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Notice of Privacy Practices

April 25, 2014

Notice of Patient/resident rights:

The patient/resident has a right to a dignified existence, self-determination, & communications with & access to persons & services inside & outside the facility.  A facility must protect & promote the rights of each resident/ patient including each of the following rights:  You or your legal representatives have the right to:

1. Be informed of his/her rights as a patient in advance of, during, or when discontinuing, the provision of care.  The patient may appoint a representative to receive this information should he/she so desire.
2. Exercise these rights without regard or discrimination based upon race, color, sex, sexual orientation, cultural, economic, education, religious background, national origin, religion, gender, or the source of payment for care.
3. Considerate, dignified and respectful care given by competent personnel, provided in a safe environment, free from all forms of abuse, neglect, harassment and/or exploitation.
4. Have his/her cultural, psychosocial, spiritual and personal values, beliefs and preferences respected.  The Hospital shall “not restrict, limit, or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability”.
5. Access protective and advocacy services or have these services accessed on the patient’s behalf.
6. Have access and accommodation for religious and spiritual services.
7. Appropriate assessment and management of pain.
8. Remain free from seclusion or restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience or retaliation by staff.  Be free from abuse:  verbal, sexual, physical, mental, corporal punishment, and involuntary seclusion, that is not medically indicated.
9. Choose a personal attending MD/DO and have knowledge of the name of the physician who has primary responsibility for coordinating his/her care and the names, functions, and professional relationships of other physicians and healthcare providers who shall have direct contact with him/her.
10. Receive information from his/her physician about his/her illness, health status, diagnosis, course of treatment, outcomes of care (including unanticipated outcomes), and his/her prospects for recovery in terms that he/she or the patient’s representative can understand.
11. Receive information about any proposed treatment or procedure he/she may need in order to participate in the development of the plan of care, give informed consent or refuse the course of treatment to the extent permitted by state law; to be informed of the medical consequences of refusing treatment, and to participate in planning for care after discharge.  Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved in the treatment, alternate courses of treatment or non-treatment and the risks involved in each and the name of the person who shall carry out the procedure or treatment.
12. Obtain information on disclosure of protected health information, in accordance with federal, state and local law.
13. Formulate Advance Directives regarding his/her healthcare, and to have hospital staff and practitioners who provide care in the hospital comply with these directives (to the extent provided by state laws and regulations) (which includes appointing a surrogate to make health care decisions on the patient’s behalf).
14. Have a family member or representative of his/her choice notified promptly of his/her admission to the hospital.
15. Have his/her personal attending physician notified promptly of his/her admission to the hospital. 
16. Request a change in his/her physician or have assistance in obtaining consultation with another physician or practitioner at the patient’s request and own expense.
17. Full consideration of privacy concerning his/her medical care program.  Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly.  The patient has the right to be advised as to the reason for the presence of any individual involved in his/her healthcare.
18. Confidential treatment of all communications and records pertaining to his/her care and his/her stay in the hospital.  His/her/legally designated representative’s written permission shall be obtained before his/her medical records can be made available to anyone not directly concerned with his/her care.  The right to refuse release of personal and clinical records doesn’t apply when transfer to another health care facility occurs & when records release is required by law.
19. Receive information in a manner that he/she understands.  Communications with the patient shall be effective and provided in a manner that facilitates understanding by the patient.  Written information provided shall be appropriate to the age, understanding and, as appropriate, the language of the patient.  As appropriate, communications specific to the vision, speech, hearing cognitive and language-impaired patient shall be appropriate to the impairment.
20. Access information contained in his/her medical record, through Health Information Management, with an appropriate release, within a reasonable time frame (usually within 48 hours of the written request/release-excluding weekends and holidays and may purchase, at the standard cost, photocopies of their medical record within 2 working days of the request-excluding weekends and holidays).
21. Reasonable responses to any reasonable request he/she may make for service.
22. Refuse treatment; leave the hospital even against the advice of his/her physician/provider.
23. Reasonable continuity of care.
24. Transfer to another health facility as the patients condition requires or is necessary to meet the patient’s needs, or if specifically requested by the patient and/or their representative.   
25. Be advised if hospital/personal physician proposes to engage in or perform human experimentation affecting his/her care or treatment.  The patient has the right to refuse to participate in such research projects or refuse any form of treatment.  Refusal to participate or discontinuation of participation shall not compromise the patients right to access care, treatment or services.
26. Full support and respect of all patient rights should the patient choose to participate in research, investigation and/or clinical trials.  This includes the patient'™s right to a full informed consent process as it relates to the research, investigation and/or clinical trial.  All information provided to subjects shall be contained in the medical record or research file, along with the consent form(s).
27. Be informed by his/her physician or a delegate of his/her physician of the continuing healthcare requirements following his/her discharge from the hospital.  Be involved in formulating the plan of care.
28. Examine and receive an explanation of his/her bill regardless of source of payment.  Receive information concerning services for which may or may not be charged.
29. Know which hospital rules and policies apply to his/her conduct while a patient.
30. Have all patient's rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient.
31. Be advised of the hospital grievance process, should he/she wish to communicate a concern regarding the quality of the care he/she receives or if he/she feels the determined discharge date is premature.  Notification of the grievance process includes: whom to contact to file a grievance, and that he/she shall be provided with a written notice of the grievance determination that contains the name of the hospital contact person, the steps taken on his/her behalf to investigate the grievance, the results of the grievance and the grievance completion date.
    1. Girard Medical Center Quality Department...620-724-8291, ext 512
    2. Girard Medical Center Administrator..620-724-8291
    3. Kansas Department of Health & Environment complaint hotline¦.1-800-842-0078
    4. Kansas Foundation for Medical Care....1-800-432-0407
    5. Centers for Medicare & Medicaid Services (CMS)¦..1-877-267-2323 or 1-866-226-1819
32. Work or not work if described in the plan of care and/or if ordered by the physician. 
33. Privacy in written communications, including he right to send and promptly receive mail that is unopened; and have access to stationery, postage, and writing implements at the patient'™s own expense.
34. Retain and use personal possessions, unless to do so would infringe upon the rights or health and safety of others. 
35. Share a room with his/her spouse when married couples are in the same facility and both spouses consent to the agreement.
36. Transfer or discharge for:  the patient'™s welfare when the patient'™s needs cannot be met; when the health or safety of the patient or other patients is endangered; or when the patient'™s health has improved.

Copy provided upon request.