1. Respect and Dignity: You have the right to have your dignity as an individual human being recognized and respected. Your cultural and spiritual beliefs, values, traditions and rituals are held in reverence, and to the extent possible, are integrated into your care.
2. Quality of Care: You have the right to the same quality healthcare without regard to race, creed, sex, national origin or sources of payment. You have the right to file a concern without fear of reprisal.
3. Privacy: You are entitled to privacy, to the extent possible, in treatment and interviewing and in caring for your personal needs
4. Notification: You have the right to have a family member representative and your physician notified of your admission to the hospital.
5. Caregiver Identity: You are entitled to know who is responsible for and who is providing your direct care, are entitled to receive information concerning your continuing health needs and alternatives for meeting those needs, and to be involved your care and discharge planning, if appropriate.
6. Participation in Care: You have the right to be included in the development, implementation and revision of your plan of care and make informed decisions.o You are entitled to receive adequate and appropriate care, and to receive, from the appropriate individual within the facility, information about your medical condition, proposed course of treatment, and prospects for recovery, in terms that you can understand, unless medically contraindicated as documented by the attending physician in the medical record.
7. Personal Safety: You have the right to receive care in a clean and safe environment within the current standards of practice, security, and infection control. You are entitled to an emotionally safe environment free from harassment, and mental and physical abuse. You have the right to be free from restraints unless it is necessary to protect you or others.
8. Pain Management: You have the right to have your pain managed.
9. Consent and Refusal: You are entitled to refuse treatment to the extent provided by law and to be informed of the consequences of that refusal. When a refusal of treatment prevents a health facility or its staff from providing appropriate care according to ethical and professional standards, the relationship with the patient may be terminated upon reasonable notice.
10. Communication: You are entitled to have private communications and consultations with your physician, attorney, or any other person of your choice and to send and receive personal mail unopened on the same day it is received at the health facility unless medically contraindicated as documented by the attending physician in the medical record. Your civil and religious liberties, including the right to independent personal decisions and the right to knowledge of available choices, shall not be infringed and the facility shall encourage and assist in the fullest possible exercise of these rights. You may meet with, and participate in, the activities of social, religious, and community groups at your discretion, unless medically contraindicated as documented by the attending physician in the medical record.
11. Advance Directive: You have the right to provide an advance directive that will identify your wishes and a surrogate decision maker if you are unable to make health care decisions for yourself.
12. Clinical Research: If you are invited and make a decision to participate in clinical investigation or research, you will be informed of your right as human subject. You will be expected to receive detailed information about the study, procedures to be followed, benefits and any risks involved and understand that you may decline any and all such participation without having your care compromised.
13. Business Relationship: You have a right to ask and be informed of the existence of business relationships among the medical center, educational institutions, other health care providers, or payors that may influence your treatment and care.
14. Charges: Upon Request, you are entitled to an explanation of your bill regardless of your source of payment and to receive information relating to financial assistance and methods of payment available through St. Mary’s of Michigan.
15. Notice of Non-Coverage: You have the right to know if your care is not covered by your insurance plan.
16. Hospital Rules and Regulations: You are entitled to information about the hospital rules and regulations affecting your care and conduct.
17. Notice of Privacy Practices: In compliance with the privacy portion of the federal law, Health Information Portability and Accountability Act (HIPAA), you have received the St. Mary’s of Michigan "Notice of Privacy Practices”.
18. Confidentiality: You are entitled to confidential treatment of your medical records and personal information.
19. Access, Review and Amendment of Medical Record: You have the right to access, review, and amend information contained in your medical record. You are entitled to inspect, or receive for a reasonable fee, a copy of your medical record upon request. A third party shall not be given a copy of your medical record without your prior authorization. You are entitled to confidential treatment of personal and medical records, and may refuse their release to a person outside the facility except as required because of a transfer to another health care facility or as required for treatment, payment or operations.
20. Notice of Medicare/Medicaid beneficiary discharge rights: 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 after your planned date of discharge, it is likely that the charges for additional days will not be covered by Medicare or your Plan.
21. Right to Appeal Premature Discharge (For Medicare Beneficiaries): 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 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 1-800-633-4227) or TTY/TTD: 1-877-486- 2048, for more information. If you appeal to the QIO by noon of the day after your receive non-coverage 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. You may need to speak with a Care Coordinator for assistance.
22. Other Appeal Rights: If you miss the deadline for filing an immediate appeal, you may still request review by the QIO (or 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 your Plan).
23. Concerns about Care: You are entitled to exercise your rights as a patient and as a citizen, and to this end may present grievances or recommend changes in policies and services on behalf of yourself or others to the facility staff, to governmental officials, or to another person of your choice within or outside the facility, free from restraint interference, coercion, discrimination, or reprisal.
1. You have the responsibility to provide, to the best of your knowledge, 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 responsible for making it known whether you clearly comprehend a contemplated course of action and what is expected of you.
2. You are responsible for following the treatment plan recommended by the care providers. This may include following the instructions of nurses and allied health associates as they carry out the coordinated plan of care and implement the physician's orders, and as they enforce the applicable hospital rules and regulations. You are responsible for keeping appointments and, when you are unable to do so for any reason, for notifying the physician or the hospital.
3. You are responsible for your actions if you refuse treatment or do not follow the care provider's instructions.
4. You are responsible for providing the hospital with accurate and timely information concerning your sources of payment and ability to meet financial obligations. These objectives are fulfilled as promptly as possible.
5. You are responsible for following hospital rules and regulations affecting patient care and conduct.
6. You are responsible for being considerate of the rights of other patients and hospital associates and for assisting in the control of noise and the number of visitors. You are responsible for being respectful of the property of other persons and of the hospital.
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©2012 AHIS / St. Mary's of Michigan