The patient shall be treated with consideration, respect and full recognition of the patient’s dignity and individuality, including privacy and personal care and including being informed of the name, licensure status, and staff position of all those whom the patient has contact, pursuant to RSA 151:3-b.
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 decisions, the signing of the acknowledgment must be by the person legally responsible for the patient.
The patient shall be fully informed of the Hospital’s basic per diem rate in writing in language that the patient can understand, before or at the time of admission and as necessary during the patient’s stay. Room rates vary. The most common room rate is $1,147.00 for a semi-private medical/surgical bed. Additional information about room rates is available upon request from the Patient Financial Services Department. A statement of services that are not normally covered by Medicare or Medicaid shall also be included in this disclosure.
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 period between testing and receiving results, unless medically inadvisable and so documented in the medical record. The patient 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.
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.
The patient shall be encouraged and assisted throughout his/her stay to exercise the patient’s rights. 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. Patients who have concerns should notify their physician, nurse or Hospital Administration at 603-752-2200.
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 patients rights under this document and in conformance with State law and rules.
The patient shall be free from emotional, psychological, sexual and physical abuse and from exploitation, neglect, corporal punishment and involuntary seclusion.
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.
The patient shall be ensured confidential treatment of all information contained in the patient’s personal and clinical record, including that stored in an automated 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, for a reasonable cost, upon request.
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.
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 unmonitored use of a telephone.
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. Androscoggin Valley Hospital is not responsible for patients’ personal belongings. Patients should leave or send valuables home.
The patient shall be entitled to privacy for visits and, 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 the 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 or when there are no additional accommodations available.
The patient shall not be denied appropriate care on the basis of race, religion, color, national origin, sex, age, disability, sexual orientation, marital status, or source of payment.
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. The Hospital utilizes an established on-call roster of practitioners that coordinate the care of patients who are emergently admitted to the facility.
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.
The patient shall be entitled to receive representatives of approved organizations as provided in RSA 151:28.
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.
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 a legally valid advance directive.
The patient is informed that the Centers for Medicare and Medicaid Services has established standards for hospitals that participate in Medicare and Medicaid to ensure protection of patient rights.
Your Responsibilities as a Patient
Patients have the responsibility to provide, to the best of their knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, advance directives or changes in advance directives, and other matters relating to their health or care. Patients have the responsibility to report unexpected changes in their condition to the practitioner responsible for their care. Patients are responsible for requesting information about anything that is not understood and expressing concerns in regard to the services provided.
Patients are responsible for following the treatment plan recommended by the practitioner primarily responsible for their care. This includes following the instructions of nursing staff and other allied health personnel as they carry out the individualized plan of care, implement the responsible practitioner’s orders, and enforce the applicable Hospital Rules and Regulations. Patients are responsible for keeping appointments, and when unable to do so for any reason, notifying the responsible practitioner and/or the Hospital.
Patients are responsible for their actions if they refuse treatment or do not follow practitioner orders.
Patients are responsible for assuring that the financial obligations of their health care are fulfilled as promptly as possible. Patients experiencing financial difficulties may ask for assistance from the Patient Financial Services Department.
Patients are responsible for following Hospital Rules and Regulations affecting patient care and conduct.
Patients are responsible for being considerate of the rights of other patients and Hospital staff and for assisting in the control of noise and the number of visitors.
Patients are responsible for being respectful of the property of other persons and of the Hospital.
Patients do not have the right and, in fact, have the responsibility not to bring weapons into the Hospital.