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Patient Bill of Rights

Patient Bill of Rights
New Hampshire law provides that all patients have the following rights:
 
  1. The patient shall be treated with consideration, respect, and full recognition of the patient’s dignity and individuality, including privacy in treatment and personal care and including being informed  of the name, licensure status, and staff position of all those with whom the patient has contact, pursuant to RSA 151:3-b.
 
  1. The patient shall be fully informed of a patient’s rights and responsibilities and of all procedures governing patient conduct and responsibilities. This information must be provided orally and in writing before or at admission, except for emergency admissions. Receipt of the information must be acknowledged by the patient in writing. When a patient lacks the capacity to make informed judgments, the signing must be by the person legally responsible for the patient.
 
  1. The patient shall be fully informed in writing in language that the patient can understand, before or at the time of admission and    as necessary during the patient’s stay, of the facility’s basic per diem rate and of those services included and not included in the basic per diem rate. A statement of services that are not normally covered by Medicare or Medicaid shall also be included in this disclosure.
 
  1. The patient shall be fully informed by a health care provider   of his or her medical condition, health care needs, and diagnostic test results, including the manner by which such results will be provided and the expected time interval between testing and receiving results, unless medically inadvisable and so documented in the medical record, and shall be given the opportunity to participate in the planning of his or her total care and medical treatment, to refuse treatment, and to be involved in experimental research upon the patient’s written consent only. For the purposes of this paragraph “health care provider” means any person, corporation, facility, or institution either licensed by this state or otherwise lawfully providing health care services, including, but not limited to, a physician, hospital or other health care facility, dentist, nurse, optometrist, podiatrist, physical therapist, or psychologist, and any officer, employee, or agent of such provider acting in the course and scope of employment or agency related to or supportive of health care services.
 
  1. The patient shall be transferred or discharged after appropriate discharge planning only for medical reasons, for the patient’s welfare or that of other patients, if the facility ceases to operate, or for nonpayment for the patient’s stay, except as prohibited by Title XVIII  or XIX of the Social Security Act. No patient shall be involuntarily discharged from a facility because the patient becomes eligible for Medicaid as a source of payment.
 
  1. The patient shall be encouraged  and  assisted  throughout  the patient’s stay to exercise the patient’s rights as a patient and citizen. The patient may voice grievances  and recommend  changes in policies and services to facility staff or outside representatives free from restraint, interference, coercion, discrimination, or reprisal.
 
  1. The patient shall be permitted to manage the patient’s personal financial affairs. If the patient authorizes the facility in writing to assist in this management and the facility so  consents,  the  assistance  shall be carried out in accordance with the patient’s rights under this subdivision and in conformance with state law and rules.
 
  1. The patient shall be free from emotional, psychological,  sexual and physical abuse and from exploitation, neglect, corporal punishment and involuntary seclusion.
  1. The patient shall be free from chemical and physical restraints except when they are authorized in writing by a physician for a specific and limited time necessary to protect the patient or others from injury. In an emergency, restraints may be authorized by the designated professional staff member in order to protect the patient or others  from injury. The staff member must promptly report such action to the physician and document same in the medical records.
 
  1. The patient shall be ensured confidential treatment of all information contained in the patient’s personal and clinical record, including that stored in an automatic data bank, and the patient’s written  consent  shall  be  required  for  the  release  of  information   to anyone not otherwise authorized by law to receive it. Medical information contained in the medical records at any facility licensed under this chapter shall be deemed to be the property of the patient. The patient shall be entitled to a copy of such records upon request.
 
The charge for the copying of a patient’s medical records shall not exceed $15 for the first 30 pages or $.50 per page, whichever is greater; provided that copies of filmed records such as radiograms, x-rays, and sonograms shall be copied at a reasonable cost.
 
  1. The patient shall not be required to perform services for the facility. Where appropriate for therapeutic or diversional purposes and agreed to by the patient, such services may be included in a plan of care and treatment.
 
  1. The patient shall be free to communicate with, associate with, and meet privately with anyone, including family and resident groups, unless to do so would infringe upon the rights of other patients. The patient may send and receive unopened personal mail. The patient has the right to have regular access to the unmonitored use of a telephone.
 
  1. The patient shall be free to participate in activities of any social, religious, and community groups, unless to do so would infringe upon the rights of other patients.
 
  1. The patient shall be free to retain and use personal clothing and possessions as space permits, provided it does not infringe on  the rights of other patients.
 
  1. The patient shall be entitled to privacy for visits &, if married,  to share a room with his or her spouse if both are patients in the   same facility and where both patients consent, unless it is medically contraindicated and so documented by a physician. The patient has the right to reside and receive services in the facility with reasonable accommodation of individual needs and preferences, including choice of room and roommate, except when the health and safety of the individual or other patients would be endangered.
 
  1. The patient shall not be denied appropriate care on the basis of race, religion, color, national origin, sex, age, disability, marital status, or source of payment, nor shall any such care be denied on account of the patient’s sexual orientation.
 
  1. The patient shall be entitled to be treated by the patient’s physician of choice, subject to reasonable rules and regulations of the facility regarding the facility’s credentialing process.
 
