PATIENT INFORMATION GUIDE...PATIENT INFORMATION GUIDE - 5 - PATIENT RIGHTS You have the right to: 1....

PATIENTINFORMATIONGUIDE

WELCOME

Overtheyears,wehaveneverforgottenthatthehumantouchhasasgreataneffectasthemostpowerfulmedicine.

Forthisreason,ourentirestaffiscommittedtomakingyourstayascomfortableandpleasantaspossible.

Duringyourhospitalization,wewillrespectyourindividuality,dignityandprivacy,whileofferingyouthebestinhealthcare

regardlessofyourpaymentsource,race,sex,color,ancestry,national

origin,age,disability,medicalcondition,maritalstatus,sexualorientation,cultural,economic,educationalorreligiousbackground.

Wewillalsorespectyourrighttobeinformedaboutandparticipateindecisionsregardingyourcare,

informyouoftheprocessforresolutionofcomplaints,

andmakeeveryreasonableefforttograntrequestsforspecialservicestomeetyourindividualneeds.

Atthesametime,wewillmaintainasecureandsafeenvironmentwithinthemedicalcenter,

ensuringthatyourmedicalrecordsremainconfidential,

andencourageyoutocommunicatefreelywithfriendsandfamilythroughvisits,aswellasbyphoneandmail.

Youareaveryimportantpersontous.Ourfirstandonlypriorityistoprovideyou

andyourfamilywithqualityhealthcareservicesinasensitiveandcompassionatemanner.

Wewelcomethisopportunitytoserveyouandyourfamily.

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TABLEOFCONTENTS

Mission, Vision, and Values 3

Patient Experience 4

Your Rights Regarding Medical Information About You 4

Patient Rights 5

Patient Responsibilities 9

Patient Safety 10

Your Right to Make Decisions About Medical Treatment 12

Notice of Privacy Practices 15

How We May Use and Disclose Health Information 16

Complaints 20

A Patient’s Guide to Blood Transfusions 20

Understanding Your Pain – Family and Patient Information 21

Stop Smoking – Be a Quitter 22

Notice of Accessibility for Persons with Disabilities 23

The Ethics Committee 23

Medical Social Work 23

Safety First 24

Interpreters 24

Patient Assessments 25

Infection Prevention 25

Patient and Family Education 26

Condition Reports 26

Understanding and Preventing Blood Clots 26

Going Home 27

Financial Matters 28

MISSIONOur Hospital endeavors to provide comprehensive, quality healthcare in a convenient,

compassionate and cost effective manner.

VISIONOur Hospital is consistently at the forefront of evolving national healthcare reform.

Our organization provides an innovative and integrated healthcare delivery system. We remain ever cognizant of our patients’ needs and desires for high

quality affordable healthcare.

VALUES• COMPASSION •

We provide an environment that is caring and conducive to healing the whole person physically, emotionally and spiritually. We respect the individual needs, desires and rights of our patients.

• QUALITY •We believe in continuous quality of care and performance improvement

as the foundation for preserving and enhancing healthcare delivery. Effective communication and education of our patients, physicians, staff

and the community we serve are essential elements of this process.

• COMPREHENSIVE •We are committed to an integrated healthcare delivery system that

encompasses the entire spectrum of healthcare delivery. This continuum of care encompasses all aspects of an individual’s healthcare.

• COST EFFECTIVENESS •We offer high quality healthcare that is accessible and affordable.

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MISSION, VISION, AND VALUES

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PATIENTEXPERIENCE

Westrivetoprovideoutstandingandcompassionatecareandservice,everystepoftheway.PrimeHealthcarerecognizestheimportanceofthepatientexperience,includingcol-lectingfeedbackfromyouthatwillhelpusbetterunderstandthequalityofcareandexpe-rienceatourfacilities.Ifyouhaveanyquestionsorsuggestionsduringyourstay,please

reachouttoyourcaregiveroranyofourleadersandvoiceyourconcerns. Followingyourdischargefromoneofourfacilities,youmayreceiveaphonesurveyask-ingyouaboutyourexperience.Pleasetakeamomenttoprovidehonestfeedback.Wearehereforyouandthankyouforchoosingourhospitalforyourcare.

YOURRIGHTSREGARDING

MEDICALINFORMATIONABOUTYOU

•RighttoInspectandCopy Youhavetherighttoinspectandcopymedicalinformationthatmaybeusedtomakede-cisionsaboutyourcare. Toinspectandcopymedicalinformationthatmaybeusedtomakedecisionsaboutyou,youmustsubmityourrequestinwritingtotheHealthInfor-mationServicesDepartment.Wemaychargeafeefortheservice. Wemaydenyyourrequesttoinspectandcopyincertainverylimitedcircumstances.Ifyouaredeniedaccesstomedicalinformation,youmayrequestthatthedenialbereviewed.Anotherlicensedhealthcareprofessionalchosenbythehospitalwillreviewyourrequestandthedenial.Thepersonconductingthereviewwillnotbethepersonwhodeniedyourrequest.Wewillcomplywiththeoutcomeofthereview.•RighttoAmend Ifyoufeelthatmedicalinformationwehaveaboutyouisincorrectorincomplete,youmayaskustoamendtheinformation.Pleaseaskhospitalstaffaboutthisprocess.•RighttoanAccountingofDisclosures Youhavetherighttorequestan“accountingofdisclosures.”Thisisalistofthedisclosureswemadeofmedicalinformationaboutyouotherthanourusesfortreatment,paymentandhealthcareoperations,(asthosefunctionsaredescribedabove)andwithotherexpectationspursuanttothelaw. Torequestthislistoraccountingofdisclosures,youmustsubmityourre-questinwritingtotheHealthInformationServicesDepartment.Thefirstlistyourequestwithina12-monthperiodwillbefree.Foradditionallists,wemaychargeyouforthecostsofprovidingthelist.•RighttoRequestRestrictions Youhavetherighttorequestarestrictionorlimitationonthemedicalinformationweuseordiscloseaboutyoufortreatment,paymentorhealthcareoperations. Wearenotrequiredtoagreetoyourrequest.Torequestrestrictions,youmustmakeyourrequestinwritingtotheHealthInformationServicesDepartment.•RighttoRequestConfidentialCommunications Youhavetherighttorequestthatwecommunicatewithyouaboutmedicalmattersinacertainwayoratacertainlocation.Forexample,youcanaskthatweonlycontactyouatworkorbymail.Torequestconfidentialcommunications,youmustmakeyourrequestinwritingtotheHealthInformationServicesDepartment.

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PATIENTRIGHTS

Youhavetherightto:1.Considerateandrespectfulcare,andtobemadecomfortable.Youhavetherighttore-spectforyourcultural,psychosocial,spiritual,andpersonalvalues,beliefsandpreferences.Youhavetherighttoparticipateinthedevelopmentandimplementationofhisorherplanofcare.2.Hisorherrepresentative(asallowedunderStatelaw)hastherighttomakeinformeddecisionsregardinghisorhercare.Thepatient’srightsincludebeinginformedofhisorherhealthstatus,beinginvolvedincareplanningandtreatment,andbeingabletorequestorrefusetreatment.Thisrightmustnotbeconstruedasamechanismtodemandtheprovi-sionoftreatmentofservicesdeemedmedicallyunnecessaryorinappropriate.3.Haveafamilymember(orotherrepresentativeofyourchoosing)andyourownphysi-ciannotifiedpromptlyofyouradmissiontothehospital.4.Knowthenameofthelicensedhealthcarepractitioneractingwithinthescopeofhisorherprofessionallicensure,whohasprimaryresponsibilityforcoordinatingyourcare,andthenamesandprofessionalrelationshipsofphysiciansandnon-physicianswhowillseeyou.5.Receiveinformationaboutyourhealthstatus,diagnosis,prognosis,courseoftreatment,prospectsforrecoveryandoutcomesofcare(includingunanticipatedoutcomes)intermsyoucanunderstand.Youhavetherighttoeffectivecommunicationandtoparticipateinethicalquestionsthatariseinthecourseofyourcare,includingissuesofconflictresolu-tion,withholdingresuscitativeservices,andforgoingorwithdrawinglife-sustainingtreat-ment.6.Makedecisionsregardingmedicalcare,andreceiveasmuchinformationaboutanypro-posedtreatmentorprocedureasyoumayneedinordertogiveinformedconsentortore-fuseacourseoftreatment.Exceptinemergencies,thisinformationshallincludeadescrip-tionoftheprocedureortreatment,themedicallysignificantrisksinvolved,alternatecoursesoftreatmentornon-treatmentandtherisksinvolvedineach,andthenameofthepersonwhowillcarryouttheprocedureortreatment.7.Requestorrefusetreatment,totheextentpermittedbylaw.Youhavetherighttoleavethehospitalevenagainsttheadviceofmembersofthemedicalstaff,totheextentpermit-tedbylaw.8.Beadvisedifthehospital/licensedhealthcarepractitioneractingwithinthescopeofhisorherprofessionallicensureproposestoengageinorperformhumanexperimentationaf-fectingyourcareortreatment.Youhavetherighttobefullyinformedofandtoconsentorrefusetoparticipateinanyunusual,experimentalorresearchprojectwithoutcompromis-inghis/heraccesstoservices.

