Patient Rights & Responsibilities, Privacy Notice
Patient Rights & Responsibilities Downloadable PDF
No Surprise Billing/Good Faith Estimate
Patient Privacy Notice PDF
Patient Rights
The Patient has the right:
1. To impartial access to medically indicated treatment regardless of race, religion, sex, sexual
orientation ethnicity, age or handicap.
2. To considerate and respectful care.
3. To receive information in a language he/she can understand including translation services for
patients who do not speak English, are deaf, unable to speak or who are blind.
4. To participate in the development and implementation of his or her plan of care.
5. To request a discharge planning evaluation.
6. Or his/her representative has the right to make informed decisions regarding his/her care
including being informed of his/her health status, being involved in care planning and treatment,
and being able to request or refuse treatment. This right must not be construed as a mechanism to
demand the provision of treatment or services deemed medically unnecessary or inappropriate.
7. To formulate advance directives and to have hospital staff and practitioners who provide care
in the hospital comply with these directives.
8. To have a family member or representative of his/her choice along with his/her own physician
notified promptly of his/her admission to the hospital.
9. To personal privacy.
10. To receive care in a safe setting
11. To be free from all forms of abuse and harassment including physical and mental abuse and
corporal punishment.
12. To confidentiality of his/her clinical records.
13. To access information contained in his/her clinical records within a reasonable time frame. The
hospital must not frustrate the legitimate efforts of individuals to gain access to their own
medical records and must actively seek to meet these requests as quickly as its record keeping
system permits.
14. To be free from restraints of any form that are not medically necessary or are used as a means
of coercion, discipline, convenience, or retaliation by staff.
15. To be fully informed of and to consent or refuse to participate in any unusual, experimental or
research project without compromising his/her access to services.
16. To know the professional status of any person providing his/her care or services.
17. To know the reasons for any proposed change in the Professional Staff responsible for his/her
care;
18. To know the reasons for his/her transfer either within or outside the hospital.
19. To know of the relationship of the hospital to other persons or organizations participating in
the provision of his/her care.
20. To information regarding the process to file a grievance and prompt resolution of grievances.
21. To access the cost itemized, when possible, of services rendered within a reasonable period of
time.
22. To be informed of the source of the hospital’s reimbursement for his/her services, and of any
limitations which may be placed upon his/her care.
23. To have pain treated as effectively as possible.
24. The right to have visitors to be informed of the visitation rights of patients including those
setting forth any clinically necessary or reasonable restrictions or limitations that the hospital
may need to place on such rights and the reason the clinical restrictions or limitations.
25. The patient’s family has the right of informed consent for donation of organs and tissues.
Patient Responsibilities -
The Patient has the responsibility:
1. To provide those participating in his/her care with accurate and complete information about
matters relating to his/her past and present healthcare.
2. To be respectful and considerate of the rights and property of other patients and staff.
3. To be responsible in a timely way regarding his/her financial obligations and information to
the hospital.
4. To follow the hospital rules and regulations affecting patient care and conduct.
5. To inform the nurse or physician of any medication brought from home.
6. To accept responsibility for the consequences following a decision to refuse or alter
prescribed treatment or instructions.
7. To refrain from the use of any drugs not prescribed or authorized by his/her physician and
administered by hospital staff.
8. To ask questions if he/she does not understand the course of treatment.
9. To refrain from the use of tobacco products on the hospital campus.
10. To provide a copy of any advance directives to the hospital staff.
11. To care for all personal property that is kept in his or her possession during the hospital
stay; to send home valuable items such as cash, credit
cards or jewelry; or to arrange for such items to be placed in the cashier’s department for
safekeeping.
Patient Privacy Notice
Your Information. Your Rights. Our Responsibilities.
Questions or Concerns?
We encourage you to share your concerns or questions with any hospital staff person present during your visit with us.
The patient advocate may be reached at 937-498-5542.
A patient may also contact the Ohio Department of Health Complaint Hotline at 800-342-0553 or 246 N. High St., Columbus, Ohio 43215; Healthcare Facilities Accreditation Program (ACHC/HFAP) at 312-920-7383 or 506 North Clark Suite 301, Chicago, Illinois 60654.
Medicare patients may contact Livanta at 888-524-9900 or BFCC QIO 10820 Guilford Rd, Suite 202, Annapolis Junction, MD 20701-1262.