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EXHIBITAͲ#21.01
THEVALLEYHOSPITAL
PatientBillofRights
EveryNewJerseyhospitalpatientshouldhavethefollowingrights,noneofwhichshallbeabridgedbythehospitalor
anystaff.Thehospitaladministratorshallberesponsiblefordevelopingandimplementingpoliciestoprotectpatient
rightsandtorespondtogrievancespertainingtopatientrights.Theserightsshallincludeatleastthefollowing:
1. ToreceivethecareandhealthservicesthatthehospitalisrequiredtoprovideunderN.J.S.A.26:1Ͳ1et.Seq.and
rulesadoptedbytheDepartmentofHealthandSeniorServicestoimplementthislaw;
2. To treatment and medical services without discrimination based on race, age, religion, national origin, sexual
preferences,handicap,diagnosis,abilitytopay,orsourceofpayment;
3. To retain and exercise to the fullest extent possible all the constitutional, civil, and legal rights to which the
patientisentitledbylaw;
4. To be informed of the names and functions of all physicians and other health care professional who are
providing direct care to the patient. These people shall identify themselves by introduction or by wearing a
nametag;
5. Toreceive,assoonaspossible,theservicesofatranslatororinterpretertofacilitatecommunicationbetween
thepatientandthehospital’shealthcarepersonnel;
6. Toreceivefromthepatient’sphysician(s)orclinicalpractitioner(s)–intermsthatthepatientunderstands–an
explanation of his or her complete medical condition, recommended treatment, risk(s) of the treatment,
expectedresultsandreasonablemedicalalternatives.Ifthisinformationwouldbedetrimentaltothepatient’s
health,orifthepatientisnotcapableofunderstandingtheinformation,theexplanationshallbeprovidedtohis
orhernextofkinorguardiananddocumentedinthepatient’smedicalrecord.
7. Togiveinformed,writtenconsentpriortothestartofspecifiednonemergencyproceduresortreatmentsonly
afteraphysicianorclinicalpractitionerhasexplainedͲintermsthatthepatientunderstands–specifieddetails
abouttherecommendedprocedureortreatment,therisksinvolved,thepossibledurationofincapacitation,and
anyreasonablemedicalalternativesforcareandtreatment.Theproceduresrequiringinformed,writtenconsent
shallbespecifiedinthehospital’spoliciesandprocedures.Ifthepatientisincapableofgivinginformed,written
consent,consentshallbesoughtfromthepatient’snextofkinorguardianorthroughanadvancedirective,to
theextentauthorizedby law.Ifthepatient doesnotgivewrittenconsent, aphysicianorclinicalpractitioner
shallenteranexplanationinthepatient’smedicalrecord;
8. To refuse medication and treatment to the extent permitted by law and to be informed of the medical
consequencesofthisact;
9. To be included in experimental research only when he or she gives informed, written consent to such
participation,orwhenaguardianprovidessuchconsentforanincompetentpatientinaccordancewithlawand
regulation.Thepatientmayrefusetoparticipateinexperimentalresearch,includingtheinvestigationsofnew
drugsandmedicaldevices;
10. Tobeinformedifthehospitalhasauthorizedotherhealthcareandeducationalinstitutionstoparticipateinthe
patient’s treatment. The patient also shall also have a right to know the identity and function of these
institutions,andmayrefusetoallowtheirparticipationinthepatient’streatment.
11. To be informed of the hospital’s policies and procedures regarding lifeͲsaving methods and the use or
withdrawal of lifeͲsupport mechanisms. Such policies and procedures shall be made available promptly in
writtenformattothepatient,hisorherfamilyorguardian,andtothepublic,uponrequest;
12. To be informed by the attending physician and other providers of healthcare services about any continuing
healthcarerequirementsafterthepatientsdischargefromthehospital.Thepatientshallalsohavetherightto
receive assistance from the physician and appropriate hospital staff in arranging for required followͲup care
afterdischarge;
13. To receive sufficient time before discharge to have arrangements made for healthcare needs after
hospitalization;
14. Tobeinformedbythehospitalaboutanydischargeappealprocesstowhichthepatientisentitledbylaw;
15. To be transferred to another facility only for one of the following reasons, with the reason recorded in the
patient’smedicalrecord:
a. Thetransferringhospitalisunabletoprovidethetypeorlevelofmedicalcareappropriateforthepatient’s
needs.Thehospitalshallmakeanimmediateefforttonotifythepatient’sprimarycarephysicianandthe
nextofkin,anddocumentthatthenotificationswerereceived;or
b. The transfer of requested by the patient, or by the patient’s next of kin or guardian when the patient is
mentallyincapacitatedorincompetent.