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9.Reasonableresponsestoanyreasonablerequestsmadeforservice.10.Tobeinformedoftherighttohavepaintreatedaseffectivelyaspossible.Therighttoappropriateassessmentandmanagementofyourpain,informationaboutpain,painreliefmeasuresandtoparticipateinpainmanagementdecisions.Youmayrequestorrejecttheuseofanyorallmodalitiestorelievepain,includingopiatemedication,ifyousufferfromseverechronicintractablepain.Thedoctormayrefusetoprescribetheopiatemedication,butifso,mustinformyouthattherearephysicianswhospecializeinthetreatmentofse-verechronicpainwithmethodsthatincludetheuseofopiates.11.Therighttoformulateadvancedirectivestohavehospitalstaffandpractitionerswhoprovidecareinthehospitalcomplywiththesedirectives.Thisincludesdesignatingadeci-sionmakerifyoubecomeincapableofunderstandingaproposedtreatmentorbecomeun-abletocommunicateyourwishesregardingcare.Allpatients’rightsapplytothepersonwhohaslegalresponsibilitytomakedecisionsregardingmedicalcareonyourbehalf,withoutcoercion,discriminationorretaliation.12.Therighttopersonalprivacy.Casediscussion,consultation,examinationandtreatmentareconfidentialandshouldbeconducteddiscreetly.Youhavetherighttobetoldtherea-sonforthepresenceofanyindividual.Youhavetherighttohavevisitorsleavepriortoanexaminationandwhentreatmentissuesarebeingdiscussed.Privacycurtainswillbeusedinsemi-privaterooms.13.Therighttotheconfidentialityofhisorherclinicalrecords.Therighttoconfidentialtreatmentofallcommunicationsandrecordspertainingtoyourcareandstayinthehospi-tal.Youwillreceiveaseparate“NoticeofPrivacyPractices”thatexplainsyourprivacyrightsindetailandhowwemayuseanddiscloseyourprotectedhealthinformation.14.Therighttoreceivecareinasafesetting.Therighttobefreefromallformsofabuseorharassment.Tobefreefrommental,physical,sexualorverbalabuseandneglect,exploita-tionorharassment.Youhavetherighttoaccessprotectiveandadvocacyservicesincludingnotifyinggovernmentalagenciesofneglectorabuse.15.Therighttobefreefromrestraintsandseclusionofanyformthatarenotmedicallynecessaryorareusedasameansofcoercion,discipline,convenience,orretaliationbystaff.16.Reasonablecontinuityofcareandtoknowinadvancethetimeandlocationofap-pointmentsaswellastheidentityofthepersonsprovidingthecare.17.Beinformedbythephysician,oradelegateofthephysician,ofcontinuinghealthcarerequirementsandoptionsfollowingdischargefromthehospital.Youhavetherighttobeinvolvedinthedevelopmentandimplementationofyourdischargeplan.Uponyourre-quest,afriendorfamilymembermaybeprovidedthisinformationalso.18.Knowwhichhospitalrulesandpoliciesapplytoyourconductwhileapatient.

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19.Thehospitalmusthavewrittenpoliciesandproceduresregardingthevisitationrightsofpatients,includingthosesettingforthanyclinicallynecessaryorreasonablerestrictionorlimitationthatthehospitalmayneedtoplaceonsuchrightsandthereasonfortheclini-calrestrictionorlimitation.Ahospitalmustmeetthefollowing:

ü Informeachpatient(orsupportperson,whereappropriate)ofhisorhervisitationrights,includinganyclinicalrestrictionoflimitationonsuchrights,whenheorsheisinformedofhisorherotherrightsunderthissection.Thehospitalmayestablishrea-sonablerestrictionsuponvisitation,includingrestrictionsuponthehoursofvisitationandnumberofvisitors.Otherlimitationsmayincludelimitationsorrestrictionsofvis-itationsfromthepresenceofaparticularvisitorasitwouldendangerthehealthorsafetyofapatient,amemberofthehealthfacility,stafforothervisitortothehealthfa-cility,orwouldsignificantlydisrupttheoperationsofthefacility.ü Informeachpatient(orsupportperson,whereappropriate)oftheright,subjecttohisorherconsent,toreceivethevisitorswhomheorshedesignates;including,butnotlimitedto,aspouse,adomesticpartner(includingsamesexdomesticpartners),anoth-erfamilymember,orafriend,andhisorherrighttowithdrawordenysuchconsentatanytime.ü Notrestrict,limitorotherwisedenyvisitationprivilegesonthebasisofrace,color,nationalorigin,religion,sex,genderidentity,sexualorientation,ordisability.ü Ensurethatallvisitorsenjoyfullandequalvisitationprivilegesconsistentwithpatientpreferences.

20.Haveyourwishesconsidered,ifyoulackdecision-makingcapacity,forthepurposesofdeterminingwhomayvisit.Themethodofthatconsiderationwillcomplywithfederallawandbedisclosedinthehospitalpolicyonvisitation.Ataminimum,thehospitalshallin-cludeanypersonslivinginyourhouseholdandanysupportpersonpursuanttofederallaw.21.Therighttoaccessthecost,itemizedwhenpossible,ofservicesrenderedwithinarea-sonableperiodoftimeaswelltherighttoexamineandreceiveanexplanationofthehospi-tal’sbillregardlessofthesourceofpayment.22.Exercisetheserightswithoutregardtosex,race,color,religion,ancestry,nationalorigin,age,disability,medicalcondition,maritalstatus,registereddomesticpartner,sexualorientation,educationalbackground,economicstatusorthesourceofpaymentforcare. 23.Youhavetherighttoknowtheprofessionalstatusofanypersonprovidinghis/hercare/services.TherighttoknowthereasonforanyproposedchangeintheProfessionalStaffresponsibleforhis/hercare.24.Therighttoaccessinformationcontainedinhisorherclinicalrecordswithinareason-abletimeframe.Thehospitalmustnotfrustratethelegitimateeffortsofindividualstogainaccesstotheirownmedicalrecordsandmustactquicklyasitsrecordkeepingsystempermits.25.Therighttoknowthereasonsforhis/hertransfereitherwithinoroutsidethehospital.

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26.Therelationship(s)ofthehospitaltootherpersonsororganizationsparticipatingintheprovisionofhis/hercare.27.Therighttobeinformedofthesourceofthehospital’sreimbursementforhis/herser-vices,andofanylimitationswhichmaybeplaceduponhis/hercare.28.Thepatient’sfamilyhastherightofconsentfortissueandorgandonation.(SeeOrganDonation)29.TherighttointerpretiveservicesforcertainindividualwhospeaklanguagesotherthanEnglish,alternativecommunicationtechniquesoraidesforthosewhoaredeaforblind,orotherstepsasneededtoeffectivelycommunicate.30.Fileagrievance.Ifyouwanttofileagrievancewiththishospital,youmaydosobywritingorbycallingthehospital.TheRiskManagement/PerformanceImprovementdepartmentwillrevieweachgrievanceandprovideyouwithawrittenre-sponsewithin7days.Ifthegrievanceisnotresolvedwithin7daysafollowupcallwillbemadeevery30daysuntilthegrievanceisresolved.Thewrittenresponsewillcontainthenameofapersontocontactatthehospital,thestepstakentoinvestigatethegrievance,theresultsofthegrievanceprocess,andthedateofcompletionofthegrievanceprocess.Con-cernsregardingqualityofcareorprematuredischargewillalsobereferredtotheappro-priateUtilizationandQualityControlPeerReviewOrganization(PRO).31.Tofileacomplaint,usethehospital’sgrievanceprocessand/orcontacttheDepartmentlistedbelowforyourstate:

AL AlabamaDepartmentofPublicHealth 800-252-1818CA CaliforniaDepartmentofPublicHealth 916-558-1784FL FloridaDepartmentofHealth 850-245-4339GA GeorgiaDepartmentofPublicHealth 404-657-2700IN IndianaStateDepartmentofHealth 317-233-1325KS KansasDepartmentforAgingandDisabilityServices 800-842-0078MI MichiganDepartmentofHealthandHumanServices 517-373-3740MO MissouriDepartmentofHealthandSeniorServices 573-751-6400NV BureauofHealthcareQualityandCompliance 775-684-1030NJ NewJerseyDepartmentofHealth 800-792-9770OH OhioDepartmentofHealth 614-466-3543PA PennsylvaniaDepartmentofHealth 877-724-3258RI StateofRhodeIslandDepartmentofHealth 401-222-5960TX TexasDepartmentofStateHealthServices 888-963-7111

32.TofileacomplaintwithanAccreditationProgram,thecontactinformationis: TheJointCommission:OneRenaissanceBlvd.,OakbrookTerrace,IL60181•800-994-6610

HealthcareFacilitiesAccreditationProgram:142EastOntarioSt.,Chicago,IL60611•800-621-1773DNVGL-Healthcare:400TechneCenterDr.,Suite100,Milford,OH45150•866-523-6842

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PATIENTRESPONSIBILITIES

Sothatyoumaycontributeeffectivelytoyourhealthcare,youhave,asapatientorpatient’srepresentative,thefollowingresponsibilities:

1.Behonestandaccuratewhenaskedforinformationaboutyourmedicalhistoryandeverythingthathappenstoyouasapatient.

