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 for service.
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 by staff.
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:
24. Contact the DNV organization if you have any unresolved patient safety or quality of care concerns by writing, calling or emailing:
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 as possible.
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 the hospital.
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.