16. To receive from a physician an explanation of the reasons for transferring the patient to another facility,
information about alternatives to the transfer, verification of acceptance from the receiving facility, and
assurance that the movement associated with the transfer will not subject the patient to substantial,
unnecessaryriskofdeteriorationofhisorhermedicalcondition.Thisexplanationofthetransfershallbegiven
inadvancetothepatient,and/ortothepatient’snextofkinorguardianexceptinalifeͲthreateningsituation
whereimmediatetransferisnecessary;
17. Tobetreatedwithcourtesy,consideration,andrespectforthepatient’sdignityandindividuality;
18. Tofreedomfromphysicalandmentalabuse;
EXHIBITAͲ#21.01
THEVALLEYHOSPITAL
PatientBillofRights
19. Tofreedomfromrestraints,unlesstheyareauthorizedbyaphysicianforalimitedperiodoftimetoprotectthe
patientorothersfrominjury;
20. Tohavephysicalprivacyduringmedicaltreatmentandhygienefunctions,suchasbathingandusingthetoilet,
unless the patient needs assistance for his or her own safety. The patient’s privacy shall also be respected
duringotherhealthcareproceduresandwhenhospitalpersonnelarediscussingthepatient;
21. To confidential treatment of information about the patient. Information in the patient’s records shall not be
released to anyone outside the hospital without the patient’s approval, unless another healthcare facility to
whichthepatientwastransferredrequirestheinformation,orunlessthereleaseoftheinformationisrequired
and permitted by laws, a thirdͲparty payment contract, a medical peer review, or the New Jersey State
Department of Health. The hospital may release data about the patient for studies containing aggregated
statisticswhenthepatient’sidentityismasked;
22. Toreceiveacopyofthehospitalpaymentrates,regardlessofsourcepayment.Uponrequest,thepatientor
responsiblepartyshallbeprovidedwithanitemizedbillandanexplanationofthechargesiftherearefurther
questions. The patient or responsible party has a right to appeal the charges. The hospital shall provide the
patientorresponsiblepartywithanexplanationofprocedurestofollowinmakingsuchanappeal.
23. Tobeadvisedinwritingofthehospitalrulesandregulationsthatappliestotheconductofpatientsandvisitors.
a. Thepartnerinacivilunionofapatient,and/orthedomesticpartnerofapatient,shallhavethesame
visitationprivilegesasifthevisitorwerethepatient’sspouse.
b. Afacilityshallnotrequireapatientorthepatient’scivilunionpartnerordomesticpartnertoproduce
proof of that partnership status as a condition of avoiding visitation privileges, unless the facility in
similarsituationsrequiresmarriedpatientsortheirspousestoproduceproofofmaritalstatus.
c. Visitation privileges shall not be denied or abridged on the basis of race, creed, color, national origin,
ancestry,age,maritalstatus,affectionalorsexualorientation,familialstatus,disability,nationality,sex,
genderidentityorexpressionorsourceoflawfulincome.