2.Participateactivelyinagreed-upondecisionsregardingyourhealth.3.Notifyyourdoctorornurseifyouhaveanyconcernaboutyourcareornotice,orthinkyounotice,orperceiveanychangesinyourhealth.4.Askpromptlyforclarificationifyoudonotunderstandwhatisaskedofyou,orwhyitisasked.5.Letyourdoctorornurseknowifyouareconcernedaboutatreatment,orifyoufeelyoucannot,orwillnot,followacertaintreatmentplanandtoberesponsibleforthecon-sequencesifyourefusetreatmentordonotfollowinstructions.6.Examineyourbillandaskanyquestionsyoumayhaveregardingthechargesormeth-odsofpayments,andforassuringthatthefinancialobligationsofyourhealthcarearefulfilledaspromptlyaspossible.7.Followhospitalrulesandregulationsaffectingpatientcareandconduct,tobeconsid-erateofotherpatientsandhospitalstaffandtheirproperty,andforassistingincontrol-lingthenoiseandnumberofyourvisitors.8.Providethehospitalwithacopyofanyadvancedirectivesyoumayhaveexecuted.9.Contributetoasafeenvironmentofcare,thereforethefollowingisprohibited:

• Possessionofweapons,dangerousobjects,alcohol,illegaldrugsanddrugsnotpre-scribedbythepatient’sphysician.

• Visitingwhileundertheinfluenceofdrugsand/oralcohol.

Thehospital’sobligationtoprovideasafeenvironment

forpatientcaremustoverridethepatient’srighttoprivacy.

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PATIENTSAFETYInoureffortstoprovideasafeenvironmentfreefrommistakes,weencouragepatientstoaskquestionsregardingallaspectsoftheirmedicalcare.Beinginvolvedineverydecisionaboutyourhealthcarecanleadtoabetteroutcomes.1.Thesinglemostimportantwayyoucanhelpoptimizeyourcareandhelptopreventer-rorsistobeanactivememberofyourhealthcareteam.ASKQUESTIONS!Activelypartici-pateineverydecisionaboutyourhealthcarefromstarttofinish.2.Makesureallofyourdoctorsandnursesknowaboutanymedicationsyouaretaking–includingprescriptions,over-the-countermedication,anddietarysupplementssuchasvitaminsandherbs.Justbecauseitisherbalornaturaldoesnotmeanitissafe.Tellyourdoctorandnurseaboutanyallergiesoradversereactionsthatyouhavehadtomedica-tion(s)orfoodproducts.3.Besuretoaskforinformationaboutyourmedicationwhenitisprescribedandwhenyournursegivesittoyou.Makesurethatcaregiversgiveyouinformationintermsthatyoucanunderstand.IfyoudonotunderstandanyinformationitisOKtoask!4.Askwhyatestortreatmentisneededandhowitmayhelpyou.

5.Whenyouhaveanytypeofsurgery,askforinformationaboutyoursurgeryintermsthatyoucanunderstand.Whowillbeas-sistingwithmysurgery?Whatisinvolved?Howlongwillittake?Whataretherisksinvolved?Howlongwillmyrecoverybe?Whataretheexpectedoutcomes?6.Ifyouarehavingsurgery,makesurethatyou,yourdoctor,andyoursurgeonallagreeandareclearonexactlywhatwillbedone.Beinvolvedinmarkingthecorrectsiteofyoursurgerywiththeword“YES.”

7.Donotbeafraidtoaskquestionsofanyonewhoisinvolvedinyourcare.Askyourdoctorornurseaboutresultsofalltestsperformed,yourcondition,andtreatmentduringyourhospitalstay.8.Provideallhealthprofessionalsinvolvedinyourcarewithaccurateinformationaboutyourself.Thisisespeciallyimportantifyouhavemanyhealthproblems.9.Upondischargefromthehospital,askyourdoctorsandnursestoexplainthetreatmentplanyouwillneedtofollowathome.

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10.Ifyouwillbetakingmedicationsafterdischargefromthehospital,youwillbegivenin-structionsalongwithalistofmedications.Topromotemedicationsafety,itishighlyrec-ommendedthatyoukeepacurrentlistofyourmedicationsinyourwalletorpursesoyoucansharethisinformationwithyourdoctors,retailpharmacistandifyouarere-admittedwithyourhealthcareprovider.11.Askafamilymemberorfriendtobeherewithyoutobeyouradvocateandaskques-tionsifyoucan’t.Evenifyouthinkyoudon’tneedhelpnow,youmightneeditlater.AskaboutanAdvanceDirectiveifyoudonothaveone.Ifyoudo,besuretogiveacopytoyourprimaryphysicianandthehospital.12.Practicinggoodhandwashingisthesinglemostim-portantthingwecanalldotostopthespreadofinfection.Itisahealthyhabitforanyone,whetheryouareinthehospital,atworkorathome.Encourageyourvisitorstowashtheirhandsandpracticegoodhandwashingyourself.Ifyoudonotseethehealthcareproviderwashingtheirhandswithsoapandwaterorusingthewaterlessalcoholhandsanitizerwhenenteringyourroomtoprovidecare,remember,itisOKtoask! 13.Thereisacallbuttonatyourbedsideandabutton/pullcordinthebathroomtosum-monassistance.Justpressthebuttonorpullthecordandastaffmemberwillrespondinpersonorbyintercom.Pleasedon’thesitatetouseitifyouhavequestionsorneedhelp.14.Wecannotberesponsibleforvaluablesthatyoukeepinyourpossession.Youshould

leaveyourjewelry,cellphones,electronicdevices,money(largesum),wallets,andpursesathometoensuretheirsafekeeping.Pleasebealertconcern-ingyourbelongingssuchasdentures,contactlenses,eyeglasses,hearingaids,andcomparablepersonalbelongings.Pleasestoretheseitemscare-fullywhennotinuse.Neverleavethemonamealtrayorwrapthemintissuepaper.Ifyouforgettoleaveyourvaluablesathomeanddonotwishto

entrustthemtoafriendorrelative,theymaybedepositedintheHospitalsafeforsafe-keeping.Askyournurseforassistance.

Communicationaboutallaspectsofyourcare,treatment,andservicesisanimportantpartofourcultureofsafety.

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YOURRIGHTTOMAKEDECISIONSABOUTMEDICALTREATMENT

Afederallawrequiresustogiveyouthisinformation.

Wehopethisinformationwillhelpincreaseyourcontroloveryourmedicaltreatment.Q:WHODECIDESABOUTTREATMENT?A:Yourdoctorswillgiveyouinformationandadviceabouttreatment.Youhavetherighttochoose.Youcansay“Yes”totreatmentsyouwant.Youcansay“No”toanytreatmentthatyoudon’twant-evenifthetreatmentmightkeepyoualivelonger.Q:HOWDOIKNOWWHATIWANT?A:Yourdoctormusttellyouaboutyourmedicalconditionandaboutdifferenttreatments,sideeffects,andpainmanagementalternatives.Q:CANOTHERPEOPLEHELPWITHMYDECISIONS?A:Yes.Patientsoftenturntotheirrelativesandclosefriendsforhelpinmakingmedicaldecisions.Youcanaskthedoctorsandnursestotalkwithyourrelativesandfriends.

