You have the right to:                                                  

• Considerate, respectful, and dignified care and respect for personal values, beliefs, and preferences.
• Access to treatment without regard to race, ethnicity, national origin, color, creed/religion, sex, gender identity, age, mental disability, or physical disability. Any treatment determinations based on a person’s physical status or diagnosis will be made based on medical evidence and treatment capability.
• Respect for personal privacy.
• Receive care in a safe and secure environment.
• Exercise your rights without being subjected to discrimination or reprisal.
• Know the identity of persons providing care, treatment, or services and, upon request, be informed of the credentials of healthcare providers and, if applicable, the status of their malpractice coverage.
• Expect the facility to disclose, when applicable, physician financial interests or ownership in the facility.
• Receive assistance when requesting a change in primary or specialty physicians, dentists, or anesthesia providers if other qualified physicians, dentists, or anesthesia providers are available.
• Receive information about health status, diagnosis, the expected prognosis, and expected outcomes of care, in terms that can be understood, before a treatment or a procedure is performed.
• Receive information about unanticipated outcomes of care.
• Receive information from the physician about any proposed treatment or procedure as needed in order to give or withhold informed consent.
• Participate in decisions about the care, treatment, or services planned and to refuse care, treatment, or services, in accordance with law and regulations.
• Be informed, or when appropriate, have your representative be informed (as allowed under state law) of your rights in advance of furnishing or discontinuing patient care whenever possible.
• Receive information in a manner tailored to your level of understanding, including provision of interpretative assistance or assistive devices.
• Have family be involved in care, treatment, or services decisions to the extent permitted by you or your surrogate decision maker, in accordance with laws and regulations.
• Appropriate assessment and management of pain, information about pain, pain relief measures, and participation in pain management decisions.

• Give or withhold informed consent to produce or use recordings, film, or other images for purposes other than care, and to request cessation of production of the recordings, films, or other images at any time.
• Be informed of and permit or refuse any human experimentation or other research/educational projects affecting care or treatment.
• Confidentiality of all information pertaining to care and stay in the facility, including medical records, and, except as required by law, the right to approve or refuse the release of your medical records.
• Access to and/or copies of your medical records within a reasonable time frame and the ability to request amendments to your medical records.
• Obtain information on disclosures of health information within a reasonable time frame.
• Have an advance directive, such as a living will or durable power of attorney for healthcare, and be informed as to the facility’s policy regarding advance directives/living wills. Expect the facility to provide the state’s official advance directive form upon request, where applicable.
• Obtain information concerning fees for services rendered and the facility’s payment policies.
• Be free from restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff.
• Be free from all forms of abuse or harassment.
• Access to language assistance service, free of charge, by a qualified interpreter for individuals with limited English proficiency or individuals with a disability.
• Expect the facility to establish a process for prompt resolution of patients’ grievances and to inform each patient whom to contact to file a grievance. Grievances/complaints and suggestions regarding treatment or care that is (or fails to be) furnished may be expressed at any time. Grievances may be lodged with the state agency directly using the contact information provided below.

If a patient is adjudged incompetent under applicable State laws by a court of proper jurisdiction, the rights of the patient will be exercised by the person appointed under State law to act on the patient’s behalf. If a state court has not adjudged the patient incompetent, any legal representative or surrogate designated by the patient in accordance with state law may exercise the patient’s right to the extent allowed by State law.

You are responsible for:

• Being considerate of other patients and personnel and assisting in the control of noise, smoking, and other distractions.
• Respecting the property of others and the facility.
• Identifying any patient safety concerns.
• Observing the prescribed rules of the facility during your stay and treatment.
• Providing a responsible adult to transport you home from the facility and remain with you for 24 hours if required by your provider.
• Reporting whether you clearly understand the planned course of treatment and what is expected of you, and asking questions when you do not understand your care, treatment, or services, or what you are expected to do.
• Keeping appointments and, when unable to do so for any reason, notifying the facility and physicians.
• Providing caregivers with the most accurate and complete information regarding present complaints, past illnesses, hospitalizations, medications – including over-the-counter products and dietary supplements, and any allergies or sensitivities, unexpected changes in your condition, or any other patient health matters.
• Promptly fulfilling your financial obligation to the facility, including charges not covered by insurance.
• Payment to the facility for copies of the medical records you may request.
• Informing your providers about any living will, medical power of attorney, or other advance directives that could affect your care.