. This may include following
instructions of nurses and Allied Health personnel as they carry out the
coordinated care plan, implement the practitioner’s orders, and enforce the
applicable Medical Center rules and regulations. You are responsible for keeping
appointments and, if unable to keep an appointment, to notify the responsible
practitioner or the Medical Center.
Refusal of treatment
You are responsible for your actions if you refuse treatment or do not follow
practitioner instructions.
Medical center charges
You are responsible for ensuring that the financial obligations of your
health care are fulfilled as promptly as possible.
You may not be required to perform services for the Medical Center that are
not included for therapeutic reasons in your care plan.
Medical Center rules and regulations
You are responsible for following Medical Center rules and regulations
affecting patient care and conduct.
Respect and consideration
You are responsible for being considerate of the rights of other patients and
Medical Center personnel and for assisting in the control of noise, smoking, and
the number of visitors. You are also responsible for being respectful of the
property of other persons and of the Medical Center.
Important message from Medicare
Your rights as a hospital patient
- You have the right to receive necessary hospital services covered by
Medicare, or covered by your Medicare Health Plan ("your Plan") if you are a
Plan enrollee.
- You have the right to know about any decisions that the hospital, your
doctor, your Plan, or anyone else makes about your hospital stay and who
will pay for it.
- Your doctor, your Plan, or the hospital should arrange for services you
will need after you leave the hospital. Medicare or your Plan may cover some
care in your home (home health care) and other kinds of care, if ordered by
your doctor or by your Plan. You have a right to know about these services,
who will pay for them, and where you can get them. If you have any
questions, talk to your doctor or Plan, or talk to other hospital personnel.
Your hospital discharge & Medicare appeal rights
Date of Discharge: When your doctor or Plan determines that you can be
discharged from the hospital, you will be advised of your planned date of
discharge. You may appeal if you think that you are being asked to leave the
hospital too soon. If you stay in the hospital after your planned date of
discharge, it is likely that your charges for additional days in the hospital
will not be covered by Medicare or your Plan.
Your Right to an Immediate Appeal without Financial Risk: When you are
advised of your planned date of discharge, if you think you are being asked to
leave the hospital too soon, you have the right to appeal to your Quality
Improvement Organization (also known as a QIO). The QIO is authorized by
Medicare to provide a second opinion about your readiness to leave. You may call
Medicare toll-free, 24 hours a day, at 1-800-MEDICARE (1-800-633-4227), or
TTY/TTD: 1-877-486-2048, for more information on asking your QIO for a second
opinion. If you appeal to the QIO by noon of the day after you receive a
noncoverage notice, you are not responsible for paying for the days you stay in
the hospital during the QIO review, even if the QIO disagrees with you. The QIO
will decide within one day after it receives the necessary information.
Other Appeal Rights: If you miss the deadline for filing an immediate
appeal, you may still request a review by the QIO (or by your Plan, if you are a
Plan enrollee) before you leave the hospital. However, you will have to pay for
the costs of your additional days in the hospital if the QIO (or your Plan)
denies your appeal. You may file for this review at the address or telephone
number of the QIO (or of your Plan).
OMB Approval No. 0938-0692. Form No. CMS-R-193 (January 2003)
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