d. Visitationmayberestrictedinmedicallyappropriatecircumstancesorbasedontheclinicaldecisionofa
healthcareprofessionalchargedwiththepatient’scare;
24. Tohavepromptaccesstotheinformationcontainedinthepatient’smedicalrecord,unlessaphysicianprohibits
such access as detrimental to the patient’s health, and explains the reason in the medical record. In that
instance,thepatient’snextofkinorguardianshallhavearighttoseetherecord.Thisrightcontinuesafterthe
patientisdischargedfromthehospitalforaslongasthehospitalhasacopyoftherecord;
25. Toobtainacopyofthepatient’smedicalrecord,atareasonablefee,within30daysofawrittenrequesttothe
hospital. If access by the patient is medically contraindicated (as documented by a physician in the patient’s
medicalrecord),themedicalrecordshallbemadeavailabletoalegallyauthorizedrepresentativeofthepatient
orthepatient’sphysician;
26. To have access to individual storage space in patient’s rooms for the patient’s private use. If the patient is
unabletoassumeresponsibilityforhisorherpersonalitems,thereshallbeasysteminplacetosafeguardthe
patient’spersonalpropertyuntilthepatientornextofkinisabletoassumeresponsibilityfortheseitems;
27. Tobegivenasummaryofthesepatientrights,asapprovedbytheNewJerseyStateDepartmentofHealth,and
anyadditionalpoliciesandproceduresestablishedbythehospitalinvolvingpatientrightsandresponsibilities.
Thissummaryshallalsoincludethenameandphonenumberofthehospitalstaffmembertowhompatients
cancomplainaboutpossiblepatientrightsandresponsibilities.Thissummaryshallalsoincludethenameand
phone number of the hospital staff member to whom patients can complain about possible patient rights
violations. This summary shall be provided in the patient’s native language if 10 percent or more of the
populationinthehospitalserviceareaspeakthatlanguage.Inaddition,asummaryofthesepatientrights,as
approvedbytheNewJerseyStateDepartmentofHealthshallbepostedconspicuouslyinthepatient’sroomand
inpublicplacesthroughoutthehospital.Completecopiesofthissubchaptershallbeavailableatnursestations
andotherpatientcareregistrationareasinthehospitalforreviewbypatientsandtheirfamiliesorguardians;
28. To be assisted in obtaining public assistance and the private healthcare benefits to which the patient may be
entitled. This includes being advised that they are indigent or lack the ability to pay and that they may be
eligibleforcoverage,andreceivingtheinformationandotherassistanceneededtoqualifyandfileforbenefits
orreimbursement;
29. To contract directly with a New Jersey licensed registered professional nurse of the patient’s choosing for
privateprofessionalnursingcareduringhisorherhospitalization.Aregisteredprofessionalnursesocontracted
shalladheretohospitalpoliciesandproceduresinregardtotreatmentprotocols,andpoliciesandproceduresso
longastheserequirementsarethesameforprivatedutyandregularlyemployednurses.The hospital,upon
request, shall provide the patient or designee with a list of local nonͲprofit professional nurses association
registriesthatrefernursesforprivateprofessionalnursingcare;and
30. Toexpectandreceiveappropriateassessment,managementandtreatmentofpainasanintegralcomponentof
thatperson’scare,inaccordancewithN.J.A.C.8:43EͲ6.
31. Topresenthisorhergrievancestothehospitalstaffmemberdesignatedbythehospitaltorespondtoquestions
orgrievancesaboutpatientrightsandtoreceiveananswertothosegrievanceswithinareasonableperiodof
time. Thehospitalisrequiredtoprovideeach patientorguardianwiththe names,addresses,andtelephone
EXHIBITAͲ#21.01
THEVALLEYHOSPITAL
PatientBillofRights
numbers of the government agencies to which the patient can complain and ask questions. This information
shallalsobepostedconspicuouslyinpublicareasthroughoutthehospital.
TheNewJerseyDepartmentofHealthandSeniorServices
HealthandAgricultureBuilding
P.O.Box360 Trenton,NewJersey08625Ͳ0360
ComplaintHotline:(800)792Ͳ9770
TheValleyHospitalPatientRelationsDept. 223N.VanDienAve. Ridgewood,NJ07450
(201)447Ͳ8169
TheJointCommission OneRenaissanceBoulevard
OakbrookTerrace,Illinois60181
(800)994Ͳ6610
or
[email protected]
QIO(QualityImprovementOrganization)
(732)238Ͳ5570