Q:CANICHOOSEARELATIVEORFRIENDTOMAKEHEALTHCAREDECISIONSFORME,INTHEEVENTIAMUNABLETODOSO?A:Yes.Youmaytellyourdoctorthatyouwantsomeoneelsetomakehealthcaredecisionsforyou.Q:WHATIFIBECOMETOOSICKTOMAKEMYOWNHEALTHCAREDECISIONS?A:Ifyouhaven’tnamedasurrogate,yourdoctorwillaskyourclosestavailablerelativeorfriendtohelpdecidewhatisbestforyou.Q:WHOCANMAKEANADVANCEDIRECTIVE?A:Youcanifyouare18yearsorolderandarecapableofmakingyourownmedicaldeci-sions.Youdonotneedalawyer.Q:WHOCANINAMEASMYAGENT?A:Youcanchooseanadultrelativeoranyotherpersonyoutrusttospeakforyouwhenmedicaldecisionsmustbemade.Q:DOIHAVETOWAITUNTILIAMSICKTOEXPRESSMYWISHESABOUTHEALTHCARE?A:No.Infact,itisbettertochoosebeforeyougetverysickorhavetogointoahospital,nursinghome,orotherhealthcarefacility.YoucanuseanAdvancedHealthCareDi-rectivetosaywhoyouwanttospeakforyouandwhatkindoftreatmentsyouwant.Q:WHENDOESMYAGENTBEGINMAKINGMYMEDICALDECISIONS?A:Usually,ahealthcareagentwillmakedecisionsonlyafteryoulosetheabilitytomakethemyourself.But,ifyouwish,youcanstateinthePowerofAttorneyforHealthCarethatyouwanttheagenttobegindecisionsimmediately.

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Q:HOWDOESMYAGENTKNOWWHATIWOULDWANT?A:Afteryouchooseyouragent,talktothatpersonaboutwhatyouwant.Sometimestreat-mentdecisionsarehardtomake,andittrulyhelpsifyouragentknowswhatyouwant.Youcanalsowriteyourwishesdowninyouradvancedirective.Q:WHATIFIDON’TWANTTONAMEANAGENT?A:Youcanstillwriteyourwishesinyouradvancedirective,withoutnaminganagent.Youcansaythatyouwanttohaveyourlifecontinuedaslongaspossible.Oryoucansaythatyouwouldnotwanttreatmenttocontinueyourlife.Also,youcanexpressyourwishesabouttheuseofpainrelieforanyothertypeofmedicaltreatment.EvenifyouhavenotfilledoutawrittenIndividualHealthCareInstruction,youcandis-cussyourwisheswithyourdoctor,andaskyourdoctortolistthosewishesinyourmedicalrecord.Oryoucandiscussyourwisheswithyourfamilymembersorfriends.Butitwillprobablybeeasiertofollowyourwishesifyouwritethemdown.Q:WHATIFICHANGEMYMIND?A:Youcanchangeorcancelyouradvancedirectiveatanytimeaslongasyoucancom-municateyourwishes.Tochangethepersonyouwanttomakeyourhealthcaredecisions,youmustsignastatementortellthedoctorinchargeofyourcare.Q:WILLISTILLBETREATEDIFIDON’TMAKEANADVANCEDIRECTIVE?A:Absolutely.Youwillstillgetmedicaltreatment.Wejustwantyoutoknowthatifyoube-cometoosicktomakedecisions,someoneelsewillhavetomakethemforyou.Q:WHATHAPPENSWHENSOMEONEELSEMAKESDECISIONSABOUTMYTREAT-MENT?A:Thesamerulesapplytoanyonewhomakeshealthcaredecisionsonyourbehalf:ahealthcareagent,asurrogatewhosenameyougavetoyourdoctor,orapersonappointedbyacourttomakedecisionsforyou.AllarerequiredtofollowyourHealthCareInstruc-tionsor,ifnone,yourgeneralwishesabouttreatment,includingstoppingtreatment.Ifyourtreatmentwishesarenotknown,thesurrogatemusttrytodeterminewhatisinyourbestinterest.Thepeopleprovidingyourhealthcaremustfollowthedecisionsofyouragentorsurrogateunlessarequestedtreatmentwouldbebadmedicalpracticeorineffec-tiveinhelpingyou.Ifthiscausesdisagreementthatcannotbeworkedout,theprovidermustmakeareasonableefforttofindanotherhealthcareprovidertotakeoveryourtreat-ment.Q:HOWCANIGETMOREINFORMATIONABOUTMAKINGANADVANCEDIRECTIVE?A:Askyourdoctor,nurse,socialworker,orhealthcareprovidertogetmoreinformationforyou.Youcanhavealawyerwriteanadvancedirectiveforyou,oryoucancompleteanadvancedirectivebyfillingintheblanksonaform.

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Remember:

APowerofAttorneyforHealthCareletsyounameanagenttomakedecisionsforyou.Youragentcanmakemostmedicaldecisions–notjustthoseaboutlifesustainingtreatment–whenyoucan’tspeakforyourself.

Youcanalsoletyouragentmakedecisionsearlier,ifyouwish.

YoucancreateanIndividualHealthcareInstructionbywritingdownyourwishesabouthealthcareorbytalkingwithyourdoctorandaskingthedoctortorecordyourwishesinyourmedicalfile.

Ifyouknowwhenyouwouldorwouldnotwantcertaintypesoftreatment,anInstructionprovidesagoodwaytomakeyourwishescleartoyourdoctorandto

anyoneelsewhomaybeinvolvedindecidingabouttreatmentonyourbehalf.

ThesetwotypesofAdvanceHealthcareDirectivesmaybeusedtogetherorseparately.

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NOTICEOFPRIVACYPRACTICES

EffectiveDate:March,2013

THISNOTICEDESCRIBESHOWMEDICALINFORMATIONABOUTYOUMAYBEUSEDANDDISCLOSEDANDHOWYOUCANGETACCESS

TOTHISINFORMATION.PLEASEREVIEWITCAREFULLY.

Ifyouhaveanyquestionsaboutthisnotice,pleasecontacttheHealthInformationManagement.

WHOWILLFOLLOWTHISNOTICEThisnoticedescribesourhospital’spracticesandthatof:• Anyhealthcareprofessionalauthorizedtoenterinformationintoyourhospitalchart• Alldepartmentsandunitsofthehospital• Anymemberofavolunteergroupweallowtohelpyouwhileyouareinthehospital• AllEmployees,staffandotherhospitalpersonnelAlltheseentities,sitesandlocationsfollowthetermsofthisnotice.Inaddition,theseenti-ties,sitesandlocationsmaysharemedicalinformationwitheachotherfortreatment,paymentorhealthcareoperationspurposesdescribedinthisnotice.

OURPLEDGEREGARDINGMEDICALINFORMATION

Weunderstandthatmedicalinformationaboutyouandyourhealthispersonal.Wearecommittedtoprotectingmedicalinformationaboutyou.Wecreatearecordofthecareandservicesyoureceiveatthehospital.Weneedthisrecordtoprovideyouwithqualitycareandtocomplywithcertainlegalrequirements.Thisnoticeappliestoalloftherecordsofyourcaregeneratedbythehospital,whethermadebyhospitalpersonneloryourpersonaldoctor.Yourpersonaldoctormayhavedifferentpoliciesornoticesregardingthedoctor’suseanddisclosureofyourmedicalinformationcreatedinthedoctor’sofficeorclinic.Thisnoticewilltellyouaboutthewaysinwhichwemayuseanddisclosemedicalinfor-mationaboutyou.Wealsodescribeyourrightsandcertainobligationswehaveregardingtheuseanddisclosureofmedicalinformation.Wearerequiredbylawto:• Makesurethatmedicalinformationthatidentifiesyouiskeptprivate(withcertain exceptions);• Giveyouthisnoticeofourlegaldutiesandprivacypracticeswithrespecttomedicalin-formationaboutyou;and• Followthetermsofournoticethatiscurrentlyineffect.

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HOWWEMAYUSEANDDISCLOSEHEALTHINFORMATION

Thefollowingcategoriesdescribedifferentwaysthatwemayuseanddisclosemedicalinformation.Foreachcategoryofusesordisclosureswewillexplainwhatwemeanandtrytogivesomeexamples.Noteveryuseordisclosurein

acategorywillbelisted.However,allofthewayswearepermittedtouseanddiscloseinformationwillfallwithinoneofthecategories.

