Patient Rights and Responsibilities

Patient Rights and Responsibilities were established with the expectation that observance of these rights will contribute to more effective patient care and greater satisfaction for the patient, family, provider, and the staff caring for the patient. Patients shall have the following rights without regard to age, race, sex, national origin, religion, culture, physical handicap, personal values or belief systems: (Pursuant to Chapter 111, Section 70E, General Laws of Commonwealth of Massachusetts)

Patient Rights

A low-income patient has the right to:

• good, quality healthcare from the BNHC regardless of age, race, sex, national origin, citizenship, religion, culture, physical handicap/disability, personal values or beliefs systems.
• apply for MassHealth or other low income programs. In order to be determined a Low-income patient, you must complete a MBR and submit all required documentation. Our Intake and Pre-registration Offices are available during posted office hours to assist you.
• a payment plan, as described in 114.6 CMR 13.08(1)(f), if the patient is determined to be a Low-income patient pursuant to 114.6 CMR 13.00 or a patient that qualifies for medical hardship (114.6 CMR 13.05).
• a written healthcare benefit notice of your eligibility for assistance should be sent to you within 30 days from the Division of Medical Assistance. IMPORTANT: The benefit notice has two parts. The 1st part explains if you are eligible for MassHealth benefits; the 2nd part states if you qualify for HSN. If you have not received a written notice or need more information, please return to the BNHC for assistance.
• file a written grievance for review of the MA-21 determination of denial of HSN or medical hardship benefits with all supporting documentation to: Division of Health Care Finance and Policy, Health Safety Net Office, Two Boylston St, Boston, MA 02116. For all grievances, the Office may request additional information from the grievant, other state agencies, and/or the Brockton Neighborhood Health Center. Additional information requested by the Office must be submitted within 30 days.

A Low-income patient that receives eligible services must:

• provide all required documentation in order to qualify and retain low-income medical/dental benefits.
• inform MassHealth and the BNHC of any changes in family income, residency or insurance status. For instance, if any mail that is sent to you by the Office of Medicaid is returned, you will be deemed a non-resident and your medical/dental benefits will be terminated.
• keep track and supply documentation of more than one family member deductible and/or deductibles from more than one provider of services for Partial Health Safety Net (formerly Free Care) benefits. The family member MUST be a Low-income patient to qualify for family deductible. Once your deductible is met, you will be deemed eligible for Full Health Safety Net (HSN) benefits.
• inform the Division or MassHealth within 10 days that he/she was involved in an accident, or suffered from an illness or injury, or other loss that has or may result in a lawsuit or other 3rd party payment of a claim billed to HSNO. The patient must assist or assign rights to recover previous payments to the Division and/or repay net amounts he/she received from other 3rd party sources to HSNO for services paid by HSNO.

PATIENT RIGHTS OVERALL:

1. To receive care that meets the highest standards of BNHC, regardless of age, race, ethnicity, national origin or culture, religion, language, any disability or handicap, gender, sexual orientation, gender identity or expression, military service, socioeconomic status, or the source of payment for their care.
2. To have meaningful communication and language access services, including a qualified interpreter, which is provided at no cost. Language access is available through BNHC’s interpreter services department through many services, such as in-person interpreting, Video Remote Interpreting or VRI for patients who are deaf and for whom VRI is appropriate, and through telephone interpreters.
3. To have all reasonable requests responded to promptly and adequately within the capacity of the facility.
4. To receive the care necessary to help regain or maintain his or her maximum state of health and, if necessary, cope with death.
5. To expect personnel who care for the patient to be friendly, considerate, respectful and qualified through education and experience and perform the services for which they are responsible with the highest quality of service.
6. To expect full recognition of individuality, including privacy in treatment and care. In addition, all communications and records will be kept confidential.
7. To complete information, to the extent known by the physician, regarding diagnosis, treatment, and prognosis, as well as alternative treatments or procedures and the possible risks and side effects associated with treatment.
8. To be fully informed of the scope of services available at the facility, provisions for after hours and emergency care and related fees for services rendered.
9. Upon request, to receive from a person designated by the facility any information which the facility has available relative to financial assistance and free health care.
10. To be a participant in decisions regarding the intensity and scope of treatment. If the patient is unable to participate in those decisions, the patient’s rights shall be exercised by the patient’s designated representative or other legally designated people.
11. Upon request, to inspect his/her medical records and to receive a copy thereof in accordance with section seventy, and the fee for said copy shall be determined by the rate of copying expenses.
12. To expect your reports of pain will be believed based upon clinical assessment, and that pain relief measures will be instituted, and effective pain management will be pursued.
13. To refuse treatment to the extent permitted by law and be informed of the medical consequences of such a refusal. The patient accepts responsibility for his/her actions should he or she refuse treatment or not follow the instructions of the physician or facility.
14. To approve or refuse the release of medical records to any individual outside the facility, except in the case of transfer to another health facility, or as required by law or third-party payment contract.
15. To be informed of any human experimentation or other research/educational projects affecting his/her care or treatment and can refuse participation in such experimentation or research without compromise to the patient’s usual care.
16. To in the case of a maternity patient, at the time of pre-admission, to complete information from an admitting hospital on its annual rate of primary caesarian sections, annual rate of repeat caesarian sections, annual rate of total caesarian sections, annual percentage of women who have had a caesarian section who have had a subsequent successful vaginal birth, annual percentage of deliveries in birthing rooms and labor-delivery-recovery or labor-delivery-recovery-postpartum rooms, annual percentage of deliveries by certified nurse midwives, annual percentage which were continuously externally monitored only, annual percentage which were monitored both internally and externally, annual percentages utilizing intravenous, inductions, augmentation, forceps, episiotomies, spinals, epidurals and general anesthesia, and its annual percentage of women breastfeeding upon discharge from said hospital.
17. To express grievances/complaints and suggestions at any time.
18. Upon request, to obtain from the facility in charge of his/her care the name and specialty, if any, of the physician or other people responsible for his/her care or the coordination of his/her care.
19. To change primary or specialty physicians or providers if other qualified providers are available.
20. To prompt life saving treatment in an emergency without discrimination on account of economic status or source of payment and without delaying treatment for purposes of prior discussion of the source of payment unless such delay can be imposed without material risk to his/her health, and this right shall also extend to those persons not already patients or residents of a facility if said facility has a certified emergency care unit.
21. In the case of a patient suffering from any form of breast cancer, to complete information on all alternative treatments which are medically viable.
22. To have an advance directive, such as a living will or healthcare proxy. A patient who has advance directive must provide a copy to the facility and his/her physician so that his/her wishes may be known and honored.
23. To be fully informed before any transfer to another facility or organization.
24. If refused treatment because of economic status or the lack of a source for payment, to prompt and safe transfer to a facility which agrees to receive and treat such patient. Said facility refusing to treat such patient shall be responsible for: ascertaining that the patient may be safely transferred; contacting a facility willing to treat such patient; arranging the transportation; accompanying the patient with necessary and appropriate professional staff to assist in the safety and comfort of the transfer, assure that the receiving facility assumes the necessary care promptly, and provide pertinent medical information about the patient’s condition; and maintaining records of the foregoing.
25. To express those spiritual beliefs and cultural practices which do not harm others or interfere with the planned course of medical therapy for the patient.

