| 1. |
Be advised that Franciscan Health
Support, Inc., is an affiliate with St. Joseph's Hospital Health
Center; |
| 2. |
Receive considerate, respectful,
and individualized care/service with full recognition of your dignity
and individuality without regard to race, creed, color, religion,
sex, national origin, sexual preference, handicap or age; |
| 3. |
Be informed before service starts
the extent to which payment for your services may be expected from
your insurance company and the extent to which you will be financially
responsible for services provided when possible; |
| 4. |
Receive information of any financial
benefit, if any, to the referring organization when/if you are referred
to another organization, service or individual; |
| 5. |
To have explained to you the services/care
you are to have provided in a way that you understand prior to receiving
those services. This includes use of an interpreter, special devices,
or other aids so that you will understand the care. You will be
asked to be given written permission by signing the consent to treatment
from which will be provided to you. This will include who will perform/provide
the services you receive and who they work for. Personnel will have
identification including a name tag with a photo on it; |
| 6. |
You will included in the development
of the care plan to restore you to your optimal level of health
and any changes made in this plan, as well as discharge from our
agency or transfer to another agency for care needs which would
be better met at the level of care; |
| 7. |
Being accepted as a patient only
if the agency can meet your healthcare needs at a level that will
meet the needs of your medical condition. |
| 8. |
To have those services provided to
you timely; |
| 9. |
You have the right to appropriate
the assessment and management of pain. This includes information
about pain and pain relief measures, a timely response to reports
of pain, and concerned healthcare professionals who are committed
to pain prevention and management. |
| 10. |
To take part in the consideration/resolution
of ethical concerns related to your care; |
| 11. |
To formulate advanced directives.
Such decisions are respected to the full extent provided by the
law; |
| 12. |
Refuse treatment within the confines
of the law and to be informed of the expected outcomes of your decision; |
| 13. |
To have privacy, security and respect
of your property; |
| 14. |
Confidentiality of your medical records
and your care; |
| 15. |
Be informed of any experimental treatments
or research and your consent obtained prior to these treatments; |
| 16. |
You have the right to voice concerns and to
recommend changes in policies and services provided. Concerns may be addressed
with agency staff or management personnel. You may speak with staff directly
or call the agency at 458-3200. You have the right to prompt resolution of your
concern. If you are not satisfied with the agency resolution, you may appeal
to the agency in writing, or call the New York State Department of Health at
1-800-628-5972. Additionally, you may voice your concern directly with the
Joint Commission on Accreditation of Healthcare Organizations at 1-800-994-6610.
This is our accrediting agency responsible for our adherence to standards they
set forth; |
| 17. |
For Medicare beneficiaries, you have
the right to be informed when it is expected that Medicare will
not cover those services. If Medicare does not cover the services
provided, you will be asked to sign a Waiver of Liability and be
informed of the cost of the equipment/services being provided. You
may contact the Medicare Hotline at 1-800-331-7767 for any concerns
you may have. |