•DisclosureatYourRequest.Wemaydiscloseinformationwhenrequestedbyyou.Thisdisclosureatyourrequestmayrequireawrittenauthorizationbyyou.•ForTreatment.Wemayusemedicalinformationaboutyoutoprovideyouwithmedicaltreatmentorservices.Wemaydisclosemedicalinformationaboutyoutodoctors,nurses,technicians,healthcarestudents,orotherhospitalpersonnelwhoareinvolvedintakingcareofyouatthehospital.Forexample,adoctortreatingyouforabrokenlegmayneedtoknowifyouhavediabetesbecausediabetesmayslowthehealingprocess.Inaddition,thedoctormayneedtotellthedietitianifyouhavediabetessothatwecanarrangeforappro-priatemeals.Differentdepartmentsofthehospitalalsomaysharemedicalinformationaboutyouinordertocoordinatethedifferentthingsyouneed,suchasprescriptions,labworkandx-rays.Wealsomaydisclosemedicalinformationaboutyoutopeopleoutsidethehospitalwhomaybeinvolvedinyourmedicalcareafteryouleavethehospital,suchasotheracutefacilities,skillednursingfacilities,homehealthagencies,andphysiciansoroth-erpractitioners.Forexample,wemaygiveyourphysicianaccesstoyourhealthinfor-mationtoassistyourphysicianintreatingyou.•ForPayment.Wemayuseanddisclosemedicalinformationaboutyousothatthetreat-mentandservicesyoureceiveatthehospitalmaybebilledtoandpaymentmaybecollect-edfromyou,aninsurancecompanyorathirdparty.Forexample,wemayneedtogiveyourhealthplaninformationaboutyoursurgeryyoureceivedatthehospitalsoyourhealthplanwillpayusorreimburseyouforthesurgery.Wemayalsotellyourheathplanaboutatreatmentyouaregoingtoreceivetoobtainpriorapprovalortodeterminewhetheryourplanwillcoverthetreatment.Wemayalsoprovidebasicinformationaboutyouandyourhealthplan,insurancecompanyorothersourceofpaymenttopractitionersoutsidethehospitalwhoareinvolvedinyourcare,toassisttheminobtainingpaymentforservicestheyprovidetoyou.Ifyouwishtopayforthishospitalizationtreatmentoutofpocket,infull,youhavetherighttorestrictdisclosuresofprotectedhealthinformationtoyourhealthplan.Pleasecontactabusinessofficeassociatebeforetheendofyourhospitalization.RefertotheBusinessOfficephonenumber.•HospitalDirectory.Wemayincludecertainlimitedinformationaboutyouinthehospi-taldirectorywhileyouareapatientatthehospital.Thisinformationmayincludeyourname,locationinthehospital,yourgeneralcondition(e.g.,good,fair,etc)andyourreli-giousaffiliation.Unlessthereisaspecificwrittenrequestfromyoutothecontrary,thisdi-rectoryinformation,exceptforyourreligiousaffiliation,mayalsobereleasedtopeoplewhoaskforyoubyname.Yourreligiousaffiliationmaybegiventoamemberoftheclergy,suchasapriestorrabbi,eveniftheydon’taskforyoubyname.Thisinformationisre-leasedsoyourfamily,friendsandclergycanvisityouinthehospitalandgenerallyknowhowyouaredoing.

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•ForHealthCareOperations.WemayuseanddiscloseHealthInformationaboutyouforhealthcareoperationpurposes.Theseusesanddisclosuresarenecessarytomakesurethatallofourpatientsreceivequalitycareandforouroperationandmanagementpurpos-es.Forexample,wemayuseHealthInformationtoreviewthetreatmentandservicesweprovidetoensurethatthecareyoureceiveisofthehighestquality.Wemayalsocombinemedicalinformationaboutmanyhospitalpatientstodecidewhatadditionalservicesthehospitalshouldoffer,whatservicesarenotneeded,andwhethercertainnewtreatmentsareeffective.Wemayalsodiscloseinformationtodoctors,nurses,technicians,medicalstudents,andotherhospitalpersonnelforreviewandlearningpurposes.Wemayalsocombinethemedicalinformationwehavewithmedicalinformationfromotherhospitalstocomparehowwearedoingandseewherewecanmakeimprovementsinthecareandser-vicesweoffer.Wemayremoveinformationthatidentifiesyoufromthissetofmedicalin-formationsoothersmayuseittostudyhealthcareandhealthcaredeliverywithoutlearn-ingwhothespecificpatientsare.•FundraisingActivities.Wemayusemedicalinformationaboutyou,ordisclosesuchin-formationtoafoundationrelatedtothehospital,tocontactyouinanefforttoraisemoneyforthehospitalanditsoperations.Youhavetherighttooptoutofreceivingfundraisingcommunications.Ifyoureceiveafundraisingcommunication,itwilltellyouhowtooptout.Weonlywouldreleasecontactinformation,suchasyourname,addressandphonenumberandthedatesyoureceivedtreatmentorservicesatthehospital.•MarketingandSale.Mostusesanddisclosuresofmedicalinformationformarketingpurposes,anddisclosuresthatconstituteasaleofmedicalinformation,requireyourau-thorization.•IndividualsInvolvedinYourCareorPaymentforYourCare.Wemayreleasemedicalinformationaboutyoutoafriendorfamilymemberwhoisinvolvedinyourmedicalcare.Wemayalsogiveinformationtosomeonewhohelpspayforyourcare.Unlessthereisaspecificwrittenrequestfromyoutothecontrary,wemayalsotellyourfamilyorfriendsyourconditionandthatyouareinthehospital.Wealsomaynotifyyourfamilyaboutyourlocationorgeneralconditionordisclosesuchinformationtoanentityassistinginadisas-terreliefeffort.Ifyouarriveattheemergencydepartmenteitherunconsciousorotherwiseunabletocommunicate,wearerequiredtoattempttocontactsomeonewebelievecanmakehealthcaredecisionsforyou(e.g.,afamilymemberoragentunderahealthcarepowerofattorney).

•Research.Undercertaincircumstances,wemayuseanddiscloseHealthInformationforresearchpurposes.Forexample,aresearchprojectmayinvolvecomparingthehealthre-coveryofallpatientswhoreceivedonemedicationortreatmenttothosewhoreceivedan-other,forthesamecondition.Allresearchprojects,however,aresubjecttoaspecialap-provalprocess.Thisprocessevaluatesaproposedresearchanditsuseofmedicalinfor-mation,tryingtobalancetheresearchneedswithpatients’needforprivacyoftheirmedi-calinformation.Beforeweuseordisclosemedicalinformationforresearch,theprojectwillgothroughaspecialapprovalprocess,butwemay,however,disclosemedicalinformationaboutyoutopeoplepreparingtoconductaresearchproject,forexample,tohelpthemlookforpatientswithspecificmedicalneeds,aslongasthemedicalinformationtheyreviewdoesnotleavethehospital.

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•AsRequiredbyLaw.WewilldiscloseHealthInformationwhenrequiredtodosobyin-ternational,federal,state,orlocallaw.•ToAvertaSeriousThreattoHealthorSafety.WemayuseanddiscloseHealthInfor-mationwhennecessarytopreventorlessenaseriousthreattoyourhealthandsafetyortothehealthandsafetyofthepublicoranotherperson.Anydisclosure,however,willbetosomeonewhomaybeabletohelppreventthethreat.

SPECIALCIRCUMSTANCES

•OrganandTissueDonation.Ifyouareanorgandonor,wemayreleaseHealthInfor-mationtoorganizationsthathandleorganprocurementororgan,eyeortissuetransplanta-tionortoanorgandonationbank,asnecessary,tofacilitateorganortissuedonationandtransplantation.•MilitaryandVeterans.Ifyouareamemberofthearmedforces,wemayreleaseHealthInformationasrequiredbymilitarycommandauthorities.WemayalsoreleaseHealthIn-formationtotheappropriateforeignmilitaryauthorityifyouareamemberofaforeignmilitary.•Workers’Compensation.WemayreleaseHealthInformationforworkers’compensa-tionorsimilarprograms.Theseprogramsprovidebenefitsforwork-relatedinjuriesorill-nesses.•PublicHealthRisks.WemaydiscloseHealthInformationforpublichealthactivities.Theseactivitiesgenerallyincludedisclosurestopreventorcontroldisease,injuryordisabil-ity;reportbirthsanddeaths;reportchild,elderanddependentadultabuseorneglect;re-portreactionstomedicationsorproblemswithproducts;notifypeopleofrecallsofprod-uctstheymaybeusing;trackcertainproductsandmonitortheiruseandeffectiveness;noti-fyapersonwhomayhavebeenexposedtoadiseaseormaybeatriskforcontractingorspreadingadiseaseorcondition;andconductmedicalsurveillanceofthehospitalincertainlimitedcircumstancesconcerningworkplaceillnessorinjury.WealsomayreleaseHealthInformationtoanappropriategovernmentorauthorityifwebelieveapatienthasbeenavictimofabuse,neglectordomesticviolence;however,wewillonlyreleasethisinformationifyouagreeorwhenwearerequiredorauthorizedbylaw.TonotifyemergencyresponseemployeesregardingpossibleexposuretoHIV/AIDS,totheextentnecessarytocomplywithstateandfederallaws•HealthOversightActivities.WemaydiscloseHealthInformationtoahealthoversightagencyforactivitiesauthorizedbylaw.Theseoversightactivitiesinclude,orexample,au-dits,investigations,inspections,andlicensure.Theseactivitiesarenecessaryforthegov-ernmenttomonitorthehealthcaresystem,governmentprograms,andcompliancewithcivilrightslaws.•Coroners,MedicalExaminersandFuneralDirectors.WemayreleaseHealthInfor-mationtoacoronerormedicalexaminer.Thismaybenecessary,forexample,toidentifyadeceasedpersonordeterminethecauseofdeath.WealsomayreleaseHealthInformationtofuneraldirectorsasnecessaryfortheirduties.

