Patient Bill of Rights

These rights can be exercised on the patient’s behalf by a designated representative, surrogate or proxy decision maker if the patient lacks decision making capacity, is legally incompetent or is a minor.

1. The patient has the right to considerate and respectful care. The patient has the right to receive care in a safe setting, free from abuse or harassment. The patient has the right to be free from restraints or seclusion imposed as a means of coercion, discipline, convenience or retaliation by staff.

2. The patient has the right to have a family member or physician of his/her choosing notified of his/her admission to the hospital. The patient has the right to be informed of visiting policies, including those setting forth any clinically necessary or reasonable restriction or limitation the hospital may need to place on such rights and the reasons for those restrictions/limitations.3. The patient has the right to receive from his/her physician information necessary to give informed consent prior to the start of any procedure and/or treatment. Except in emergencies such information for informed consent should include (but not necessarily be limited to) the specific procedure and/or treatment as well as the medically significant alternatives for care or treatment. The patient has the right to know the name of the person responsible for the procedure and/or treatment.

3. The patient has the right to obtain from the physician and other direct care givers complete, current information concerning diagnosis, treatment and prognosis in terms the patient can be reasonably expected to understand. When it is not medically advisable to give such information to the patient, the information should be made available to the appropriate person on the patient’s behalf. The patient has the right to know by name the physicians, nurses and others responsible for coordinating his/her care, as well as when those involved are students, residents or other trainees. The patient has the right to know that a physician is not on the premises 24 hours a day/7 days a week but that a physician is available by phone or pager 24 hours a day/7 days a week.

4. The patient has the right to receive from his/her physician information necessary to give informed consent prior to the start of any procedure and/or treatment. Except in emergencies, such information for informed consent should include (but not necessarily be limited to) the specific procedure and/or treatment as well as the medically significant alternatives for care or treatment. The patient has the right to know the name of the person responsible for the procedure and/or treatment. The patient has the right to refuse treatment to the extent permitted by law and to be informed of the medical consequences of such action. In case of such refusal, the patient is entitled to other appropriate care and services that the hospital provides.

5. The patient has the right to have an advance directive (such as a living will, health care proxy or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy.

6. The patient has the right to privacy concerning his/her own medical care program. Case discussions, consultation, examination, and treatment are confidential and should be conducted discreetly. Those not directly involved in the patient’s care must have the permission of the patient to be present.

7. The patient has the right to expect that all communications and records pertaining to his/her care should be treated as confidential by the hospital, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law. The patient has the right to expect that the hospital will emphasize the confidentiality of this information when it releases it to any other parties entitled to review information in these records.

8. The patient has the right to review the records pertaining to his/her medical care and the right to access this information and to have the information explained or interpreted as necessary, except when restricted by law. Hospital Policy will be followed as it applies to release of information.

9. The patient has the right to participate in the development and implementation of his/her plan of care, discharge plan and pain management plan. The patient has the right to expect that within its capacity a hospital must make reasonable response to his/her request for services. The hospital must provide evaluation, service, and/or referrals indicated by the urgency of the case. When medically appropriate and legally permissible a patient may be transferred to another facility only after he/she has received complete information and explanation concerning the need for and alternatives to such a transfer. The institution to which the patient is to be transferred must first have accepted the patient for transfer.

10. The patient has the right to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers or payors that may influence the patient’s treatment and care.

11. The patient has the right to be advised if the hospital proposes to engage in or perform human experimentation affecting his/her care or treatment. The patient has the right to refuse to participate in such research projects and, if so, is entitled to the most effective care that the hospital can otherwise provide.

12. The patient has the right to expect reasonable continuity of care. He/she has the right to know in advance what appointment times and physicians are available and where. The patient has the right to expect that the hospital will provide a mechanism whereby he/she is informed by his/her physician, or a delegate of the physician, of the patient’s continuing health care requirements following discharge. The patient has the right to be informed by physicians and other caregivers of available and realistic patient care options when the provided level of hospital care is no longer appropriate.

13. The patient has the right to be informed of hospital policies and practices that relate to patient care, treatment and responsibilities. The patient has the right to be informed of available resources for resolving disputes, grievances and conflicts such as Care Managers. The patient has the right to examine and receive an explanation of his/her bill regardless of source of payment.

Patient Assessment Instrument Consent

Medicare requires rehabilitation hospitals to complete a designated evaluation called a “Patient Assessment Instrument” (PAI) on all Medicare patients at admission and discharge. This assessment requires the clinical treatment team to assess your functional skills in a variety of areas in order to document improvements made during the inpatient rehabilitation program. While the PAI is required only by Medicare, the clinical treatment team at Cardinal Hill Rehabilitation Hospital will use the PAI for all patients in order to assure consistency.

Medicare requires that you be informed of 5 specific rights concerning the Patient Assessment Instrument. Your signature indicates that you have been informed of these rights, which are as follows:

1. I understand that the PAI is used to collect data pertaining to my diagnosis, medical condition(s) and functional abilities. This information, contained on the PAI at admission and discharge, determines the payment that Cardinal Hill Rehabilitation Hospital will receive for the care provided to me.

2. I understand I have the right to expect that the information collected on the PAI will remain confidential and secure.

3. I understand that the data on the PAI will not be released to others except for legitimate purposes allowed by the Federal Privacy Act and Federal and State Regulations.

4. I understand that I have the right to refuse to answer PAI data questions.

5. I understand that I have the right to see, review, and request changes on the PAI.
I understand the Bill of Rights reviewed with me and I understand that I need to contact my Care Manager if I have any questions concerning these rights.

I understand the Patient Assessment Instrument rights reviewed with me.

I understand that refusal to answer PAI questions may result in the inability of the treatment team to collect the information needed for the PAI, which is required in order for Medicare to pay Cardinal Hill for my rehabilitation program.
I have been informed and understand that, if I have a concern or a grievance, I need to discuss it with my Care Manager, respective Program Manager or Risk Management Officer of the facility. If my concern/grievance is not resolved to my satisfaction, I may contact any of the following entities below:


Contact Information:

Commission on Accreditation of Rehabilitation Facilities (CARF)
     CARF
     6951 East Southpoint Road
     Tucson, AZ 85756
     (866) 510-2273
Kentucky Hospital Licensing
     Eastern Enforcement Branch
     P.O. Box 12250
     455 Park Place
     Lexington, KY 40511
     Phone: (859) 246-2301
     Fax: (859) 246-2307
Medicare (Medicare beneficiaries only) Quality Improvement Organization (QIO)
        Health Care Excel, Inc.
        800-288-1499 or
TTY: 877-486-2048


Administration Contact Information:

2050 Versailles Rd.

Lexington, KY 40504

859-254-5701

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