The public policy declaration and policy of St. Francis is that the interests of each patient/resident/client be protected by a bill of rights and responsibilities which shall include but not be limited to the rights specified in this policy. St. Francis has the right to expect behavior on the part of patients/residents/clients and their relatives and friends, which, considering the nature of their illness, is reasonable and responsible.
1. Information about rights.
Patients shall at admission, be told that there are legal rights for their protection during their stay at the facility and that these are described in an accompanying written statement of the applicable rights or throughout their course of treatment and maintenance in the community and that these are described in an accompanying written statement of the applicable rights and responsibilities set forth in this section. In the case of patients admitted to residential programs as defined in Section 7, the written statement shall also describe the right of a persons 16 years old or older to request release as provided in Section 253B.04, Subdivision 2, and shall list the names and telephone numbers of individuals and organizations that provide advocacy and legal services for patients in residential programs. Reasonable accommodations shall be made for those with communication impairments, and those who speak a language other than English. Current facilities policies, inspection findings of state and local health authorities, and further explanation of the written statement of rights shall be available to patients/clients, their guardians or their chosen representatives upon reasonable request to the administrator or other designated staff person, consistent with Chapter 13, the Data Practices Act, and Section 626.557, relating to vulnerable adults.
2. Courteous Treatment.
Patients have the right to be treated with courtesy and respect for their individuality by employees of or persons providing service in a health care facility.
3. Appropriate Care.
Patients/clients shall have the right to appropriate medical and personal care based on individual needs. The right is limited where the service is not reimbursable by public or private resources.
4. Physician's Identity.
Patients/clients shall have or be given in writing, the name, business address, telephone number, and specialty, if any, of the physician responsible for coordination of their care. In cases where it is medically inadvisable, as documented by the attending physician in a patient's/client's care record, the information shall be given to the patient's/client's guardian or other person designated by the patient/client as his or her representative.
5. Relationship with other health services.
Patients/clients who receive services from an outside provider are entitled, upon request, to be told the identity of the provider. Information shall include the name of the outside provider, the address, and a description of the service which may be rendered. In cases where it is medically inadvisable, as documented by the attending physician in a patient's/client's record, the information shall be given to the patient's/client's guardian or other person designated by the patient/client as his or her representative.
6. Information about treatment.
Patients/clients shall be given by their physicians complete and current information concerning their diagnosis, treatment, alternatives, risks, and prognosis as required by the physician's legal duty to disclose. This information shall be in terms and language the patients/clients can reasonably be expected to understand. Patients/clients may be accompanied by a family member or other chosen representative. This information shall include the likely medical or major psychological results of the treatment and its alternatives. In cases where it is medically advisable, as documented by the attending physician in patient's/client's medical record, the information shall be given to the patient's/client's guardian or other person designated by the patient/client as his or her representative. Individuals have the right to refuse this information.
Every patient/client suffering from any form of breast cancer shall be fully informed, prior to or at the time of admission and during her stay, of all alternative effective methods of treatment of which the treating physician is knowledgeable, including surgical, radiological, or chemotherapeutic treatments or combination of treatments and the risks associated with each of those methods.
7. Participation in planning treatment.
Notification of Family Members:
a. Patients/clients shall have the right to participate in the planning of their health care. This right includes the opportunity to discuss treatment and alternatives with individual caregivers, the opportunity to request and participate in formal care conferences, and the right to include a family member or other chosen representative. In the event that the patient/client cannot be present, a family member or other representative chosen by the patient/client may be included in such conference
b. If a patient/client who enters a facility is unconscious or comatose or is unable to communicate, the facility shall make reasonable efforts as required under Paragraph (c) to notify either a family member of a person designated in writing by the patient/client as the person to contact in an emergency that the patient/client has been admitted to the facility. The facility shall allow the family member to participate in treatment planning, unless the facility knows or has reason to believe the patient/client has an effective advance directive to the contrary or knows the patient/client has specified in writing that they do not want a family member included in treatment planning. After notifying a family member but prior to allowing a family member to participate in treatment planning, the facility must make reasonable efforts, consistent with reasonable medical practice, to determine if the patient/client has executed an advance directive relative to the patient's/client's health care decisions. For purposes of this paragraph, "reasonable efforts" include:
- examining the personal effects of the patient/client;
- examining the medical records of the patient/client in the possession of the facility;
- inquiring of any emergency contract or family member contacted whether the patient/client has executed an advance directive and whether the patient/client has a physician to whom the patient/client normally goes for care; and
- inquiring of the physician to whom the patient/client normally goes for care, if known, whether the patient/client has executed an advance directive. If a facility notifies a family member or designated emergency contact or allows a family member to participate in treatment planning in accordance with this paragraph, the facility is not liable to the patient/client for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient's/client's privacy rights.