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•LawsuitsandDisputes.Ifyouareinvolvedinalawsuitoradispute,wemaydiscloseHealthInformationinresponsetoacourtoradministrativeorder.WealsomaydiscloseHealthInformationinresponsetoasubpoena,discoveryrequest,orotherlawfulprocessbysomeoneelseinvolvedinthedispute,butonlyifeffortshavebeenmadetotellyouabouttherequest(whichmayincludewrittennoticetoyou)ortoobtainanorderprotect-ingtheinformationrequested.•LawEnforcement.WemayreleaseHealthInformationifaskedbyalawenforcementofficialforthefollowingreasons:(1)inresponsetoacourtorder,subpoena,warrant,summonsorsimilarprocess;(2)limitedinformationtoidentifyorlocateasuspect,fugi-tive,materialwitness,ormissingperson;(3)aboutthevictimofacrimeif,undercertainlimitedcircumstances,weareunabletoobtaintheperson’sagreement;(4)aboutadeathwebelievemaybetheresultofcriminalconduct;(5)aboutcriminalconductonourprem-ises;and(6)inemergencycircumstancestoreportacrime,thelocationofthecrimeorvic-tims,ortheidentity,description,orlocationofthepersonwhocommittedthecrime.•NationalSecurityandIntelligenceActivities.WemayreleaseHealthInformationtoauthorizedfederalofficialsforintelligence,counter-intelligence,andothernationalsecuri-tyactivitiesauthorizedbylaw.•ProtectiveServicesforthePresidentandOthers.WemaydiscloseHealthInformationtoauthorizedfederalofficialssotheymayprovideprotectiontothePresident,otherau-thorizedpersonsorforeignheadsofstateorconductspecialinvestigations.•SecurityClearances.Wemayusemedicalinformationaboutyoutomakedecisions,re-gardingyourmedicalsuitabilityforasecurityclearanceorserviceabroad.WemayalsoreleaseyourmedicalsuitabilitydeterminationtotheofficialsintheU.S.DepartmentofStatewhoneedaccesstothatinformationforthesepurposes.•InmatesorIndividualsinCustody.Ifyouareaninmateofacorrectionalinstitutionorunderthecustodyofalawenforcementofficial,wemyreleaseHealthInformationtotheappropriatecorrectionalinstitutionorlawenforcementofficial.Thisreleasewouldbemadeonlyifnecessary(1)fortheinstitutiontoprovideyouwithhealthcare;(2)toprotectyourhealthandsafetyorthehealthandsafetyofothers;or(3)forthesafetyandsecurityofthecorrectionalinstitution.•MultidiciplinaryPersonnelTeams.Wemaydisclosehealthinformationtoamultidisci-plinarypersonnelteamrelevanttotheprevention,identification,managementortreat-mentofanabusedchildandthechild’sparents,orelderabuseandneglect.•SpecialCategoriesofInformation.Insomecircumstances,yourhealthinformationmaybesubjecttorestrictionsthatmaylimitorprecludesomeusesordisclosuresdescribedinthisnotice.Forexample,therearespecialrestrictionsontheuseordisclosureofcertaincategoriesofinformation–e.g.,testsforHIVortreatmentformentalhealthconditionsoralcoholanddrugabuse.Governmenthealthbenefitprograms,suchasMedi-Cal,mayalsolimitthedisclosureofbeneficiaryinformationforpurposesunrelatedtotheprogram.

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COMPLAINTSIfyoubelieveyourprivacyrightshavebeenviolated,youmayfileacomplaintwiththis

hospital’sHealthInformationManagement.Allcomplaintsmustbemadeinwriting.Youmayalsocontact:

OfficeforCivilRightsU.S.DepartmentofHealthandHumanServices

200IndependenceAvenueSW,Room509F,HHHBuilding,WashingtonD.C.20201Phone800-368-1019•FAX202-619-3818•TDD800-537-7697•email:OCRPrivacy@hhs.gov

Youwillnotbepenalizedforfilingacomplaint.

OtherusesofMedicalInformation

Otherusesanddisclosuresofmedicalinformationnotcoveredbythisnoticeorthelawsthatapplytouswillbemadeonlywithyourwrittenpermission.

Ifyouprovideuspermissiontouseordisclosemedicalinformationaboutyou,youmayrevokethatpermission,inwriting,atanytime.Ifyourevokeyour

permission,thiswillstopanyfurtheruseordisclosureofyourmedicalinformationforthepurposescoveredbyyourwrittenauthorization,exceptifwehavealreadyactedinrelianceonyourpermission.Youunderstandthatweareunabletotakebackanydisclosureswehavealreadymadewithyourpermission,andthatwe

arerequiredtoretainourrecordsofthecarethatweprovidedtoyou.

APATIENT’SGUIDETOBLOODTRANSFUSIONSUSINGYOUROWNBLOOD–AUTOLOGOUSDONATION

Usingyourownbloodwillreduce,butnoteliminate,theriskoftransfusion-relatedinfec-tionsandallergicreactions.Askyourdoctorifautologousdonationisappropriateforyou.

DONATINGBEFORESURGERYBloodbankscandrawyourbloodandstoreitforyouruse.Thisprocessusuallyisper-formedforaplannedsurgery,socoordinatingthedonationswiththedateofsurgeryisanimportantconsideration.

DONATINGDURINGSURGERYImmediatelybeforesurgery,yourdoctormaybeabletoremovesomeofyourbloodandreplaceitwithotherfluids.Aftersurgery,thebloodthatwasremovedmaybereturnedtoyou.Bloodthatnormallyislostanddiscardedduringsurgerymaybecollected,processedandreturnedtoyou.

DONATINGAFTERSURGERYBloodthatislostaftersurgerymaybecollected,filteredandreturnedtoyou.Thisprocessmayminimizeoreliminatetheneedtobetransfusedwithsomeoneelse’sblood.

USINGSOMEONEELSE’SBLOODIfyouchoosenottodonateyourownblood,orifmorebloodisrequiredthanexpected,youwillreceivebloodfromcommunityordesignateddonors,ifnecessary.

DONORSHospitalsmaintainasupplyofdonorbloodtomeettransfusionneeds.Volunteer(un-paid)communityblooddonorsanddesignateddonors,orpersonsyouknowwhomaywanttogiveblood,arescreenedbyathoroughmedicalhistory,andtested.Advanceno-ticeisrequiredtoaccommodatearequestfordesignateddonors.

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UNDERSTANDINGYOURPAIN–FAMILYANDPATIENTINFORMATION

PAINRELIEFPainmedicineworksbestwhenyourelax.• Placeapillowwhereyourbodyhurts.Thissupportsthepainfulareaandishelpfulwhendeepbreathingandcoughingaftersurgery.• Usecoldorwarmpackstoeaseyourpain.Backmassageshelprelaxtightmuscles.• Breatheinandoutslowlytorelaxmuscleswhenyougetinandoutofbedorachair.Takeabreathbeforeyoumove,thenslowlybreatheoutasyougetupormove.• Listentosoftmusic.• Talkwithsomeone;forexample,stafffromthePastoralCareorSocialServicesdepart-ments.PAINRATINGSCALES

Thepainscaleisonewaywecanunderstandhowyou’refeeling.Remember,itisveryimportantforyournursesordoctortoknowifthepainmedicinedoesn’thelp,orifyourpainsuddenlychanges.MANAGINGYOURPAIN•Everyonefeelsandreactstopainindifferentways.Howyoufeelpaincandependonwhathappenedtoyouinthepastandhowworriedyouareaboutwhatiscausingyourpain.•Whenyouareadmittedtothehospital,yournursewillaskyouhowmuchpainyouarewillingtotolerateinordertomovearoundinbed,walk,cough,breathedeeply,andsleep.•Duringyourstay,thenursesandyourdoctorwilloftenaskaboutyourpaintomakesurethepainlevelisacceptable.Theywillalsoaskwhereithurtsandhowitfeels.Herearesomewordstohelpdescribeyourpain:cramp,sharp,ache,burning,dull,constant,off-and-on.Yourdoctorandnurseswillcomparethepainyoucantolerateandthewayyoude-scribethepain,todecidewhattypeofmedicineandotherpainreliefmethodstouse.•Whenyouleavethehospital,yournursewilltalktoyouaboutsafewaystotakecareofthepainathome.Donotbeafraidtotakepainmedicationwhenyouneedit,followingthedirectionsontheprescription.•Youaretheonlyonewhoknowshowmuchpainyoufeelandwhatmakesitfeelbetter.Behonestwiththenursesordoctor.Donotworryaboutbeingbraveorbotheringthenurses.Takingcareofpainisanimportantpartoftakingcareofyourhealth.

