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We know that meeting your health care needs requires trust between you and the people taking care of you. As a patient of Sanford Health, our goal is to protect your rights. You also have responsibilities. Knowing them will help you to make choices about your care that is best for you. Your rights and responsibilities can be read to you in a language you best understand. If you are not able to make choices for yourself, your legal representative may do so on your behalf. You have the right to be treated with kindness You have the right to have treatment. You will be treated with respect and worth regardless of your: • Age • Physical and/or mental status • Race • Sex (Male or Female) • The country where you came from • Sexual orientation • Religion • Gender identity or expression • Beliefs • Type of sickness • Language • If you are able to pay for your care You have the right to know the names and duties of all the people involved in your care. Staff should: • Tell you their name. • Tell you their role in your care. • Give you their work phone number and address when asked. You have the responsibility to treat others with kindness It is important to treat others with the same respect and value that you would want for yourself and your family. This includes other patients, their visitors, staff and providers who are giving you care. In the health care environment, you can do this by: • No loud voices. • No foul language/swearing. • Limit the number of guests visiting you at one time. • Keep a quiet environment when guests are visiting. • Use your T.V., radio, phones as you need, but quietly. • Being considerate of your roommate. • No weapons of any kind. • No physical or verbal threats or abuse. You have the right to privacy Your personal privacy is an important part of your care. We will respect your privacy during: • Your exams. • Your talks with your provider and staff. While you are a Sanford patient, you have the right to: • Have a person of your same sex in the room with you during certain parts of an exam or care. • Close the curtain around your bed. • Close your door for privacy. • Respect and privacy during bathing and/or other cares. • Ask for no guests to visit you. • Ask for your status to be confidential. • Privacy of your: o Mail o Phone calls o E-mails • Have staff knock on the door and ask to come into your room. Your privacy rights maybe limited in situations due to safety reasons. You have the responsibility to respect the privacy of others We ask that you be considerate of other patients. Give them privacy and a quiet environment. You have the right to confidentiality Your information is confidential. We will respect your privacy when talking about your health/medical care. Your health care record and financial information will be read: • Only by the health care team involved in your care. • For health care daily work. • For billing and insurance reasons. As health care providers, we are legally required to report information to state and federal agencies. This information may include, but is not limited to: • Harm after a crime • Suspected abuse and neglect • Public health concerns • Duty to warn if someone is in imminent danger from another person. The law also permits us to release your health care information in certain situations, such as an emergency. Otherwise, you must give your permission before your information will be released. You also have the right to receive copies of your medical records within a reasonable time frame. You have the responsibility to respect the confidentiality of others We ask that you respect the privacy of other patients and families. It is not right to: • Look into other patient rooms. • Ask staff for information about other patients. • Ask staff why a person/patient is here at Sanford. You have the right to information about your treatment Your diagnosis and proposed treatment will be explained to you in terms and language that you can understand. You may have family members or friends included in this discussion. You can expect your doctor to explain: • Your diagnosis. • Other choices for care or treatment. • The risks and benefits for each of these choices. • Likely outcomes. As a Sanford patient, you can expect: • Information about pain and pain relief measures. • Staff commitment to partner with you to manage your pain. • Staff who will listen and respond to your reports of pain. You have the responsibility to ask for clear explanations If you do not understand your medical problem and/or your treatment plan is not clear to you, you must tell your health care team. You are responsible for asking questions if