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Patient Information -
Patient Rights and Responsibilities
1. Considerate and respectful care, and to be made comfortable.
You have the right to respect for your cultural, psychosocial,
spiritual, and personal values, beliefs and preferences.
2. Have a family member (or other representative of your
choosing) and your own physician notified promptly of
your admission to the hospital.
3. Know the name of the physician who has primary
responsibility for coordinating your care and the names
and professional relationships of other physicians and
non-physicians who will see you.
4. Receive information about your health status, diagnosis,
prognosis, course of treatment, prospects for recovery and
outcomes of care (including unanticipated outcomes) in
terms you can understand. You have the right to effective
communications and to participate in the development
and implementation of your plan of care. You have the
right to participate in ethical questions that arise in the
course of your care, including issues of conflict resolution,
withholding resuscitative services, and forgoing or
withdrawing life-sustaining treatment.
5. Make decisions regarding medical care and receive as much
information about any proposed treatment or procedure as
you may need in order to give informed consent or to
refuse a course of treatment. Except in emergencies, this
information shall include a description of the procedure
or treatment, the medically significant risks involved,
alternate courses of treatment or non-treatment and the
risks involved in each, and the name of the person who will
carry out the procedure or treatment.
6. Request or refuse treatment, to the extent permitted by law.
However, you do not have the right to demand inappropriate
or medically unnecessary treatment or services. You have
the right to leave the hospital even against the advice of
physicians, to the extent permitted by the law.
7. Be advised if the hospital or personal physician proposes to
engage in or perform human experimentation affecting your
care or treatment. You have the right to refuse to participate
in such research projects.
8. Reasonable responses to any reasonable requests made
9. Appropriate assessment and management of your pain,
information about pain, pain relief measures and to participate
in pain management decisions. You may request
or reject the use of any or all modalities to relieve the pain,
including opiate medications, if you suffer from severe
chronic intractable pain. The doctor may refuse to prescribe
opiate medication, but, if so, must inform you that there are
physicians who specialize in the treatment of severe chronic
pain with methods that include the use of opiates.
10. Formulate advance directives. This includes designating a
decision maker if you become incapable of understanding
a proposed treatment or become unable to communicate
your wishes regarding care. Hospital staff and practitioners
who provide care in the hospital shall comply with these
directives. All patient rights apply to the person who has
legal responsibility to make decisions regarding medical
care on your behalf.
11. Have personal privacy respected. Case discussions,
consultation, examinations and treatment are confidential
and should be conducted discreetly. You have the right to be
told the reason for the presence of any individual. You have
the right to have visitors leave prior to an examination and
when treatment issues are being discussed. Privacy curtains
will be used in semi-private rooms.
12. Confidential treatment of all communications and records
pertaining to your care and stay in the hospital. You will
receive a separate "Notice of Privacy Practices" that explains
your privacy rights in detail and how we may use and
disclose your protected health information.
13. Receive care in a safe setting, free from mental, physical,
sexual or verbal abuse and neglect, exploitation or harassment.
You have the right to access protective and advocacy
services, including notifying government agencies of
neglect or abuse.
14. Be free from restraints and seclusion in any form used as
a means of coercion, discipline, convenience or retaliation
15. Reasonable continuity of care and to know in advance the
time and location of appointments, as well as the identity
of the persons providing the care.
16. Be informed by the physician, or a delegate of the physician,
of continuing healthcare requirements and options following
discharge from the hospital. You have the right to be
involved in the development and implementation of your
Patient Rights and Responsibilities
discharge plan. Upon your request, a friend or family
member may be provided with this information also.
17. Know which hospital rules and policies apply to your
conduct while a patient.
18. Designate visitors of your choosing, if you have
decision-making capacity, whether or not the visitor is
related by blood or marriage, unless:
- No visitors are allowed.
- The facility reasonably determines that the presence of
a particular visitor would endanger the health or safety
of a patient, a member of the health facility staff or other
visitor to the health facility, or would significantly
disrupt the operations of the facility.
- You have told the health facility that you no longer
want a particular person to visit.
However, a health facility may establish reasonable
restrictions upon visitation, including the restrictions
upon the hours of visitation and number of visitors.
19. Have your wishes considered, if you lack decision-making
capacity, for the purposes of determining who may visit.
The method of that consideration will be disclosed in the
hospital policy on visitation. At a minimum, the hospital
shall include any persons living in your household.
20. Examine and receive an explanation of the hospital's bill
regardless of the source of payment.
21. Exercise these rights without regard to sex, economic status,
educational background, race, color, religion, ancestry,
national origin, disability, sexual orientation, marital status
or the source of payment for care.
22. File a grievance. If you want to file a grievance with this
hospital, you may do so by writing or calling:
1306 Maricopa Highway, Ojai, CA 93023
23. File a complaint with the State Department of Health
Services regardless of whether you use the hospital's
grievance process. The State Department of Health Service's
phone number and address are:
Department of Health Services
1889 N. Rice Avenue, Suite 200, Oxnard, CA 93030
805/604-2926 or TDD 800/725-2929
24. Contact the DNV organization if you have any unresolved
patient safety or quality of care concerns by writing, calling
DNV Healthcare Inc.
400 Techne Center Drive, Suite 350, Cincinnati, OH 45255
or toll free 543/947-8343
These Patient Rights combine Title 22 and other California laws.
DNV Conditions of Participation requirements. (4/05)
At Community Memorial Health System, we believe patients
and families are partners in ensuring that the best possible care
is provided in a healthful, safe environment. You can participate
in your healthcare by following these Patient Responsibilities:
1. Provide, to the best of your knowledge, accurate and
complete information about present complaints, past illness,
hospitalization, medications, and other matters relating to
your condition to the responsible practitioner.
2. Provide upon admission a copy of your healthcare proxy or
any other advance directives or power of attorney forms, if
you have them.
3. Report any perceived risks in your care and unexpected
changes in your condition to your doctor, nurse or other
member of the healthcare team.
4. Follow the treatment plan that you and your healthcare
team have developed. This includes following the instructions
of healthcare staff who are involved in your care.
5. Develop a pain management plan with your doctor, nurse
and healthcare team including:
- asking for pain relief when pain first begins,
- helping your doctor and nurse assess your pain,
- tell your doctor or nurse if your pain is not relieved,
- tell your doctor or nurse about any worries you have
about taking pain medication.
6. Tell your nurse or doctor if you do not clearly understand
the proposed plan of care and what is expected of you.
Ask questions when you don't understand.
7. Keep appointments. When you are unable to do so for any
reason, notify the office appointment center in advance.
8. You are responsible for your actions if you refuse treatment
or do not follow the practitioner's instructions as to your
provision of care.
9. Provide insurance information for processing bills and
assure that financial obligations are fulfilled as promptly
10. Treat other patients and staff with consideration and respect.
11. Be respectful of other patients' right to privacy. Respect a
roommate's and other patients' rights to privacy and quiet,
including the control of noise from use of radio, TV, and
number of visitors.
12. Be respectful of the property of other persons and of
13. You are responsible for following hospital rules and
regulations affecting patient care and conduct.
Thank you for your cooperation, and we trust that your stay with Ojai Valley
Community Hospital will be as pleasant as possible.