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STOPSMOKING–BEAQUITTER

Womenwhosmokeandtakebirthcontrolpillsare10-20timesmorelikelytohaveastrokeorheartattack.

BEAQUITTERANDGETRIDOFYOURBESTFRIEND

Peoplearemorelikelytosucceedinquittingwhentheyknowwhatobstaclestheyfaceandhaveaplantohandlethem.•Setyourquitdatetoprepareyourselfandthosearoundyou.•Stopsmokingontheplannedday.•Knowwhattodoinsituationsthattriggeryoursmoking.Triggersincludetalkingonthephone,driving,othersmokers,aftersex,aftereating,beingsad,angryorstressed.•Planforpotentialsideeffectslikeirritability,feelingtired,gastrointestinalproblems,weightgain,andcough.Thesesymptomslastforonlyashorttimeandyourmetabolismreturnstonormalquickly.

SMOKING

Toprovideahealthfulandcomfortableenvironmentforallpatientsandvisitors,wemain-tainasmokefreeenvironment.Patientsandvisitorsarenotallowedtosmokeany-whereinthehospital,includingthecafeteria,restroomsorlounges.Smokingisalsoprohibitedonthegrounds,exceptwheredesignatedbysignage.

ResourcesandSupportforSmokingCessation

RESOURCESCONTACTINFORMATION

American Cancer Society 1-800-227-2345 www.cancer.org

American Heart Association 1-800-242-8721 www.americanheart.org

American Lung Association 1-800-586-4872 www.lungusa.org

SOURCES CONTACTINFORMATION

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NOTICEOFACCESSIBILITYFORPERSONSWITHDISABILITIES[Section504.45C.F.R.§84.22(f)]

OurHospitalandallprogramsandactivitiesareaccessibletoanduseablebydisabledper-sons,includingpersonswhoaredeaf,hardofhearing,orblind,orwhohaveothersensoryimpairments.Accessfeaturesmayinclude:•Convenientoff-streetparkingdesignatedspecificallyfordisabledperson.•Curbcutsandrampsbetweenparkingareasandbuildings.•Levelaccessintofirstfloorlevelwithelevatoraccesstoallotherfloors.•Fullyaccessibleoffices,meetingrooms,bathrooms,publicwaitingareas,cafeteria, patienttreatmentareas,includingexaminingroomsandpatientwards.•Afullrangeofassistiveandcommunicationaidsprovidedtopersonswhoaredeaf, hardofhearing,orblind,orwithothersensoryimpairments. Thereisnoadditionalchargeforsuchaids.Someoftheseaidsmayinclude:

ü Qualifiedsignlanguageinterpretersforpersonswhoaredeaforhardofhearing.ü Atwenty-fourhour(24)telecommunicationdevice(TTY/TDD)whichcanconnect

thecallertoallextensionswithinthefacilityand/orportable(TYY/TDD)units,forusebypersonswhoaredeaf,hardofhearing,orspeechimpaired.

ü Readersandtapedmaterialfortheblindandlargeprintmaterialsforthevisually-impaired.

ü FlashCards,Alphabetboardsandothercommunicationboards.ü Assistivedevicesforpersonswithimpairedmanualskills.

Ifyourequireanyoftheaidslistedabove,pleaseletthereceptionistoryournurseknow.

THEETHICSCOMMITTEESometimesadifficultchoicemustbemadefromtwoormorealternatives,noneofwhichcompletelyprovidesasatisfactoryanswer.TheEthicsCommitteemaybecomposedofphy-sicians,hospitalstaffmembers,andcommunitymembers,anditfunctionsasanadvisorybodytotheHospitalregardingethicalandmoralissueswhichariseintheprovisionofmedicalcare.AccesstotheEthicsCommitteeisavailabletopatientsandtheirfamiliesuponrequest.Askyournurseforaccess.

MEDICALSOCIALWORKOurMedicalSocialWorkStaffisapartofthehealthcareteamthatisworkingtoassurethatthesupportandcompassionatecareourpatientsandfamiliesneedduringhospitalizationisthere.Wecanassistyouandyourfamilyindealingwithemotional,socialand/oreco-nomicstresseswhichmayoccurasaresultofillnessandhospitalization.Wearealsospecialistsinidentifyingthemanycommunity,stateandfederalresourcesthatmaybeofhelptoyouintheweeksahead.Ifyouneedhelpinsortingoutyourneeds,askyournursetocontactasocialworkerforyou.

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SAFETYFIRSTYourwell-beingisofprimaryimportancetous.Forthisreason,wehaveequippedyourbedwithsiderailstokeepyousafewhenyouaremedicatedorasleep.Pleaseaskforassistanceifyouwishtolowerorraisethem.Whenyougetoutofbed,pleasedon’trelyonyourbed-sidetableforsupport.Itcanshiftunderyourweight.Also,weaskthatyouwearnon-skidslipperswhenwalkingaroundtheunit,andthatyourequestassistancewhengettinginoroutofabedorchair,unlessotherwiseinstructedbyyournurseordoctor.Makesureyouandyourfamilyknowyourallergiesandmedications.

ASK,ASK,ASKKnowallthewho,what,when,whereandwhyaboutthecareandtreatmentyouaretore-ceive.Expecteveryoneinvolvedinyourcaretointroducethemselvesbyname,andtowearanidentificationbadge.Makesuretotellyourhealthcareprofessionalifyouthinkheorshehasyouconfusedwithanotherpatient.Tellthenurseordoctorifyouthinkyouareabouttoreceivethewrongmedicationorifsomethingdoesn’tseemright.Don’tassumeanything.

SHAREINFORMATIONWeaskthatyouopenlydiscussyourcompletehealthhistorywithyourhealthcareteam.Thisincludesanymedicinesyoutake,anysurgeriesyou'vehad,oranyallergiesyoumayhave.

PROVIDEYOURIDENTIFICATIONForyoursafety,ourteammayaskyouthesamequestionsmanytimes,includingyourfullnameanddateofbirth,tomakesureyoureceivethecorrecttreatmentorservices.Theywillmostoftendothisbefore:givingamedication;takingbloodorothersamples;andoth-ertreatmentsorprocedures.Thesestepshelpensureyoureceivethebestpossiblecare.

NOTIFYUSOFANYCHANGEINYOURCONDITIONIfsomethingdoesn’tseemright,oryoufeelthatyourconditionisworsening,alertyournurse,whowillassessyoursituation.

INTERPRETERSBecauseweprovidehealthcareservicestopeoplewithculturallydiversebackgrounds,ourinterpretingservicesincludethetranslationphoneoruseofanoutsidecompanyforin-personinterpreting.Ifyouneedtheirhelpinunderstandinganyaspectofyourcare—orinexpressingyourconcerns—yournursewillarrangefortheirassistance.Thereisnochargeforthisservice.Signlanguageinterpretersareavailableaswell.

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PATIENTASSESSMENTSEachpatientwillreceiveaninitialnursingassessmentuponadmission.Thisinformationwillhelpustoidentifyandprioritizeyouroveralltreatmentplan.Thescope,intensityandtimelinessoffurtherassessmentswillbedefinedbyyourhealthcareteambasedonyourdiagnosis,caresetting,desireforcareandresponsetoprevioustreatment.Anassessmentofyourdischargeplanningneedswillalsobeginwithin8hoursofyouradmission.Dis-chargeplanningisacollaborativeprocessandwillinvolveyou,yourfamilyandqualifiedindividualsonthehealthcareteam.

INFECTIONPREVENTION Healthcareproviderscomeintocontactwithmanygerms.That'swhytheyshouldcleantheirhandswithsoapandwateroruseaspecialcleansinggelbeforetreatingyou-eveniftheyusegloves.Anotherwaytohelppreventthespreadofinfectionsisthroughrespirato-ryhygiene.Tellyourcaregiversimmediatelyifyouhaveflusymptoms,suchasacoughorsneeze.Alwaysremembertocleanyourhandsaftercoughing,sneezing,andusingtissues. Infectionscanbespreadthroughtheairandbycontactwithclothing,hands,personalitemsorhealthcareequipment.Thebestwaytostopthespreadofinfectionistowashyourhands.Washyourhandsthoroughlyandoften–afterusingthebathroom,touchingsoileditems,orcoughingandsneezing.Usethehandsanitizerlocatedonthewalloutsideyourroom,orusesoapandwaterforatleast20seconds. Whencoughingorsneezing,ifyoudon’thaveatissue,coughorsneezeintoyoursleeve.Remembertoputyourusedtissueinthewastebasket,andimmediatelyusehandsanitizerorsoapandwaterifyouareable.Youmayalsobeaskedtoputonasurgicalmasktoprotectothers. Dependingonyourillness,symptomsormedicalhistory,youmaybeplacedin“isola-tionprecautions”.Thesemeasuresarenec-essaryforyourprotectionandtopreventthespreadofdiseasetootherpatients,staffandvisitors.Ifyouhaveanyquestionsorneedtoknowwhythisprotectionisnecessary,pleasespeakwithyournurseorphysician.Whileyouarein“isolation”,yourfriendsandfamilyneedtofollowtheserules:• Visitthenurses’stationbeforeenteringtheroom.Protectiveclothingwillbeprovided.• Beforeenteringtheroom,washyourhandswithsoapandwaterorusehandsanitizer.• Visitorsarelimitedtotwoatatimeandshouldnotbeillwhenvisiting.• Forthesafetyofourpatients,thoseunder18yearsofageshouldnevervisitapatientin

isolation.• Asfewitemsaspossibleshouldbebroughtintotheroom.

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PATIENTANDFAMILYEDUCATIONWebelievethatpatienteducationisoneofthemostimportantwayseverypatientcanhelptheirownrecovery.Knowingwhatiswrongwithyouandwhattreatmentsareavailable,allowyoutohelpmakethedecisionsaboutyourcarethatyouwant.Weknowthateveryonehashisorherownwaysoflearning.Wewanttohelpyoulearnaboutyourconditionintheeasiestwaypossible.Youwillbeaskedquestionsabouthowyoulearnbest,ifyouhaveanyreligiousorculturalbeliefsthatwillaffectourteaching.Thetypesoftopicswewanttocoverincludehowtobesafe,nutrition,howtosafelytakeyourmedicines,howtouseanyequipmentyouneedandanyquestionsyouhaveaboutyourdiagnosis.

CONDITIONREPORTSWhenfriendscalltoinquireaboutyourcondition,thecallwillbedirectedtoyourroom.Ifyou’dpreferthatwewithholdallinfor-mation,includingyourconditionandlocationwithinthehospital,pleasenotifyyournurse.

KNOWYOURMEDICATIONS

PrimeHealthcareiscommittedtoprovidinghighqualityandsafepatientcare.Thisin-cludesprovidingyouwithimportantinformationaboutyourmedicationsduringyourstaywithus.Ifyouhaveanyquestionsorconcerns,pleasediscussthesewithamemberofyourhealthcareteam.

IFYOUNEEDHELPSuicide is the 10th leading cause of death in the United States, claiming more lives each year than traffic accidents. Suicide is always intended to eliminate or manage pain that an individual finds unbearable, it is fueled by feelings of despair. Suicide doesn’t just happen it is a result of a person’s level of pain exceeding their coping resources. There is help available if you or someone you know is at risk for Suicide. You can learn more about Suicide and Suicide Prevention at http://www.suicidepreventionlifeline.org/learn/riskfactors.aspx. If you or someone you know needs to talk to someone immediately please call the Suicide Prevention Lifeline, Call 24/7 at 1-800-273-8255 or go to your nearest Emergency Room.

UNDERSTANDING&PREVENTINGBLOODCLOTSBloodclots(deepveinthrombosisorDVT)mostoftenoccurinpeoplewhocan'tmovearoundwellorwhohavehadrecentsurgeryoraninjury.Duringyourstay,youwillbeas-sessedtofindoutifyouareatriskforbloodclots.Ifyouarefoundtobeatrisk,youwillbetreatedaccordinglyandprovidededucation.

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ORGANDONATIONS

Whensomeonedies,itisoftenpossibleforotherlivestobesavedormadebetterthroughthedonationoftheirorgansandtissues.Werealizethatthedeathofalovedoneisaverydifficulttimeandtakethisintoconsiderationwhendiscussingthepossibilityofdonation.Wearerequiredbylawtoreferourpatientstoourlocalorgandonationagencywhomaydiscusstheoptionoforgan/tissuedonation.Manyfamilieshavetakencomfortinthisdif-ficulttimeinknowingthatsomeoneelse’slifewasmadebetterthroughthedonationoftheirlovedones’organs/tissues.

GOINGHOMECASEMANAGEMENT

TheCaseManagementstaffareexperiencedprofessionalswhocollaborativelymonitorandcoordinateyourcarewhileassessingyourneedsonanongoingbasisduringyourstay.Theyworkcloselywithyourphysicianandthehealthcareteam,aswellasyourinsurer,toassureyoureceivethehighestqualitycare.YourCaseManagementStaffwillworkwithyouandyourfamilytoarrangeforappropriatepostdischargeneeds.

DISCHARGEPLANNINGThefirstthingmostpeoplethinkaboutwhentheyenterahospitalis,“WhencanIgoHome?”Goinghomefromthehospitalortoanotherfacilitycanpresentspecialneedsandchallenges.Pleaseletyournurseoranymemberofyourhealthcareteamknowifyouhaveanyspecialconcernsregardingyourneedsafterleavingthehospitalasearlyaspossible.Yourhealthcareteambeginsthinkingandformulatingaplanwithyouforyourdischargeearlyinyourhospitalstay.Letyournurseknowifyourequestadischarge

planevaluationfromtheCaseManager.YoumayalsorequestaCaseManagertodiscusschangesandquestionsyouhaveaboutyourdischargeplanningandneeds.Avarietyofhealthcareteammemberswillhelpminimizeanyproblemsandassistyouintransitioningfromonelevelofcaretoanother.Incollaborationwithyouandyourfamilyandthephysician,yourcasemanager,dischargeplanner,socialworkerandnursecanassistinarrangingtheappropriateafterhos-pitalservicesyoumayneed.Theseservicesmayincludehomehealthcare,

skillednursingfacilities,and/orresourcestoenhancethesuccessofyourhospitalstay.

LEAVINGTHEHOSPITALWhenyouandyourdoctordecideyouareready,youwillleavethehospitaltocontinueyourrecoveryathomeoratatransitionalfacility.Beforeyougo,yourphysicianandnursewillreviewyourdischargepapersanddiscussyourpost-hospitalcarewithyouandyourfamily.Makesureyouunderstandyourphysician’sinstructions.Theentirehealthcareteamisavailabletoassistinansweringyourquestions.Don’tforgettoarrangeforaridehomewitharelativeorfriendwellinadvanceofyourdischarge.

P A T I E N T I N F O R M A T I O N G U I D E

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KNOWHOWTOCAREFORYOURSELFATHOMERecoveringfromanillnessorinjurycanbechallenging,andyouandyourfamilymaybeconcernedabouthowyouaregoingtomanageyourcareafteryouarehome.Yourphysi-cian,nurses,CaseManagementteam,andthehospitaldischargeteamwillgiveyouwrittendischargeinstructions,andreviewthemwithyousothatyouunderstandhowtocareforyourselfafteryouleavethehospital.It'simportanttofollowtheseinstructionsforthebestpossiblerecovery.

FINANCIALMATTERS

YOURBILL

Weknowthatmedicalbillscanbeconfusing.Inanefforttosimplifymatters,wewillassistyouinverifyingyourinsuranceandidentifyingpriorauthorizationrequirements,deducti-blesandcopayments.Pleasebepreparedtopayallapplicableinsurancedeductibles,andcopaymentsbeforeyouenterthehospitaloratthetimeyouareadmitted.Afteryouleavethehospital,wewillbillyourinsurancecompanydirectly.Oncewehavereconciledyouraccountwithyourinsurancecompany,youwillreceiveabillforanyre-mainingcopaymentsordeductions,aswellasforanynon-covereditemsandservices.Foryourconvenience,youmaypaybycash,check,Discover,AmericanExpress,Visa,orMas-terCard.Ifyouhavequestionsaboutourbillingprocedures—orinquiriesaboutyourhos-pitalbill—wewillbehappytoanswerthem.PleasecallourbusinessofficeonMondaythroughFriday,from8:00a.m.to4:30p.m.Checkyourhospitalforspecifichours.Inadditiontoyourhospitalbill,youmayalsoreceiveseparatebillsfromyourdoctor,anes-thesiologist,radiologist,pathologist,andotherspecialistswhocaredforyou.

MEDICAREIfyouareenrolledinMedicare,wewillsendyouabillonlyifyouhaveanoutstandingde-ductibleamountorhaveincurredchargesfornon-covereditemsorservices.Thisalsoap-pliestopatientsenrolledinsupplementalpolicies.Iftherearenouninsureditems,wewillbillMedicaredirectlyandyouwillnotreceiveabillfromus.TheQualityImprovementOrganizationsKeproandLivantaworkunderthedirectionoftheCentersforMedicare&MedicaidServices(CMS).Ifyouhaveconcernsaboutthecareyouhavereceived,youcancalltheCIOlistedforyourstate:

Region1:PA,NJ,RI Livanta 877-588-1123Region2:GA,FL KEPRO 844-455-8708Region3:TX,AL KEPRO 844-430-9504

Region4:KS,MO,IN,MI,OH KEPRO 855-408-8557Region5:CA,NV Livanta 877-588-1123

NOTES:

NOTES:

070-034 (2/16)