Patient Rights and Responsibilities
Health care is a shared experience involving patients and those who give care. The personal worth and dignity of each patient is recognized at Good Samaritan Hospital (GSH). Your Rights and Responsibilities are offered as an expression of our philosophy and commitment to you.
1. You have the right to considerate, respectful, and responsive care. You have the right to medical treatment regardless of your age, gender, race, religion, disability, diagnosis, or national origin.
2. You have the right to respectful consideration of your psychosocial, spiritual, and cultural values, needs, and preferences. You have the right to have a family member or representative of your choice notified upon your admission to the hospital, if you so wish. You have the right to request and receive pastoral services.
3. You have the right to prepare a Living Will and/or appoint a surrogate to make decisions on your behalf in accordance with Ohio Law. You have the right to present your Advance Directive, (Living Will and/or Health Care Power of Attorney) at the time of admission and to have hospital staff and practitioners comply with your Directive. In accordance with its philosophy, GSH is opposed to and will not participate in assisted suicide and/or active euthanasia, nor will life-sustaining treatment be withheld or withdrawn in the presence of a viable fetus. Should you want to formulate your wishes through an Advance Directive at or after admission, you have a right to do so. To arrange for this, contact your nurse or call Customer Service at extension 1000.
4. You have the right to have your physician promptly notified of your admission to the hospital.
5. You have the right, as a competent adult, to become involved in all aspects of your care. If you are unable to make decisions for yourself, you have the right to know that the appropriate involvement of your next of kin, family member, or surrogate decision-maker will be sought.
6. You have the right to discuss the available information about your condition and treatment options with your physician so you understand the potential risks, alternatives, and benefits before making decisions about your treatment.
7. You have the right and are encouraged to obtain timely, relevant, current, and
understandable information concerning diagnosis, treatment, and prognosis from physicians and other direct caregivers.
8. You have a right to have any pain you might experience assessed and managed in a manner consistent with accepted medical standards.
9. You have the right to an explanation of treatments and procedures you are receiving, including the name of the physician who has primary responsibility for your care and the identity and credentials of professionals responsible for authorizing and performing treatments.
10. You have the right to refuse treatment to the extent permitted by law and to be informed of the consequences of your refusal. This refusal includes, but is not limited to, experimental research.
11. You and/or your next of kin, or an appointed surrogate speaking on your behalf, have the right to request and participate in appropriate discussion of ethical concerns/issues related to your care. To arrange such discussion, speak with the nursing personnel caring for you or your loved one or call the administrative representative for the Ethics Committee at extension 2262 or Customer Service at extension 1000.
12. You have the right to a reasonable response to your requests for hospital services within the available resources of the hospital based on priority of need and continuity of care. This includes discharge planning services such as facilitating transfers to another medical or extended care facility.
13. You have the right to reasonable resources to facilitate communications, i.e., language interpreter, sign language interpreter, and devices to assist the hearing-impaired.
14. You have the right to confidentiality of information related to your care.
15. You have the right to access information contained within your medical record in accordance with hospital policy.
16. You have the right to information from appropriate hospital staff in all matters relating to hospital charges, payment of your bill, completion of insurance forms, and utilization review procedures. You have the right to ask and be informed about the existence of business relationships among hospitals, educational institutions, and other health care providers or payers that may influence your care.
17. You have the right to personal privacy and security, including access to protective services (i.e., guardianship and advocacy services) if they should be required. You have the right to receive care in a safe setting without being subject to abuse or harassment.
18. You have the right to be free from any form of restraint that is not medically or behaviorally necessary. Seclusion may not be used as a means of discipline, coercion, convenience, or retaliation.
19. You have the right to express concerns about your care at GSH. Speak to your physician or the staff caring for you should you have any concerns about your care. If the issue is not resolved to your satisfaction, contact our Customer Service Department at extension 1000 to speak to a Customer Service Representative. You have the right to expect that your concerns will be heard, investigated, and responded to in a timely manner. GSH is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and complies with the Conditions of Participation for Medicare and Medicaid. To express concerns not resolved through the hospital, visit JCAHO’s website at www.jointcommission.org or call (800) 994-6610. The Centers for Medicare and Medicaid may be reached at www.cms.hhs.gov or by calling (800) 633-4227. You may also contact the Ohio Department of Health at www.odh.state.oh.us or by calling (800) 342-0553.
20. You have the right to know the rules that apply to your conduct and that of your family and your visitors while you are a patient at GSH.
1. You have the responsibility to exercise your right to make informed decisions about your health care. This includes seeking and considering the information provided by your physician and other caregivers.
2. You have the responsibility to inform the hospital staff and your health care providers of the existence of any Living Will and/or Health Care Power of Attorney you have prepared, to present these documents, and to inform those providers of any concerns you have about their consideration of these documents.
3. You have the responsibility to inform your surrogate decision-maker and/or those to whom you have entrusted your Living Will and/or Health Care Power of Attorney of your wishes concerning your health care.
4. You have the responsibility to report any changes in your condition to your physician and/or the nurse caring for you.
5. You have the responsibility to follow treatment plans and instructions recommended by your physician. This includes your responsibility to ask questions when you do not understand the plan of care or instructions given to you. If you choose not to follow instructions, you are responsible for the outcome.
6. You have the responsibility to cooperate with the GSH staff caring for you and to ask questions when you do not understand instructions or need clarification.
7. You have the responsibility to provide, to the best of your knowledge, accurate and complete information about all matters relating to your health.
8. You have the responsibility to contact a nurse, physician, or Customer Service at extension 1000 to receive answers to questions about your care in the hospital or to file a complaint when you have concerns regarding your care or treatment.
9. You have the responsibility to consider and abide by the rules that apply to your conduct and that of your family and visitors while you are a patient at GSH. You also have the responsibility to be considerate of the hospital’s staff and property, as well as other patients and their property, privacy, and confidentiality, while you are receiving care.
10. You have the responsibility to ensure payment of your bill(s) for care/treatment received. This includes the responsibility to cooperate with appropriate hospital staff to provide information for processing insurance forms and other payment processes.
11. You have the responsibility to send valuables home with your family/friends or to secure them in the hospital safe while you are a patient.
Questions or Concerns
If you have questions or concerns about any of your rights and responsibilities at GSH, please call our Customer Service Department at (937) 734-1000.