Patient Responsibilities

1. Developing and maintaining positive health practices: good nutrition, sleep and rest, exercise, positive relationships, and stress management.
2. Being considerate of other patients and personnel and for assisting in the control of noise, smoking, and other distractions. Respecting the property of others and the facility.
3. Treating providers and staff with respect and calling with questions during reasonable hours (unless it’s a true emergency).
4. Telling your primary care provider if you do not understand the treatment you receive and to ask if you do not understand how to care for your illness.
5. Asking what to expect regarding pain and pain management, discussing pain relief options with your provider and working toward developing a pain management plan, helping your provider and nurse assess your pain, informing your provider if the pain is not relieved, and expressing worries you have about taking pain medication.
6. Following the directions and advice you and your provider have agreed upon.
7. Upon request, to obtain an explanation as to the relationship, if any, of the physician to any other health care facility or educational institutions insofar as said relationship relates to his/her care or treatment, and such explanation shall include said physician’s ownership or financial interest, if any, in the facility or other health care facilities insofar as said ownership relates to the care or treatment of said patient or resident.
8. Consulting with your primary care provider for referrals to non-emergency specialists or hospital care.
9. Upon request, to obtain an explanation as to the relationship, if any of the facility to any other health center facility or educational institution insofar as said relationship relates to his/her care or treatment.
10. Keeping appointments and, when unable to do so for any reason, notifying the facility.
11. Providing caregivers with the most accurate and complete information regarding present complaints, past illnesses, and hospitalization, medications, unexpected changes in the patient’s condition or any other patient health matters.
12. To obtain from a person designated by the facility, a copy of any rules or regulations of the facility which apply to his/her conduct as a patient or resident.
13. Observing prescribed rules of the facility during his/her stay and treatment and, if instructions are not followed, forfeiting the right to care at the facility and being responsible for the outcome.
14. Upon request to receive a copy of an itemized bill or other statements of charges submitted to any third party by the facility for the care of the patient or resident and to have a copy of said itemized bill or statement sent to the attending physician of the patient or resident.
15. Upon request to receive an itemized bill, including third-party reimbursements paid toward the said bill, regardless of the sources of payment.
16. Promptly fulfilling his/her financial obligations to the facility.
17. Any person whose rights under this section are violated may bring, in addition to any other action allowed by law or regulation, a civil action under sections sixty band e inclusive, of chapter two hundred and thirty-one.

Patient Complaints

• If patients feel their rights have not been respected, or if they wish to report on a service, they may speak directly with the supervisor of the department involved with their care. If the issue is not resolved to the patient’s satisfaction, or if the patient would like the help of someone not immediately involved, BNHC’s Patient Advocate or BNHC’s Compliance Officer are available to help resolve the problem. Department staff members can assist you with contacting these individuals. If there is a specific complaint regarding the safety of the patient’s care that the patient believes remains unresolved, they may contact the Massachusetts Department of Public Health’s Bureau of Healthcare Safety & Quality (BHCSQ) at 800-462-5540 or 617-753-8000, the Commonwealth of Massachusetts Board of Registration in Medicine at 800-377-0550 or the Joint Commission Office of Quality Monitoring at 800-994-6610 or by visiting www.jointcommission.org. For concerns about discrimination patients have the right to file a complaint with the US DHHS, Office of Civil Rights’ Customer Response Center at 800-368-1019.