Like many people, I have been an advocate for family members who have been ill. Several years ago my Dad was in the hospital and wasn’t capable of coming right home after fracturing his hip. He wasn’t able to get out of bed or walk without help because of pain, weakness, and confusion.
The health care system is moving very fast, and insurance companies look for ways to decrease health care costs. Like it or not, people are forced to move to lower cost settings in one or two days. It’s rapid fire and you’re left with confusion. In my dad’s situation, the case manager told me Dad was accepted at a rehab, however she didn’t prep me or even ask me which rehab we would choose. Instead, she told me where she was sending him.
Where was choice?
Do you have a choice?
Yes, you do!
Choice is derived from the Patient Bill of Rights. Every patient is given this notice when receiving services in an inpatient setting. It is often housed in a folder or pamphlet provided by the healthcare organization.
The Patient Bill of Rights was adopted by the U.S. Advisory Commission on Consumer Protection and Quality in the Health Care Industry in 1998. Virtually any organization that provides services and bills Medicare and Medical Assistance are required to inform patients of these rights when they start providing services to the individual.
So what does the Patient Bill of Rights say?
- Information Disclosure: You have the right to accurate and easily-understood information about your health plan, health care professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just don’t understand something, help should be provided so you can make informed health care decisions.
And here is the notice about choice:
Choice of Providers and Plans: You have the right to a choice of health care providers who can give you high-quality health care when you need it.
Additional points in the Patient Bill of Rights include:
- Access to Emergency Services: If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. These services should be provided whenever and wherever you need them, without the need to wait for authorization and without any financial penalty.
- Participation in Treatment Decisions: You have the right to know your treatment options and to take part in decisions about your care. Parents, guardians, family members, or others that you select can represent you if you cannot make your own decisions.
- Respect and Non-discrimination: You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.
- Confidentiality of Health Information: You have the right to talk privately with health care providers and to have your health care information protected. You also have the right to read and copy your own medical record. You have the right to ask that your doctor to change your record if it is not accurate, relevant, or complete.
- Complaints and Appeals: You have the right to a fair, fast, and objective review of any complaint you have against your health plan, doctors, hospitals or other health care personnel. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy of health care facilities.
Some additional practical advice to assure that you are adequately informed to make the best possible choices:
- Ask to speak to the assigned case manager within 24 hours when your loved one enters the hospital. Ask questions and share your concerns. Ask about the next steps in care and get the case managers advice about any after-care needed. For example, does the case manager expect that your loved one will go right home? Is home health care recommended? Or are the care needs more extensive and require an inpatient rehabilitation facility? Get a list of providers that you can contact to find the right fit for your loved one’s needs. There may be a need for a different level of care than you originally anticipated. In my dad’s case, I told the case manager that my family was not interested in the facility that she chose; it was 45 minutes away and we wouldn’t be able to visit or advocate for him. I asked her to check availability in more local facilities that I knew and trusted.
- Pay attention to the care you or your loved one is receiving. Make sure you/they are getting the right treatments and medications. Don’t assume anything.
- Make sure staff providing care are introducing themselves and you know what their credentials are.
- Notice whether or not the staff are washing their hands. Hand washing is the most important way to prevent the spread of infections. Don’t be afraid to gently remind the caregiver. You and your ill loved one need to do the same.
- Be sure the health care professional confirms your/ your loved one’s identity before giving medications or treatments.
- Educate yourself about the diagnosis, services provided and the care plan. Gather information. Write down important information the doctor tells you and ask if the doctor has any written information you can take with you to look at later.
- Thoroughly read all forms and make sure you understand them before you sign anything. If you don’t understand something, ask for a better explanation.
- Make sure you understand how to use any equipment the doctor orders for your care, especially if you will need to continue use once you are home.
- Know the medications and why they are prescribed. Ask about the purpose and ask for written information which can be provided by the pharmacy. Know both the brand and generic names of the medications. Know the possible side effects to watch out for. Whenever a new medication is prescribed, tell the doctor about any allergies and other medications prescribed to be sure that it is safe to also take the new medication.
You have rights, you have choice and you have a voice. Use them. Aim to be an educated consumer for your loved one’s successful recovery.
Resources to help you:
Making the Right Decision For Rehabilitation Care