Each Patient has the Right to:

1. Be informed of your rights. When possible, this information is given to you in advance by the Admissions or Registration representative.
2. Be medically treated in a dignified and respectful manner, express your beliefs and cultural practices and preferences, if they do not harm others or violate any laws. You may wear personal clothing and other religious articles or symbols if they do not interfere with procedures or treatment.
3. Access treatment within the scope of Monroe County Hospital's mission and services, Monroe County Hospital will provide impartial access to treatment and services that are available and medically indicated, regardless of race, creed, sex, age, national origin, religion, diagnosis, or source of payment for care.
4. Monroe County Hospital will recognize all state-sanctioned marriages and spouses regardless of any laws to the contrary of the state of Georgia.
5. Receive care in a safe setting to be free from mental, physical, sexual, and verbal abuse, neglect, and exploitation.
6. Effective communication and, if needed, alternative means of communication available such as written materials, signs, or interpreters.
7. Have a family member or representative and your own physician notified promptly upon admission to the hospital, if requested.
8. Be given information to you or your designee, to be involved in and/or to make informed decisions regarding your care planning and treatment, including requesting and/or refusing treatment, your health status, not to be construed as a demand for the provision of treatment or services deemed medically unnecessary or inappropriate.
9. Participate in all aspects of the development and implementation of your plan of care, and treatment, pain management plan, and to refuse care, treatment, or service in accordance with applicable laws and regulations.
10. Know the identity and professional status of individuals providing service and know which physician or other practitioner is primarily responsible for your care. You may request, at your expense, consultation with a specialist to see if those services are available.
11. Be informed of your health status, possible treatments, likely outcome, and practical alternatives and discuss this information with your doctor to give informed consent prior to treatment and the start of procedures. To be informed about the outcome of care, treatment, and services that have been included, including unanticipated outcomes.
12. Receive reasonable continuity of care, when appropriate, and be informed by the physicians and other caregivers of available and realistic patient care options when hospital care is no longer appropriate.
13. You have the right to receive information that will assist you in the recovery after discharge from the hospital.
14. Be transferred to another facility, if medically necessary and permissable, or when a patient so requests, after complex explanation to you of the need for such transfer, including the risks, benefits, and alternatives. The institution and physician to which you are to be transferred must first have accepted you for transfer. You have the right to expect that services needed and ordered by the physician will be available.
15. Formulate Advanced Directives and to have practitioners and staff provide care that is consistent with these Advanced Directives in accordance with applicable laws and the Hospital's Advance Directives policy. You shall not be discriminated against based on the execution of the Advanced Directive.
16. Express concerns/grievances about your care, treatment, or services and to recommend improvements without being subjected to coercion, discrimination, reprisals or unreasonable interruptions to your care, treatment, or services.
17. If you have a concern, problem or complaint related to any aspect of care during your hospital stay, you may contact the Executive Assistant at 478-994-2521, If your grievance is not satisfied, you may contact:

The Georgia Department of Community Health-Healthcare Facility Regulation at 404-657-5700, DNV Healthcare USA, Inc. (DNV) toll free at 1-866-496-9647, Kepro QIO at 1-888-317-0751 or Centers for Medicare and Medicaid Services at:

Division of Survey and Certification Operations Office of the Regional Administrator Atlanta
Federal Center
61 Forsyth Street SW
Suite 4T20
Atlanta, GA 30303-8909
404-562-7150

18. The patient has the right to file a grievance with the Georgia Composite Medical Board, concerning the physician, staff, office, and treatment received. The patient should send a written complaint to the board. The patient should be able to provide the physician or practice name, address, and the specific nature of the complaint. Complaints or grievances may be reported to the Board at the following address or telephone number:

Georgia Composite Medical Board
Attn. Complaints Unit
2 Martin Luther King Jr. Drive SE
11th Floor, East Tower
Atlanta, GA 30334
404-656-3913
www.medicalboard.georgia.gov

