For Patients & Visitors

I. Patients Have the Right to Caring, Respectful, Personal, Quality Care

A. Patients can expect:

1. That health care providers at Health Pointe will welcome, respect and serve all
   people regardless of ethnicity, color, gender, national origin, religion, disability,
   age, HIV status, sex, sexual orientation, race, or source of payment for
   services. Patients will be cared for in a manner consistent with their gender identity.
2. Their care to be provided in a professional and respectful manner at all times.
3. Sign and spoken language services, free of charge, if the patient has limited English
   proficiency or is hearing impaired.
4. Treatment, services and referral as needed. If we cannot meet the patient’s medical
   needs, we will arrange a transfer to another facility. Referrals will be made only
   after the patient is given full information about why the transfer is needed and
   offered other choices for treatment if they choose not to be transferred. The facility
   receiving the patient must agree to accept the transfer.
5. To be told how to file complaints and settle disputes, arguments or conflicts.
   Resources include services such as Patient Relations and other regulatory agencies
   as required by law.
6. To be able to use protective and advocacy services as needed.
7. To have a family member or a representative of their choice and their physician
   notified promptly of their admission.
8. Equal access to communications and electronic and information technology for
   individuals with disabilities.

II. Patients Have the Right to Receive Information about Their Treatment and Health Care Team

A. The patient can expect the health team to provide:

1. Clear explanations about diagnosis and treatment.
2. Information about specific treatments or procedures, including their benefits and
   risks, and the medically reasonable options to these treatments.
3. The name and professional title of the physician in charge of the patient’s care
   and the names and titles of other health care providers.
4. Results of treatments, including unexpected results, from their physician or their
   designee.
5. Access to their medical record. It is encouraged that the patient will review their
   record with their physician or designee. The patient also has the right to ask for and
   receive a copy of his or her own medical record for a fair fee.
6. The patient’s chart or other personal health information to third parties only when
   approved by the patient (except as required or allowed by law for treatment, payment or health care operations).

III. Patients Have the Right to Make Decisions about Their Own Care

A. The patient or their legally designated representative can expect:

1. To participate and make decisions about their own health care and care planning.
2. To be encouraged to take an active involvement in their care as a patient safety
   strategy.
3. To have the choice to accept or refuse medical care and treatment to the extent
   allowed by law and to be told of the medical results of these decisions.
4. The opportunity to complete an Advance Directive and know that it will be
   followed to the extent allowed by law.
5. Health Pointe recognizes the need for patients to make decisions regarding
   the health care they receive.
6. Health Pointe will honor the following health care advance directives:
   • Durable Power of Attorney
   • Appointment of a Health Care Representative
   • Living Will (exception to Do Not Resuscitate statue for Ambulatory Surgery Center, including endoscopy)
7. Health Pointe Ambulatory Surgery Center, including Endoscopy,
   does not honor a Do Not Resuscitate Order. It is Health Pointe’s policy
   that if an adverse event occurs, the medical team will initiate resuscitative
   or other stabilizing measures and transfer the patient to an appropriate
   hospital for further evaluation. A copy of the corresponding Advance
   Directive on file at Health Pointe will be sent with the patient during
   transfer.
8. For patients having a procedure performed at Health Pointe and
   who have an Advance Directive on file, with a Do Not Resuscitate Order,
   the performing surgeon or the anesthesiologist will discuss the temporary
   suspension of the patient’s Do Not Resuscitate Order as well as review
   the risks and benefits of the procedure with the patient. If the patient
   Printouts of this document may be out of date and should be considered uncontrolled.
   Policy Reference #: 23161 Policy Version #: 4 Effective Date: 07/27/2019 Page 3 of 6
   wishes to not have a suspended Do Not Resuscitate status, then the
   procedure is cancelled.
9. If asked, the facility and care team can help the patient prepare the
   Advance Directive.
10. To have the right to a second opinion with another physician, at their own request
    and expense.
11. To seek the advice or opinion of the Safety, Quality, Peer Review Committee
12. To make decisions to include or exclude any or all family members or significant
    others in the involvement of their care.
13. To get information about end of life care.
14. An explanation of their bill, financial assistance and payment options. Patients
    also have a right to receive a copy of their bill, regardless of payer.