c. In making reasonable efforts to notify a family member or designated emergency contact, the facility shall attempt to identify family members or a designated emergency contact by examining the personal effects of the patient/client and the medical records of the patient/client in the possession of the facility. If the facility is unable to notify a family member or designated emergency contact within 24 hours after the admission, the facility shall notify the county social service agency or local law enforcement agency that the patient/client has been admitted and the facility has been unable to notify a family member or designated emergency contact. A county social service agency or local law enforcement agency that assists a facility is not liable to the patient/client for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient's/client's privacy rights.
8. Continuity of Care.
Patients/clients shall have the right to be cared for with reasonable regularity and continuity of staff assignment as far as facility policy allows.
9. Right to refuse care
Competent patients/clients shall have the right to refuse treatment based on the information required in Right number 6. In cases where a patient/client is incapable of understanding the circumstances but has not been adjudicated incompetent, or when legal requirements limit the right to refuse treatment, the conditions and circumstances shall be fully documented by the attending physician in the patient's/client's medical record.
10. Experimental research
Written, informed consent must be obtained prior to patient's/client's participation in experimental research. Patients/clients have the right to refuse participation. Both consent and refusal shall be documented in the individual care record.
11. Freedom from abuse
Patients/clients shall be free from maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means conduct described in Section 626.5572, Subdivision 15, or the intentional and non-therapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce mental or emotional distress. Every patient/client shall also be free from non-therapeutic chemical and physical restraints, except in fully documented emergencies, or as authorized in writing after examination by a patient's/client's physician for a specified and limited period of time, and only when necessary to protect the patient/client from self-injury or injury to others.
12. Treatment privacy
Patients/clients shall have the right to respectfulness and privacy as it relates to their medical and personal care program. Care discussion, consultation, examination, and treatment are confidential and shall be conducted discreetly. Privacy shall be respected during toileting, bathing, and other activities of personal hygiene, except as needed for patient/client safety or assistance.
13. Confidentiality of records
Patients/clients shall be assured confidential treatment of their personal and medical records, and may approve or refuse their release to any individual outside the facility. Copies of records and written information from the records shall be made available in accordance with this subdivision and section 144.335. This right does not apply to complaint investigations and inspections by the department of health, where required by third party payment contracts, or where otherwise provided by law.
14. Disclosures of services available
Patients/clients shall be informed, prior to or at the time of admission and during their stay, of services which are included in the facility's basic per diem or daily room rate and that other services are available at additional charges. Facilities shall make every effort to assist patients/clients in obtaining information regarding whether the Medicare or Medical Assistance program will pay for any or all of the aforementioned services.
15. Responsible service
Patients/clients shall have the right to a prompt and reasonable response to their questions and requests.
16. Personal privacy
Patients/clients shall have the right to every consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being.
Patients/clients shall be encouraged and assisted, throughout their stay in the facility or their course of treatment, to understand and exercise their rights as patients/clients and citizens. Patients/clients may voice grievances and recommend changes in policies and services to facility staff and others of their choice, free from restraint, interference, coercion, discrimination, or reprisal, including threat of discharge. Notice of the grievance procedure or the facility or program, as well as addresses and telephone numbers for the Office of Health Facility Complaints and the area nursing home ombudsman pursuant to the Older Americans Act, Section 307(a)(12) shall be posted in a conspicuous place.
