Patient Rights and Responsibilities
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In keeping with our mission, Columbia
St. Mary's has developed this document
consistent with the CSM Core Values.
A high regard for the worth,
dignity and uniqueness of each person.
A commitment to the highest standards
delivered with competence and pride.
Honesty, openness and sincerity.
Actions that are marked by
innovation, flexibility, openness to
change and imagination.
Connecting with another person through
an act of assistance or benefit.
Columbia St. Mary's – a healthcare
provider founded in response to
identified community needs – is
sponsored by Ascension Health, Catholic
national healthcare system, and Columbia
Health System, a non-sectarian community
health system.
Columbia St. Mary's exists to make a
positive difference in the health status
and lives of individuals and our
community, with special concern for
those who are vulnerable.
At Columbia St. Mary's we are committed
to providing high quality, accessible,
values-driven programs and services with
equal attention physical, spiritual, and
emotional dimensions of health.
We believe that a mutual understanding
our goals and beliefs as a healthcare
provider will lead to a more meaningful
relationship with you and your family.
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Believing the patient to be an integral member of the healthcare team,
Columbia St. Mary’s wants all patients and their families to know about
the following Patient Rights and Responsibilities. These rights and
responsibilities are designed to help assure safe and effective delivery
of healthcare at all Columbia St. Mary’s hospitals and facilities.
You have the right:
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To be informed of the organization’s policy regarding patient
rights and responsibilities.
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To access available treatment which values you without regard to
your race, creed, color, national origin, ancestry, religion,
gender, marital status, lifestyle preference, age, newborn
status, disability or source of payment.
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To be treated with consideration, respect, and recognition of
your individuality and personal needs.
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To recognition of your personal dignity and the psychosocial,
spiritual, and cultural variables that influence the perceptions
of illness.
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To access available pastoral care and other spiritual services.
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To an environment that respects your need for confidentiality,
privacy, and security.
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To expect safe surroundings, free from all forms of abuse or
harassment.
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To know who is treating you, as well as why they are treating
you.
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To privacy and confidentiality of your medical information.
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To know your diagnosis and what to expect regarding your
healthcare choices.
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To be involved in decisions about your care, treatment,
services, and care provider(s) with the exception of requests
which result in discrimination against employees based on
race/ethnicity, national origin, religion, gender, lifestyle
preference, age or disability.
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To provide consent before treatment is administered or
procedures are performed.
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To be informed of the risks, side effects, and expected results
of the recommended treatment or procedures.
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To be informed about the outcomes of your care, treatment and
services, including unanticipated outcomes.
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To refuse, withdraw and/or withhold treatment, and be informed
of the medical consequences of your decision.
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To be involved in your pain management, which includes being
able to express your pain, have your pain assessed, and have it
managed using the most currently accepted methods.
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To give consent or refuse to participate in clinical trials.
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To request discharge and be discharged against medical advice.
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To be free from physical or chemical restraint and/or seclusion
that is not medically necessary.
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To know what your medical record says, to request changes where
appropriate, and to receive an accounting of disclosures
regarding your personal health information.
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To request information regarding transfer to, or treatment in
another healthcare location and except in emergencies, to be
given a full explanation for a transfer if it is initiated by
Columbia St. Mary’s.
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To refuse transfer, except in emergencies, in circumstances
where provision has not been made for continuing care and/or the
receiving facility has not accepted the transfer.
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To information regarding advance directives and to have
assistance in formulating an advance directives document.
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To have someone represent you in making healthcare decisions.
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To request an Ethics Committee consultation.
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To express a concern and/or initiate Columbia St. Mary’s patient
grievance process.
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To consent, limit, stop, and/or deny use of any recording or
filming related to your care.
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To receive visitors, phone calls, and mail.
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To receive information in a manner you understand, including
interpreter assistance when English is not your primary language
or if visual, hearing or cognitive impairments prevent effective
communication during your hospital stay and/or clinic visit.
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To access protective, legal, and advocacy services.
Patients who have a concern should contact the
Nurse Director and/or Patient Representative on duty. The Nurse Director
and/or Patient Representative will direct the concern to the appropriate
individual who will, in turn, act to resolve the matter to the patient’s
satisfaction. Should the patient wish to pursue the matter further, they
may address the concern to the Administration of the respective hospital
or clinic.
State of Wisconsin
Bureau of Quality Assurance
P.O. Box 2969
Madison, WI 53701-2969
phone: (608) 266-8481;
OR
Joint Commission on Accreditation for Healthcare Organizations
Office of Quality Monitoring
phone: (800) 994-6610
email: complaint@jcaho.org
You have the responsibility:
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To provide accurate and complete information about your health,
to the best of your ability.
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To notify staff if you do not understand your healthcare plan
and what is expected of you.
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To mention concerns about your care and report changes in your
condition.
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To be considerate of the rights of other patients, hospital
and/or clinic personnel, and hospital property, as well as to
follow the rules and regulations pertaining to patients and
families.
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To provide the hospital and/or clinic with information
concerning your sources of payment and your ability to meet
these obligations.
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To cooperate with the advice, treatment plan, and
prescription(s) you are given.
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To discuss with your doctor or nurse any questions or intention
not to follow your treatment plan and accept the outcomes of
such a decision(s).
If patients have questions regarding their responsibilities, the Nurse
Director and/or the Patient Representative on duty should be contacted.