DURING YOUR STAY

If you have concerns, complaints, or questions you may:

• Speak personally to the Director of the Department or to the Administrative Supervisor
• Call the Patient Safety Officer at 618-241-8796 if you do not wish to speak to the Director or if your concern has not been satisfactorily resolved
• The phone number for complaints is available 24 hours a day and is attended by staff during normal business hours.  Any call received after normal business hours will be followed up on the next business day
• Forward a written complaint to the attention of Patient Safety Officer, Crossroads Community Hospital, #8 Doctors Park Road, Mt. Vernon, IL  62864.  The Patient Safety Officer will contact you to discuss your complaint
• For concerns regarding the quality of care, coverage decisions or want to appeal a premature discharge, contact the State Quality Improvement Organization (QIO).  Contact information for the QIO is:  IFMC - IL, 711 Jorie Blvd, Suite #301, Oak Brook, IL  60523-4425 or call the state HelpLine which is staffed from 8 a.m. to 4:30 p.m., Monday through Friday.  In Illinois, the HelpLine telephone number is 1-800-647-8089.

PATIENT RIGHTS & RESPONSIBILITIES

We believe that patients who understand and participate in their treatment achieve better results.  Please take a moment and familiarize yourself with your rights and responsibilities as a patient.

You have the right to:

• Know the risks, benefits and alternatives to proposed treatments or procedures
• Choose the physicians or other clinicians who will be providing care or treatment, as well as have information about them
• Receive information in easy to understand terms that will allow for an informed consent
• Privacy regarding medical care
• Participating in the plan of care, including your treatment plan, notifying your family or physician of admission and discharge planning
• Pain management
• Refuse care, treatment, and services in accordance with law and regulation
• Be informed about the outcomes of care, treatment, and services
• Receive information and communication in an understandable manner and preferred language including provision of interpreter and translation services
• Receive information and communication to accommodate vision, speech, hearing, or cognitive impairments
• Formulate advanced directives and have staff and practitioners comply with those directives
• Reasonable responses to reasonable requests of service
• Leave the medial center against the advice of the physician
• Examine and receive an explanation of the bill for services regardless of the source of payment
• Select providers of goods and services after discharge
• Receive a Notice of Privacy Practices
• Request privacy protection
• Access protected health information in a reasonable time frame
• Amend protected health information
• Request an accounting of disclosures of protected health information
• Be free from any forms of restraint or seclusion as a means of convenience, discipline, coercion, or retaliation
• The least restrictive restraint or seclusion should be used only when necessary to ensure patient safety
• Care regardless of your race, color, religion, sex, national origin, age, ability to pay or disability and any other legally prohibited reasons
• Receive care in a safe and dignified environment, free from all forms of abuse, neglect, harassment and/or exploitation
• Protection and respect of your rights if you are participating in a human research clinical trial
• Have a support person during care provided it does not interfere with the rights of other patients or the care process
• Consent to receive the visitors who you designate, including but not limited to a spouse, a domestic partner (including a same sex domestic partner), another family member, or a friend.  You may withdraw your consent to receive any visitor at any time.  To the extent this hospital places limitations or restrictions on visitation, you have the right to set any preference of order or priority for your visitors to satisfy those limitations or restriction.  This hospital does not and will not restrict, limit, or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability.  This hospital will ensure that the visitors chosen by you will be able to enjoy full and equal visitation privileges, consistent with your preferences.

You have the responsibility to:

• Provide accurate and complete information concerning your present medical condition, past illnesses or hospitalizations and any other matters concerning your health
• Tell your caregivers if you do not completely understand your plan of care
• Follow the caregivers' instructions
• Follow all medical center policies and procedures while being considerate of the rights of other patients, medical center employees and medical center properties

You also have the right to:

Lodge a concern with the state, whether you have used the hospital's grievance process or not.  If you have concerns regarding the quality of your care, coverage decisions or want to appeal a premature discharge, contact the State Quality Improvement Organization (QIO). See contact information above. 

Regarding problem resolution, you have the right to:

Express your concerns about patient care and safety to hospital personnel and/or management.  If your concerns and questions cannot be resolved at this level, contact The Joint Commission at 1-800-994-6610, by Fax at 630-792-5636, by e-mail at complaint@jointcommission.org, or by mail at: