Patient Rights and Responsibilities
1. You have the right to receive this written statement of patient rights.
2. You have the right of access to treatment regardless of your race, color, national origin, religion, sex, sexual orientation, gender identity, age or disability.
3. You have the right to define your "family" and/or support people, including those who may visit you when you are a patient of Ohio Valley Surgical Hospital regardless of their race, color, national origin, religion, sex, sexual orientation, gender identity, age or disability.
4. You have the right to receive prompt, considerate and respectful care in a safe setting.
5. You have the right to be involved in all aspects of your care including the right to participate in the development and implementation of your plan of care and the right to make decisions regarding your care.
6. You have the right to receive information, in a language/communication style that will help you understand and be fully informed of your total health status, including your diagnosis and possible prognosis, the benefits and risk of treatment, and the expected outcome of treatment, including realistic alternatives and unexpected outcomes.
7. You have the right to give informed consent and make decisions regarding your care, proposed treatment, procedures and/or healthcare services.
8. You have the right (to the extent permitted by law) to refuse or request treatment, to refuse or request the withdrawal of life-sustaining treatment, to withhold resuscitative services, and to be informed of the medical consequences of your decision.
9. You have the right to expect unrestricted access to communications such as visitors, mail and telephone calls. If there is a need for communication restrictions, you have the right to be informed of the reasons, participate in the decision and have the restriction evaluated for therapeutic effectiveness.
10. You have the right to the confidentiality of your clinical records and the right to access these records within a reasonable time frame.
11. You have the right to designate another person to make medical decisions on your behalf and/or to make an advance directive, appoint someone to make health care decisions for you if you are unable, and to have Ohio Valley Surgical Hospital staff members and practitioners who provide care comply with this directive. If you do not have an advance directive, we can provide you with information regarding how to complete one.
12. You have the right to timely and accurate answers to your questions regarding hospital and physician charges, insurance reimbursement and methods of payment.
13. You have the right to know the relationship of Ohio Valley Surgical Hospital to other healthcare providers, educational institutions and payers as it pertains to your care; including the right to know if a physician is an investor in Ohio Valley Surgical Hospital.
14. You have the right to be free from all forms of abuse, harassment, unreasonable restraint and/or seclusion.
15. You have the right to have a family member or representative and your own physicians notified promptly upon your admission to the hospital.
16. You have the right to give or refuse treatment or consent for recordings, photographs, films, or other images to be produced or used for internal or external purposes other than identification, diagnosis or treatment. You have the right to withdraw consent up until a reasonable time before the item is used.
17. You have the right to be informed of available resources for resolving disputes, grievances, ethical concerns, conflicts.
18. You have the right to register complaints/voice your concerns about the care you receive and receive information regarding the resolution of any grievances.
i. If you have a concern, problem, complaint, or suggestion, you may talk with your doctor, nurse, any employee or manager.
1. You may also contact any of the following by telephone or in writing.
a. The Administrator, Steve Eisentrager at 937-521-3901 or the Director of Nursing, Beth Lizza at 937-521-3903.
b. Written complaints may be sent to 100 W. Main St., Springfield, Ohio 45502 with attention to Steve Eisentrager, Beth Lizza or the Compliance Director.
2. You may also contact any/all of the following regulatory agencies:
a. The Joint Commission (hospital accreditation) at (800) 994-6610
b. The Ohio Department of Health Hotline at (800)342-0553 or (800) 669-3534
c. Beneficiary & Family Centered Quality Improvement Organization —
KePro at (855) 408-8557
To help assure you receive prompt, considerate and respectful care in a safe setting, while you are in our facility, your responsibilities include the following:
1. You are responsible for providing information about your health, including past illnesses, hospital stays and use of medicine. You are also responsible for sharing information about changes in your condition and the management of your pain with your doctor or nurse.
2. You are responsible for asking questions when you do not understand information or instructions.
3. You are responsible to tell our doctor if you believe that you cannot follow through with your treatment. You are responsible for accepting the consequences of not following instructions.
4. You and your visitors are responsible for following hospital policies and regulations that help maintain a safe and respectful setting for care.
5. You are responsible for providing information for insurance and for working with Ohio Valley Surgical Hospital to arrange payment when needed.
6. You are responsible for working with your doctor and nurses to develop a pain management plan that includes:
• Helping the doctor and nurse measure your pain
• Asking your doctor or nurse what to expect regarding pain and pain management
• Discussing pain relief options
• Asking for pain relief when pain first begins and telling the doctor or nurse if your pain is not relieved
7. You are responsible for providing a copy of your Advance Directive(s) in order for Ohio Valley Surgical Hospital to honor them.
8. You are responsible for sending your valuables (for example watch, jewelry, wallet, etc.) home. Please do not keep valuables at the facility.