Patient Rights and Responsibilities
|You have rights and responsibilities with respect to
the care and treatment you receive at Memorial Hospital for Children. These
rights and responsibilities are set forth below. |
You have the right to:
- Care and
treatment in accordance with your medical needs, and that is respectful
and considers your dignity, cultural values, and religious beliefs,
including the right to wear personal clothing or religious, cultural, or
other symbolic items that do not interfere with treatment or
- Have an Advance Directive (such as a “Living Will”
or similar document) and name the person of your choice to make health
care decisions on your behalf, to the extent permitted by law, and to
have that person, a friend or family member, and/or your physician
promptly notified of your admission to Memorial.
with individuals outside of Memorial.
- Visual and, as
appropriate, auditory privacy, and to receive care in a safe and clean
Confidentiality of your
medical information, in accordance with state and federal laws and
regulations. If you feel that your health information has not been
maintained securely or confidentially, you may report your concerns to:
Or you may send a letter
to: Memorial Health System, Attn: Privacy Officer, 1400 E. Boulder St.,
Colorado Springs, CO 80909
in decisions regarding your care in a manner that is consistent with
state and federal laws and regulations.
- Receive information
about your treatment in the language you understand, or have the
information interpreted in a language you understand.
Receive information related to care and treatment
so that you may make an informed decision whether to consent to a
treatment. The information about your treatment should be provided by
the treating physician. Consent to treatment may be given by you or your
In order to give informed consent, you will be
provided with an explanation to include:
a.) Recommended treatments or
procedures, in terms you understand.
b.) The treatment alternatives available and the risks and
benefits of each alternative, mortality risks, prognosis, serious
side-effects, and the consequences if you decide not to undergo any
c.) The nature of recovery, anticipated problems, or
potential problems that may occur during recovery, and the anticipated
length of recuperation.
either you or your legal representative may withdraw consent and
discontinue participation in treatment.
from all forms of abuse, including mental, physical, sexual, verbal,
and neglect or exploitation.
Freedom from restraints of any
form that are not medically necessary.
A commitment to the
prevention and management of pain by Memorial’s medical and nursing
staff, consistent with state and federal laws and regulations.
of any drug, test, treatment or procedure, consistent with state and
federal statutes, including being informed of the likely medical
consequences of such refusal.
your own safety by reminding any member of Memorial’s staff to:
Verify, prior to any procedure, the site or side of your body to be
treated or operated on.
Check your ID before medication or blood is given.
c.) Wash her or his hands prior to
d.) Tell you why a
procedure is being performed, or a medication is being given.
Information about Memorial’s
grievance procedure. A patient representative may be reached directly by
The right to file a grievance with: The
Colorado Department of Public Health and Environment, 4300 Cherry Creek
Dr. South, Denver, CO 80246 303-692-2800. Alternatively, if patient
safety or care quality concerns have not been addressed, you may contact
The Joint Commission at 1-800-994-6610. You may also contact the
Colorado Department of Regulatory Agencies at (303) 894-7855 or toll
free at (800) 886-7675.
- Know the names, professional status
and experience of staff providing care or treatment.
Be informed about Memorial’s general billing
a.) Prior to the initiation of non-emergency treatment,
upon request, you have the right to be informed of routine, usual or
customary charges or estimated charges for service based on an average
patient with a diagnosis similar to your tentative admission diagnosis.
b.) If you have questions, you may
call 719-365-2138 for medical cost information, Monday through Friday, 8
a.m. to 5 p.m.
c.) Based on
the insurance information you provide, Memorial will provide
assistance, as needed, with estimates of co-payments, deductibles, or
other charges you owe. You may obtain assistance by calling Patient
Financial Services at 719-365-5242, Monday through Friday, 8 a.m. to 5
d.) An itemized bill, in
accordance with state and federal regulations.
- Consent or refuse to take part in
teaching activities, medical research where required by IRB, or any
experimental projects related to your care, regardless of whether your
care is provided by a physician, podiatrist, or dentist.
your medical records in a manner consistent with state and federal
laws. Contact Health Information Management at 719-365-5275.
accepted for ongoing treatment on the basis of a reasonable expectation
that your medical, nursing, and other health care needs can be met
adequately at Memorial.
- Disclosure as to whether referrals are
to providers in which Memorial has a financial interest.
your post-hospital care provider. As part of the discharge planning
process, Memorial will not specify or limit any qualified agency that
may provide post-hospital home health care or other services in
compliance with the Patient Choice Law. Memorial staff will provide
information about care providers or available services.
You have the responsibility to:
Memorial with accurate and complete information about your present
complaints and medications, and about your past health history.
Memorial with accurate information about your current insurance
coverage and/or eligibility for state or federal programs, and fulfill
your financial obligations to Memorial.
- Be considerate of the
rights of others at Memorial, and to follow Memorial’s rules about
controlling noise, tobacco use, number of visitors and unauthorized
- Respect the belongings of others and
- Indicate whether or not you understand a
contemplated course of treatment so that you may make an informed
decision regarding the treatment.
- Immediately inform your
physician or Memorial staff that language interpretation is required in
order for you to understand and provide informed consent regarding your
care and treatment.
- Report to your health care providers any
unexpected changes in your medical condition.
- Ask questions
when you do not understand information or instructions.
Memorial’s instructions affecting your care.