you do not understand. You should ask: • Why is this treatment suggested? • What other choices do I have? • What might be the results of this treatment? • Is this treatment new and/or experimental? • How long will this treatment take? • What will this treatment cost? • What are the risks of this treatment? • What are the side effects of this treatment? • What are the credentials of the person providing this treatment? When you and your doctor agree on the best treatment for you, it is important that you follow this plan. • Partial treatment may not help you. • If you cannot follow the treatment plan, you need to tell a staff member. You have the right to make decisions about your care We value the partnership between you and your caregivers. We want you to have an active role in your own healthcare. We respect your right to: • Choose your provider. o This may be at your own cost. Some care models such as Psychiatry, Hospitalists, and Laborists do not allow switching providers unless | extreme issues arise. • Communicate with your provider. • Give informed consent after you receive a clear explanation of: o Your disease. o The risks and benefits of the treatment and other options you may choose. • Ask for the right care. • Not be transferred to another facility. The exception to this is: o If you were given a complete explanation for the transfer need. o If you were given other options to the transfer. • A prompt response to your questions and requests. • Give your consent or decline to be a part of research studies. • Refuse a diagnostic procedure or treatment. • Be told of what may happen if you refuse the procedure or treatment. • Consult with a different specialist. • Help to develop and carry out your plan of care. • Have your spiritual and/or cultural needs met. If these needs may impact your care, you will need to tell your doctor and/or the staff taking care of you. • Know of any professional relationship that may exist between: o Your doctor o Other institutions o Sanford Health o Other doctors State law may require the consent of a relative or legal guardian if you are: • Under the age of 18 • Unconscious • Too ill to give informed consent You may be treated without consent if: • There is a medical emergency. • Immediate action must be taken for your well-being • There is a court ordered mandate. You have the responsibility to make informed decisions You are responsible for the decisions you make about your care. We encourage you to gather as much information about your illness as you can. This will help you to make an informed decision. You may be asked to sign a written consent tests and/or procedures. • Make sure you understand each document that you are asked to sign. • If you change your mind or refuse treatment: o Tell the staff right away. o Talk to your doctor about your concerns and/ or reasons. You have a right to develop an Advance Directive Advance Directives are written instructions for a patient’s health care in the event he or she is unable to make or communicate decisions. As part of an Advance Directive, a patient may choose someone to make health care decisions on his or her behalf. An Advance Directive may also be known as or include a: • Living Will. • Health Care Directive. • Power of Attorney for Health Care. You have the right to: • Information about Advance Directives. • Prepare an Advance Directive. • Have staff follow your wishes as stated in your Advance Directive: o To the degree permitted by state law. o To the extent medically appropriate. o Subject to limitations on the basis of conscience or other reason permitted by state law. o I.C.A. § 144A.8, I.C.A. § 144B.9, N.D.C.C. § 2306.5-09, N.D.C.C. § 23-06.5-12, M.S.A. § 145B.06, M.S.A. § 145C.11, M.S.A. § 145C.15, S.D.C.L. § 3412D-12, S.D.C.L. § 34-12D-19 may be referenced for further details. Sanford’s policy is to follow a patient’s Advance Directive once we have knowledge of its contents and the extent to which it is consistent with the law and reasonable standards of medical practice. If a provider cannot honor an Advance Directive, the option of transferring the patient’s care to another provider who will comply with the patient’s wishes must be discussed. You are not required to have an Advance Directive. Sanford will not condition care or discriminate against you based on whether or not you have an Advance Directive. If you have an Advance Directive, you have a responsibility to: • Give your provider a current copy of your Advance Directive. • Talk with the person you have selected as your decision maker about your wishes for your care. • Remove or replace an advanced care directive if it is no longer current. Failing to do so may lead to Sanford giving care in a manner that is no longer in line | with your wishes. You have the right to personal property You have the right to have your personal items with you. You may keep your personal items with you at all times unless: • There is not enough space for you to keep them. • Due to medical reasons, you cannot have them. • For your safety, personal property is not allowed on some units. • Use or presence of your personal items disrupts Sanford’s ability to give you care. You have the responsibility to secure your valuables It is your responsibility to make sure that your valuables are secured at all times unless secured by staff per specialty unit policy or protocol. Things that are considered valuable are (but are not limited to): • Hearing aids • Cell phones • Dentures or partial dentures • Tablets • Eyeglasses • Computers • Jewelry • iPads Do not leave your valuables where they may be mistakenly disposed of. Examples of this include (but are not limited to): • Bedside table • Meal tray • Your hospital bed Sanford Health does not accept financial responsibility if you choose to keep your personal items with you.   You have the right to safe care Our goal is to have a safe and comfortable environment for you while you are a patient at Sanford Health. We respect your right to: • Have care and services that are within professional standards of practice. • Medical and personal health care based on your own individual needs. • Be cared for in a safe environment. • Be free from being restrained or secluded (separation from others) unless needed for safety reasons. • Freedom from maltreatment (abuse or neglect). • Not be given medication you do not need. • Have the least amount of restrictions to achieve the goals of your treatment plan. • Be cared for by staff members who know about you and your plan of care. • Be told what you need to do if there is an emergency. • Expect reasonable continuity of care when you no longer need to be in the hospital and need care after discharge. You have the responsibility to: • Give correct and complete information about your: o Health history o Medications o Treatments • Tell your doctor or person caring for you, about any changes in your health status. • Tell your doctor or the person caring for you about pain you are having. • Keep your appointments for your follow-up care. o If you need to cancel or reschedule, give plenty of notice. • Follow the treatment plans given to you. • Follow Sanford policies that may affect patient care and conduct, such as: o Restrictions in the use of tobacco, cigarettes, vaping/ e-cigarettes. o Dietary limits. o Visiting policies. • Tell us of any safety concerns you may have. You have the right to know about your bill You have the right to: • Be told of the services that are included in your daily room charge. This information will be available before you are admitted and/or during your stay. o Information for services that are an added charge will also be available. • Sanford will help you get information about: o The expected payments for your care from: - Medicare - Medicaid - A third-party payer o What you may be expected to pay. • Have your total bill explained to you no matter how your bill is being paid. o You may call Patient Financial Services at (877) 629-2999. o You can request an itemized bill from them. As a Sanford patient, you have a responsibility to: • Know your insurance coverage policy. • Know your financial responsibility. • Pay your bill. • Give Sanford Health the correct insurance information. o Sanford will bill your health insurance company. o You are responsible for paying what is not covered by your insurance. Sanford Health has a Community Care Program. This program gives discounted or free care to a patient that meets the eligibility rules. To find out more information, you can: • Call Patient Financial Services: (877) 629-2999 • Look on our website: www.sanfordhealth.org You also have the right to: • Have a family member or other representative, and your provider told promptly of your admission to Sanford, if you so desire. • Have visitors whom you choose for emotional support during your stay. This can include, but is not limited to your: o Husband or wife o Domestic partner (including a same sex domestic partner) o Family member o Friend Sanford may need to limit visitation. This is to protect the health, safety, or privacy of you or others. o Withdraw or deny visitation consent at any time. o Reasonable access at reasonable times to protection or advocacy (support) services. o Refuse services. o Telephone and mail communication. o Exercise all civil rights. This includes the right to habeas corpus (hey-bee-uh s kawr-puh s). This is defined as a protection from illegal confinement (being held against your will). o Routine opportunities for outdoor physical activity unless not allowed by specialty units, or if your health does not allow. o Participate in the religious worship of your choice. o Be told of the policies and practices that relate to: - Patient care - Treatment - Responsibilities Sanford will not discriminate or retaliate against you (treat you badly) for using your rights. All rights expressed in this document are for all patients regardless of: • Age • Physical and/or mental status • Race • How much money you make/what you do for a living • Country of origin • Sex • Religion • Sexual orientation • Beliefs/Culture • Gender identity or expression • Language Concerns about Your Care: Sanford will not retaliate or discriminate against anyone who has a complaint about his or her care. If you have any questions or complaints about your rights as a patient at Sanford Health, you may contact your nurse or any local Sanford facility. You may also call or write to Patient Relations at the following locations: Patient Relations Patient Relations Sanford Health of Sanford Bismarck Northern Minnesota 300 N. Seventh St. 1300 Anne St. NW Bismarck, ND 58501 Bemidji, MN 56601 (701) 323-2873 Patient Relations Patient Relations Sanford Fargo Sanford Sioux Falls 801 Broadway 1305 W. 18th St Fargo, ND 58122 Sioux Falls, SD 57105 (701) 234-5876 (605) 333-6546 For Joint Commission Accredited locations, at any time, you or your representative may contact: The Joint Commission Office of Quality and Patient Safety One Renaissance Blvd Oakbrook Terrace, IL 60181 (800) 994-6610 Fax: (630) 792-5636 www.jointcommission.org At any time, you or your representative may contact the following: South Dakota Department of Health 600 E. Capitol Ave. Pierre, SD 57501-2536 Telephone: (605) 773-3361 Toll Free (in state): (800) 738-2301 Minnesota Department of Health Office of Health Facility Complaints P.O. Box 64970 St. Paul, MN 55164-0970 Telephone: (651) 201-4201 Toll Free: (800) 369-7994 Iowa Department of Inspections and Appeals Health Facilities Division Lucas State Office Building 321 E. 12th St. Des Moines, Iowa 50319-0083 Telephone: (515) 281-4115 Fax: (515) 242-5022 North Dakota Department of Health 600 E. Boulevard Ave. Bismarck, N.D. 58505-0200 Telephone: (800) 472-2622 Minnesota Board of Behavioral Health and Therapy 2829 University Avenue SE, Suite 210 Minneapolis, MN 55414 Telephone: (612) 548-2177 MN Department of Human Services Licensing Division 444 Lafayette Road St Paul, Mn 55155 Telephone: (651) 431-6500 Office of Ombudsman for Mental Health and Developmental Disabilities 121 7th Place E, Suite 420 St. Paul, Minnesota 55101-2117 Telephone: (651) 757-1800 or 1-800-657-3506 Behavioral Health Division North Dakota Department of Human Services 1237 W Divide Ave, Suite 1C Bismarck, ND 58501-1208 Telephone: 1-701-328-8920 or 1-800-755-2719 (ND only) If Medicare is paying your health care bills and you believe you are being discharged prematurely, you have concerns about your care, or you would like a review of coverage decisions, you may contact: Minnesota Quality Improvement Organization South Dakota Quality Improvement Organization Livanta LLC KEPRO BFCC-QIO 5700 Lombardo Center Dr., Suite 100 10820 Guilford Road, Suite 202 Seven Hills, OH 44131 Annapolis Junction, MD 20701-1105 Toll Free: (888) 317-0891 Telephone: (888) 524-9900 TTY: (855) 843-4776 TTY: (888) 985-8775 Iowa Quality Improvement Organization North Dakota Quality Improvement Organization Livanta LLC KEPRO BFCC-QIO 5700 Lombardo Center Dr., Suite 100 10820 Guilford Road, Suite 202 Seven Hills, OH 44131 Annapolis Junction, MD 20701-1105 Toll Free: (888) 317-0891 Telephone: (888) 755-5580 TTY: (855) 843-4776 TTY: (888) 985-9295 If you feel Sanford Health has failed to provide services based on effective communication or language services, or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you can file a grievance with the Section 504 Coordinator. Sanford Section 504 Coordinator 900 E 54th Street N, Route 6227 Sioux Falls, SD 57104 You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the portal at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf or by mail or phone. U.S. Department of Health and Human Services 200 Independence Avenue S.W. Room 509F HHH Building Washington, DC 20201 (800) 868-1019 (800) 537-7697 (TDD) Patient Rights and Responsibilities 019012-00403 6/19 14x22 80lb Cover Front only Black endstream endobj 3 0 obj <> endobj xref 0 4 0000000000 65535 f 0000097495 00000 n 0000097546 00000 n 0000122906 00000 n trailer <]>> startxref 116 %%EOF