19. Receive information on how to obtain protective and advocacy services, if requested. Phone numbers may be obtained through the Case Manager.
20. Be free from restraint, of any form, imposed as a means of coercion, discipline, convenience or retaliation by staff. Restraints may only be imposed to ensure the immediate physical safety of the patient, a staff member or others and must be discontinued at the earliest possible time.
21. Privacy, the hospital, doctor and others caring for you will protect your privacy as much as possible.
22. Have your care, treatment and services handled confidentially and be assured that your medical record is accessed only by authorized individuals. Any discussion or consultation involving your care will be conducted discreetly and that individuals not directly involved in his/her care will not be present without their permission.
23. Have timely access to the information contained within your medical record, request an amendment of your medical record, and be informed of any disclosure of your health information in accordance with law and regulation. Except when restricted by law, if requested, information will be provided within a reasonable time frame.
24. Refuse or consent to recording, filming or images made for purposes other than the identification, diagnosis, or treatment of a medical condition.
25. Refuse or accept participation in any experimental, educational or research activities involved in your treatment.
26. Request and receive an itemized explanation of your total bill for services rendered. Be informed of charges and receive counseling on insurance reimbursement, hospital charges, payment methods and the availability of known financial resources for health care.
27. A medicare patient has the right to appeal decisions about his or her care to a local Medicare Review Board. The Facility will provide the name, address, and phone number of the local Medicare Review Board and information about filing an appeal.
28. In advance of furnishing patient care whenever possible, the Hospital shall inform each patient (or his or her Support Person, where appropriate) at the time he or she is informed of his or her other rights in writing of:
    1. patient's visitation rights including justified clinical restrictions which may be imposed on a patient's visitation rights;
    2. patient's right to, subject his or her consent, receive the visitors whom he or she designates, including, but not limited to, a spouse, a domestic partner (including a same sex domestic partner), another family member, or a friend, and his or her right to withdraw or deny such consent at any time;
    3. visitation privileges shall not be restricted, limited, or otherwise denied on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability;
    4. All visitors designated by the patient (or Support Person where appropriate) shall enjoy full and equal visitation privileges consistent with patient preferences. (** restrictions to visitations may be necessary during a state of emergency due to a pandemic/infectious disease outbreak, for the protection of the patient, staff, and community)

PATIENT RESPONSIBILITIES:

All patients and parents of pediatric patients have the responsibility to:

• Provide, to the best of your knowledge, accurate and complete information about the present complaints, past illnesses and hospitalizations, medications, and other matters relating to your health. You have the responsibility to report unexpected changes of condition to the responsible practitioner.
• Ask for pain relief when pain first begins, to report when pain is not relieved, and discuss your pain management plan and pain relief options with your doctor and nurses. Follow the treatment plan recommended by the practitioner primarily responsible for your care.
• Understand medical treatments you are to receive. You are responsible for making it known whether you clearly comprehend a contemplated course of action.
• Be responsible for following the treatment plan recommended by the practitioner primarily responsible for your care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the physician's orders. You are responsible for keeping appointments and for notifying the responsible practitioner or the hospital when you are unable to do so. Abide by Monroe County Hospital policies, including Monroe County Hospital's smoke-free policy.
• Respect the rights and professional integrity of those providing care. Identify and report safety concerns that may affect your care.
• Be considerate of the rights and property of the other patients and assist in the control of noise and the number of visitors. Providing insurance information and paying for services not covered by a third-party payor at the time the services are rendered.
• Take precautions for personal valuables and belongings by either leaving them at home or asking Monroe County Hospital's staff to provide a safe depository during your hospital stay.
• Parents/Guardians shall have the responsibility for continuing their parenting/guardianship role to the extent of their ability being available to participate in decision-making and providing staff with knowledge of parents/guardian whereabouts.

REGARDING YOUR PERSONAL BEHAVIOR, YOU ARE RESPONSIBLE FOR:

• Acting in a considerate and cooperative manner.
• Showing consideration and respect for the rights and property of others as well as for the hospital.
• Following hospital rules and regulations regarding patient care and conduct.