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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