CONCHO COUNTY HOSPITAL

BOX 987 EDEN, TEXAS 76837

325-869-5911

Concho County Hospital is dedicated to the principles of respect, dignity and privacy in the day-to-day administration of health care. The delivery of healthcare involves rights, duties and responsibilities on the part of the patient, the hospital and health care practitioners.

PATIENTS HAVE THE RIGHT:

To have impartial access to high quality health care.

To have considerate care provided, with respect, dignity, and privacy, with regard to their personal values, culture, and beliefs.

To expect that the patient and family members participate in health care decisions and that Advance Directives will be honored within the limits of the law and the organization's mission, philosophy and capabilities.

To be assured of confidentiality of his/her medical record.

To be advised of their diagnosis, treatment and progress.

To have informed participation in decisions regarding their care and end-of-life issues.

To participate in ethical questions which may arise in the course of his/her care; to request a consult including one with the Ethics Committee.

* To have a family member or representative of his/her choice or his/her own physician notified promptly of his/her admission.

To have a representative exercise these rights when he/she (the patient) is unable to do so for himself/herself.

To expect to be cared for by qualified personnel.

To be cared for by staff educated about patient rights and their role in supporting those rights.

To expect that the hospital will take responsible steps to maintain a safe environment, including the physical environment as well as any equipment used in the connection with the treatment of the patient.

To effective communication which leads to understanding.

To have their concerns or complaints addressed within a reasonable time frame and resolved when possible (at the time the hospital is made aware of the complaint or definitely within 7 calendar days).

To pastoral counseling.

To access information contained in his/her clinical records within a reasonable time frame, except when it is determined that doing so could cause emotional or psychological distress to the patient.

To be free from seclusion or restraints of any form that is not medically necessary to promote healing or protect the patient from harming himself/herself or others.

To be free from all forms of abuse and/or harassment.

To access protective services if needed.

To have their pain appropriately assessed and managed.

To file or know who to contact to file a complaint or grievance (numbers listed below).

PATIENTS HAVE THE RESPONSIBILITY:

To follow hospital rules and regulations regarding patient care and conduct

To be considerate of the rights of others

To provide accurate and complete health care information

To indicate whether he/she understands the contemplated plan of medical and nursing management and the kind of compliance expected of him/her

To follow the treatment plan recommended by the doctor or staff, or to take responsibility for actions if he/she refuses treatment or does not comply with the plan of treatment

To report pain and results of pain management interventions

To be accountable for financial responsibilities

If at any time, you or a family member believe that while a patient at Concho County Hospital, a legal right has been unduly denied, restricted or impeded, you may contact :

Privacy Officer: Angela Regalado at 325-869-5911 -- If your complaint cannot be resolved to your satisfaction by Concho County Hospital's representatives, you have the right to call the State of Texas's Complaints Hotline. The Administration of this hospital would appreciate the opportunity to resolve your issues; please call the above numbers and we will make every effort to find a mutually acceptable resolution.

Grievance Officer: 325-869-5911
State of Texas Complaint Hotline: Willard Wagner R.N. 1-512-834-6650
Box 987
Eden, Texas 76837
willard.wagner@conchoch.com

Patient Signature_______________________________
Date _________________________________

Grievance Procedure for Patients and Visitors

Subject: Grievance Procedure for patients and visitors.

Policy Statement: Concho County Hospital has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by the regulation of the U.S. Department of Health and Human Services. HCFA 42 CFR Part 482.

"No otherwise qualified handicapped individual…shall, solely by reason of handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance."

1. A complaint should be filed in the business office of Concho County Hospital with the grievance coordinator Willard Wagner, who has been designated to coordinate the efforts to comply with the regulations, 614 Eaker St., Eden, TX 76837, phone: (325) 869-5911, within a reasonable time after the person filing the complaint becomes aware of the action alleged to be prohibited by the regulations.

2. A complaint may be filed in writing or verbally; it should contain the name and address of the person filing it and briefly describe the action alleged to be prohibited by the regulations.

3. The Administrator of Concho County Hospital or his/her designee shall conduct such investigation of a complaint as may be appropriate to determine its validity. These rules contemplate informal but thorough investigations, affording all interested persons and their representatives, if any, an opportunity to submit evidence relevant to the complaint.

4. The administrator of Concho County Hospital shall issue a written decision determining the validity for the complaint no later than thirty (30) days after its filing.

5. The Coordinator shall maintain the files and records of Concho County Hospital relating to complaints filed hereunder. The Coordinator may assist persons with the preparation and filing of complaints, participate in the investigation and advise the Administrator of Concho County Hospital

6. The right of a person to prompt and equitable resolution of the complaint filed hereunder shall not be impaired by the person's pursuit of other remedies such as the filing of a Complaint with the Office for Civil Rights of the U.S. Department of Health and Human Services. Utilization of this grievance procedure is not a prerequisite to the pursuit of other remedies.

7. Determinations made under these procedures shall be liberally construed to protect the substantial rights of interested persons, to meet appropriate due process standards and to assure the compliance of Concho County Hospital and the implementing regulations.