IV. Patients Have the Right to be Comfortable and Safe

A. They can expect:

1. To have care provided in a safe, secure and efficient environment, free from abuse
   and harassment. Chemical or physical restraints will only be used in emergencies to
   protect the patient and/or others.
2. To have ongoing assessment of their pain and be involved in plans to manage
   pain. The patient can expect:
   •  To have information about pain and pain relief options.
   • A concerned staff dedicated to preventing pain.
   • Health professionals who respond quickly to reports of pain.
3. To receive care in a setting that maintains the patient’s dignity through personal
   space and clothing suited to their condition.
4. To be told of the experimental nature of suggested procedures or treatments and
   have the right to refuse those treatments without affecting their care.
5. A validation of their name and date of birth through a visual inspection (ID band
   or other documents) and verbal acknowledgement before any medical treatment or
   intervention is provided to the patient.
6. To receive information about how to report concerns, including concerns about
   safety and to be encouraged to do so without retaliation.
7. Patients Have the Right to Have Privacy and Confidentiality. They can expect:
8. To have personal privacy, including privacy of personal medical information.
9. To have the right to refuse to talk with or see anyone not officially connected with
   the facility. This includes visitors or others not directly involved in providing care.
10. To have the use of a telephone for private conversations.
11. To be interviewed and examined in a setting that provides reasonable privacy in
    sight and sound.
12. To have a person of the same sex present during exams or procedures, if
    requested.
13. To remain disrobed only as long as is needed for medical purposes.
14. To be asked for written consent for any filming or recording to be used for any
    purpose other than identification, diagnosis and treatment.

V. Patients Have the Right to Have Privacy and Confidentiality

A. They can expect:

1. To have personal privacy, including privacy of personal medical information.
2. To have the right to refuse to talk with or see anyone not officially connected with the hospital. This includes visitors or others not directly involved in providing care.
3. To have the use of a telephone for private conversations.
4. To be interviewed and examined in a setting that provides reasonable privacy in sight and sound.
5. To have a person of the same sex present during exams or procedures, if requested.
6. To remain disrobed only as long as is needed for medical purposes.
7. To be asked for written consent for any filming or recording to be used for any purpose other than identification, diagnosis and treatment.

VI. Patient Responsibilities

A. The patient is responsible to:

1. Provide a complete, accurate and honest medical history and information including:
   • Nature of your illness.
   • Past illnesses and hospitalizations.
   • Specific problems, symptoms, pain or concerns.
   • Medication (prescription, over the counter and herbal) history, (including dose and frequency), reactions to medications (foods and latex) and concerns.
   • Changes in your medical condition, as they happen.
2. Speak up and ask questions if you do not understand the treatment plan and your role in the plan.
3. Make informed decisions about your care.
4. Follow the recommendations, advice and treatment course arranged between you and your health care team.
5. Follow Health Pointe’s rules about patient care and conduct to support quality care and a safe environment, such as:
   • Respecting the rights of other patients and Health Pointe staff and property.
   • Following our tobacco-free environment policy.
   • Knowing the name of the physician in charge of your care.
6. Provide complete, accurate and timely information about the sources of payment for the care provided and fulfill financial obligations in a timely manner. Emergency care will not be delayed while we gather this information.
7. Accept and recognize responsibility for the medical results if you refuse treatment or do not follow the health care provider’s instructions.

VII. Concerns and Complaints

If a patient has a concern or complaint, we value hearing from them and encourage them to contact the Patient Relations Department. We will work with the patient and family to address and resolve their concerns. They also have the right to file a complaint at any time with The State of Michigan, The Joint Commission, Community Health Accreditation Partner, or the Office of Civil Rights.

Health Pointe Patient Relations
Patient.Relations@Health-Pointe.Org
Office: 616-935-6398
Toll Free: 833-706-4516

To contact the state licensing agency:
Licensing and Regulatory Affairs
Bureau of Community and Health Systems
Health Facilities Division
P.O. Box 30664,
Lansing, MI 48909
State of Michigan Complaint Hotline:
1.800.882.6006

To contact the organization that accredits the Surgery and Endoscopy Departments:
The Joint Commission Office of Quality Monitoring
One Renaissance Boulevard Oakbrook Terrace, IL 60181
Visit https://www.jointcommission.org to electronically submit complaint

To contact the organization that accredits Radiology Services:
American College of Radiology
Attn: Accreditation Program Patient Complaints
1891 Preston White Drive
Reston, VA 20191
1.703.648.8900

To contact the office of civil rights:
Michigan Department of Civil Rights
350 Ottawa Ave NE
Grand Rapids, MI 49503
1.800.482.3604