Every acute care in-patient facility, every residential program as defined in Section 7, and ever facility employing more than two people that provides outpatient mental health services shall have a written internal grievance procedure that, at a minimum, sets forth the process to be followed; specifies time limits, including time limits for facility response; provides for the patient/client to have the assistance of an advocate; requires a written response to written grievances; and provides for a timely decision by an impartial decision-maker if the grievance is not otherwise resolved. Compliance by hospitals, residential programs as defined in Section 7 which are hospital-based primary treatment programs, and outpatient surgery centers with Section 144.691 and compliance by health maintenance organizations with Section 62D.11 is deemed to be in compliance with the requirement for a written internal grievance procedure.
18. Communication Privacy
Patients/clients may associate and communicate privately with persons of their choice and enter and, except as provided by the Minnesota Commitment Act, leave the facility as they choose. Patients/clients shall have access, at their expense, to writing instruments, stationery, and postage. Personal mail shall be sent without interference and received unopened unless medically or programmatically contraindicated and documented by the physician in the medical record. There shall be access to a telephone where patients/clients can make and receive calls, as well as speak privately. Facilities which are unable to provide a private area shall make reasonable arrangements to accommodate the privacy of patient's/client's calls. This right is limited where medically inadvisable, as documented by the attending physician in the patient's/client's care record. Where programmatically limited by a facility abuse prevention plan pursuant to the Vulnerable Adults Protection Act, Section 626.557, subdivision 14, paragraph (b), this right shall also be limited accordingly.
19. Personal Property
Patients/clients may retain and use their personal clothing and possessions as space permits, unless to do so would infringe upon rights of other patients/clients and unless medically or programmatically contraindicated for documented medical, safety, or programmatic reasons. The facility may, but is not required to, provide compensation for or replacement of lost or stolen items.
20. Services for the facility
Patients/clients shall not perform labor or services for the facility unless those activities are included for therapeutic purposes and appropriately goal-related in their individual medical record.
21. Protection and advocacy services
Patients/clients shall have the right of reasonable access at reasonable times to any available rights protection services and advocacy services so that the patient/client may receive assistance in understanding, exercising, and protecting the rights described in this section and in other law. This right shall include the opportunity for private communication between the patient/client and a representative of the rights protection service or advocacy service.
22. Right to communication disclosure and right to associate
Upon admission to a facility, where federal law prohibits unauthorized disclosure of patient/client identifying information to callers and visitors, the patient/client, or the legal guardian or conservator of the patient/client, shall be given the opportunity to authorize disclosure of the patient's presence in the facility to callers and visitors who may seek to communicate with the patient/client. To the extent possible, the legal guardian or conservator of the patient/client shall consider the opinions of the patient/client regarding the disclosure of the patient's/client's presence in the facility.
Additional rights in residential programs that provide treatment to chemically dependent or mentally ill minors or in facilities providing services for emotionally disturbed minors on a 24-hour basis:
23. Isolation and restraints
A minor patient/client who has been admitted to a residential program as defined in Section 7 has the right to be free from physical restraint and isolation except in emergency situations involving a likelihood that the patient/client will physically harm the patient's/client's self or others. These procedures may not be used for disciplinary purposes. To enforce program rules, or for the convenience of staff. Isolation or restraint may be used only upon the prior authorization of a physician, psychiatrist, or licensed consulting psychologist, only when less restrictive measures are ineffective or not feasible and only for the shortest time necessary.
24. Treatment plan
A minor patient/client who has been admitted to a residential program as defined in Section 7 has the right to a written treatment plan that describes in behavioral terms the case problems, the precise goals of the plan, and the procedures that will be utilized to minimize the length of time that the minor requires inpatient treatment. The plan shall also state goals for release to a less restrictive facility and follow-up treatment measures and services, if appropriate. To the degree possible, the minor patient/client and his or her parents or guardian shall be involved in the development of the treatment and discharge plan.
Inquiries or complaints regarding medical treatment or the Patients' Bill of Rights may be directed to:
Minnesota Board of Medical Practice
2829 University Avenue S.E.
Minneapolis, MN 55414-3246
(612) 617-2130 or (800) 657-3709
Office of Health Facility Complaints
85 East Seventh Place
P.O. Box 64970
St. Paul, MN 55164-0970
(651) 215-8702 or (800) 369-7994
Office of Ombudsman for Older Minnesotans
85 East Seventh Place
St. Paul, MN 55101
(651) 296-0382 or (800) 657-3591