be_ixf;ym_202105 d_06; ct_50

Patient Rights & Responsibilities

Your Rights as a Patient

As a patient you have a right to:

  • Quality medical care, regardless of race, color, religion, gender, gender identity, ethnicity, age, disability or payment source.
  • Be informed and make decisions about your care, including refusing care, transferring care or change in care team.
  • Ask for a change of provider or a second opinion.
  • Receive information in a way that meets your needs including use of an interpreter or assistive devices (such as hearing or vision assistance).
  • Identify an advocate and have your advocate ask questions and make decisions for you when you cannot, based on state law.
  • Be free from all forms of abuse or harassment, including unnecessary restraint.
  • Have a patient advocate and other visitors with you during your care or an explanation of why visitors are not allowed.
  • Confidentiality and personal privacy.
  • Have pain assessed and managed appropriately.
  • Access child or adult protective or advocacy services.
  • Make advance directives and have them followed, subject to limitations required by applicable law or medical standards.
  • Religious or spiritual services as long as they do not interfere with the rights of other patients.
  • Access your medical records in a timely fashion including a review of your medical chart with your caregivers during your hospital stay.
  • Know the relationship(s) of the hospital to other persons or organizations participating in the provision of your care.
  • Say “yes” or “no” to experimental treatments and to be advised when a physician is considering you to be part of a medical research program or donor program.
  • Have your wishes followed concerning organ donation, when you make such wishes known, in accordance with law and regulation.
  • Be informed of unanticipated adverse outcomes.
  • Request a listing of disclosures about your healthcare, and to be able to access and request to amend your medical record as allowed by law.

Your Responsibilities as a Patient

As part of the hospital and patient relationship, we ask that you accept these responsibilities to:

  • Provide complete and accurate information about your health history and medications.
  • Provide information about any changes in your condition, including pain.
  • Follow the care plan, understanding the medical consequences if you refuse.
  • Follow hospital rules and regulations.
  • Communicate if you are confused about your care plan or have concerns about your care.
  • Be considerate and respect the property and rights of others.
  • Refrain from bringing any valuable property to the Hospital or to have valuables secured, and to accept responsibility for personal property you have chosen to leave in your room.

Our goal is to make your stay with us as comfortable and pleasant as possible. Your wellbeing is our utmost concern. You can play a vital role in this effort by being an active member of our team.

If you have questions or concerns about care given while at the hospital, please inform your clinical team.

If you have continued concerns or have been discharged from the hospital, please contact us at the number listed where you received care so that we may try to resolve the situation:

Community Hospital of Bremen
574.546.8179

Elkhart General Hospital
574.296.6472

Memorial Hospital
(Memorial, Granger, Epworth)
574.647.7600

You have a right to appeal any continued unresolved grievance or directly submit your claim to the following agencies:

State Department of Health (ISDH)
2 North Meridian Street
Indianapolis, IN 46204
317.223.1325 | www.in.gov/isdh

The Joint Commission
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
Attn: Office of Quality and Patient Safety
Fax: 630.792.5636
gro.noissimmoctnioj@troperytefastneitap
www.jointcommission.org

Office for Civil Rights (OCR)
U.S. Department of Health & Human Services
200 Independence Ave., S.W.,
Washington D.C. 20201
800.368.1019 | www.hhs.gov/ocr

KEPRO (Medicare Patients)
5700 Lombardo Center Drive, Suite 100
Seven Hills, OH 44131
855.408.8557 | www.kepro.org

Centers for Medicare & Medicaid Services Ombudsman
7500 Security Boulevard
Baltimore, MD 21244
www.cms.gov/center/special-topic/ombudsman-center.html