  1. The patient shall be entitled to have the patient’s parents,       if  a minor, or spouse, or next of kin, or a personal representative, if   an adult, visit the facility, without restriction, if the  patient  is considered terminally ill by the physician responsible for the patient’s care.

XIX.    The patient shall be entitled to receive representatives of approved organizations as provided in RSA 151:28. 

XX.     The patient shall not be denied admission to the facility based on Medicaid as a source of payment when there is an available space in the facility.
 
XXI.     Subject to the terms and conditions of the patient’s insurance plan, the patient shall have access to any provider in his or her insurance plan network and referral to a provider or facility within such network shall not be unreasonably withheld pursuant to RSA 420-J:8, XIV.
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In addition to the rights provided for by law, LRGHealthcare provides the following additional rights to its patients:

1.  The patient shall have the right to appropriate assessment and management of pain.

2.  The patient shall have the right to reasonable access to care.

 3.  The patient shall have the right to consideration of psychosocial, spiritual, and cultural variables that influence the perception of illness.

 4.  The patient shall have the right to obtain information as to   any relationship of the Hospital to other health care and educational institutions insofar as his/her care is concerned. The patient has the right to obtain information as to the existence of any professional relationships among individuals, by name,  who  are  treating  him/  her. The patient has the right to ask and be informed of existence of business relationships among the Hospital, educational institutions, other health care providers, or payers that may influence the patient’s treatment and care.

 5.  The patient shall have the right to have an advance directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation  that  the  Hospital  will  honor  the  intent of that directive to the extent permitted by law and Hospital policy. Health care institutions must advise patients of their  rights  under state law and Hospital policy to make informed medical choices, ask   if the patient has an advance directive, and include information about Hospital policy that may limit its ability to implement fully a legally valid advance directive.
 
6.  The patient shall have the right to examine and receive an explanation of his/her bill regardless of source of payment.
 
7.  The patient has the right to receive a Beneficiary Notice of non-coverage and right to appeal premature discharge.
 
8.  The patient shall participate in making informed decisions regarding his/her plan of care; information shall be provided to the patient or family of patient care to allow patients to make informed decisions regarding their care planning and treatment, including requesting and/or refusing treatment, understanding of their health status, not to be construed as a demand for the provision of treatment or services deemed medically unnecessary or inappropriate.
 
9.  The patient and his/her representative is entitled to prompt notification of patient choice and to prompt notification of the patient’s physician of admission.
 
10.  The patient is entitled to provision of care in a safe setting.

11.  Patients shall understand and have provided an informed written consent, or from an authorized representative, for the provision of medical and/or surgical care except in medical emergencies. The consent shall include an explanation of risks, benefits, and alternatives for high-risk procedures, sedation, and participation in research projects, as defined by the medical staff and State law.
 
Patient Responsibilities
The patient (parent/guardian, if a minor) has the responsibility:
  1. to recognize and accept that for one to have rights, one must also have responsibilities.
  2. to cooperate with the physician in supplying requested medical information and health history data.
  3. to cooperate with staff by reporting any change in his/her condition or any unusual incident.
  4. to be open and candid with the physician and staff members of  the facility, to request assistance or explanation when necessary   if instructions or expectations for care and/or treatment are not understood.
  5. to discuss with the physician  and/or  facility  staff  his/her  plans for discharge and to provide information necessary to assist in appropriate discharge planning.
  6. to discuss with an appropriate person on the facility staff any matters or policies causing concern or dissatisfaction to him/her.
  7. to cooperate with the facility staff as they implement the designated therapeutic plan of care.
  8. to assume responsibility for his/her own actions.
  9. to abide by facility policies that are established for the safety and comfort of all patients.
  10. to be considerate of fellow patients and ensure that his/her visitors are also considerate of others.
  11. to be considerate of another patient's right to privacy and confidentiality.
  12. to cooperate in supplying information necessary for Medicare, Medicaid, or other insurance processing of Hospital bills, to make arrangements for payment of Hospital and medical bills not covered by insurance, and to discuss with the Patient Financial Services Department any questions he may have concerning a bill.
A full range of assistive and communication aids will be available and provided to patients with impaired hearing, vision, speech, or manual skills, without additional charge for such aids. Some of these aids include:

             A.  Qualified sign language interpreters for the Deaf (see policy entitled “Hearing Impaired, Communication/TDD Machine,  and Sign Interpreters).
              B.  A twenty-four hour (24) telecommunication device for the deaf (TTY/TDD) which can connect the caller to all extensions within the facility (see policy entitled “Hearing Impaired, Communication/TDD Machine, and Sign Interpreters).
              C.  Readers and taped material for the blind and large print and magnifiers for the visually impaired.

    13.  Interpreter services will be available and provided for non-English speaking patients.

     14.  A disclosure of LRGHealthcare's basic per diem rate (average semi-private room rate) and those services included and not included in the rate shall be made to the patient in writing and in language the patient can understand at the time of admission.  A statement of services not normally covered by Medicare or Medicaid shall also be included on the Patient Authorization and Payment Guarantee Form and shall be kept as part of the patient's medical record.
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