Patient Rights & Responsibilities - Wheaton Franciscan Healthcare

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Patient Rights & Responsibilities

Important Information from Ascension Wisconsin
Download a copy of Patient Rights & Responsibilities (PDF).

Ascension Wisconsin provides compassionate, personalized care to all. As a patient, you have the right, consistent with laws and regulations, to:

  1. Not be denied the right to appropriate care or visitors because of your race, creed, color, national origin, ancestry, religion, sex, sexual orientation, gender identity or expression, marital status, age, newborn status, handicap, ethnicity, culture, language, physical or mental impairment or disability, socioeconomic status, or source of payment.
  2. Designate person(s) who are permitted to visit you during your stay, including, but not limited to, your spouse, domestic partner (including a same sex domestic partner), another family member or a friend. You have the right to receive or refuse a visitor. You will be informed of any clinically necessary or reasonable visitation restrictions that we may need to put in place.
  3. Have a family member or representative of your choice and your physician promptly notified of your admission to this facility.
  4. Participate in the development, implementation, and revision of your plan of care, treatment and services, and the involvement of your family, with your permission. Make informed decisions and provide consent about your care, treatment and services, unless you are unable to do so. Except in emergencies, your consent or the consent of your representative shall be obtained before treatment is administered.
  5. Know who is treating you as well as why they are treating you and who is responsible for your overall care.
  6. Receive, from an appropriate person within the facility, a clear explanation of:
    • All proposed treatment, care, services, medications, interventions, or procedures;
    • Potential benefits, risks, or side effects;
    • Any problems related to recovery;
    • Any significant alternative treatment, care or services;
    • Your condition, any changes in your condition and your prognosis for recovery;
    • Outcomes of your care.
  7. Refuse any care, treatment, or services and the right to be informed of the possible consequences.
  8. Participate in resolving dilemmas about care, treatment, services, or discharge, including withholding resuscitative services and declining or removing life-sustaining treatment.
  9. Identify someone to make decisions for you if/when you cannot make decisions about your care, treatment or services, as permitted by law. Prepare and/or revise advance directives or instructions about your medical treatment, to appoint a decision maker, and to have staff comply with these directives, as permitted by law.
  10. Effective communication.
    • Ascension Wisconsin provides free aids and services to people with disabilities to communicate effectively with us such as qualified sign language interpreters and written information in other formats (large print, audio, accessible electronic formats and other formats)
    • Ascension Wisconsin provides free languages services to people whose primary language is not English, such as qualified interpreters and information written in other languages.
    • If you need these services, please discuss with your care provider.
  11. Receive compassionate, personal care, consistent with sound medical and nursing practice, in a clean, safe and secure environment.

  12. Be free from restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff. A restraint can only be used if needed to improve your (the patient’s) well-being and less restrictive interventions have been determined to be ineffective.

  13. Be treated with consideration and respect in recognition of your individuality and dignity, including reasonable visual and auditory privacy during personal hygiene activities and consultations, examinations and treatments.

  14. Privacy and confidentiality of your health information. You have a right to receive a copy of the Notice of Privacy Practices that discusses our privacy practices and your rights.

  15. Be assured of reasonable safety within the care setting, including the right to be free from mental, physical, sexual, and verbal abuse, neglect, mistreatment, exploitation, humiliation, and retaliation.

  16. Effective, clinically appropriate management of your pain.

  17. Access to pastoral/spiritual care that includes consideration of psychosocial, spiritual and cultural variables.

  18. Participate or refuse to participate in research and/or clinical trials after receiving an explanation of the nature and possible consequences of the research. Your refusal to participate will not compromise your access to care, treatment or services.

  19. Except in emergencies, remain in the hospital for care without being transferred to another facility unless you have received a full explanation of the need for a transfer or requested the transfer, provisions have been made for your continuing care, and the receiving institution has accepted you as a patient.

  20. Access or referral to advocacy, legal or protective services.

  21. Information about the cost of your care including the right to look at and receive a reasonable explanation of your total bill and detailed charges for services received, regardless of the source of payment. You also have a right to request and receive information about financial assistance available through the hospital.

  22. Be informed in writing about hospital policies and procedures for initiation, review, and resolution of patient complaints. Voice a complaint to your caregivers without fear of reprisal if you are dissatisfied with any aspect of your care. This would include issues related to quality of care, patient safety, coverage decisions, and transition/discharge concerns.

If your complaint cannot be resolved promptly, we encourage you to discuss your concern with the department leader or call your hospital and ask for Patient Relations. You also have the right to file a complaint with:

State of Wisconsin
Division of Quality Assurance
PO Box 2969
Madison, WI 53701-2969
(608) 266-8481
(800) 642-6552

Office of Quality and Safety
Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
(800) 994-6610
complaint@jointcommission.org

Any person (resident, employee, ombudsman, relative, friend, other) may file a complaint regarding a facility staff person, a regulated healthcare facility, a clinical lab or other DQA related issue via the DQA Complaint webpage.

As a patient, you have the responsibility to:

  • Participate in decisions regarding your treatment.
  • Notify staff and ask questions if you do not understand your health care plan, including medications, instructions and what is expected of you.
  • Cooperate with the advice, treatment plan, and prescription(s) indicated. If you have questions or concerns, please discuss any intention not to follow your treatment plan with your doctor or nurse and accept the outcomes of such a decision(s).
  • Notify staff of any concerns about your care and report changes in your condition.
  • Provide accurate and complete information about your health and medical history.
  • Notify your care team if you need assistance communicating, including any interpretation needs.
  • Provide a copy of your Advance Directive (i.e., “Living Will” or Power of Attorney for Health Care) if you have completed one.
  • Be considerate of the rights of other patients, visitors/families, staff and follow the rules and regulations pertaining to patients, families and visitors.
  • Support mutual consideration and respect by maintaining civil language and conduct in interactions with doctors, nurses and other staff. Provide information concerning your sources of payment and your ability to meet these obligations. Promptly meet financial obligations.
  • Leave all valuables at home or with a family member whenever possible, as we assume no liability for loss or damage. Contact security if you have a lost personal item.
  • Keep scheduled appointments and notify the appropriate department and/or professional when unable to keep an appointment.

For your visitors, we ask that they help us maintain a peaceful atmosphere by:

  • Lowering voices and fostering a quiet, healing space.
  • Monitoring children for their safety.
  • Placing all electronic devices on “silent mode” - Videotaping and photography of associates, patients, visitors is forbidden.
  • Understanding that to provide a positive experience for all visitors, the number of visitors for each patient may be limited, and larger groups may be redirected to alternative spaces.
  • Refraining from visiting while sick. Adhering to our no alcohol, smoking, illegal substances and firearms policies. Maintaining respectful language and behavior. Using designated meal areas, including our cafeteria.
  • Disposing of garbage in the receptacles provided.
  • Notifying staff if something needs to be cleaned and/or repaired.

We reserve the right to limit visitation time, or in certain instances to discontinue visitation rights, if we determine it is in the best interest of the patients we serve.

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For further information about our accessibility policy and our coordinator, please visit www.ascensionwipatientrights.org. If you feel that we have discriminated on the basis of race, color, national origin, age, disability or sex, including not providing the free aides or language services outlined above, please contact patient relations or call our 1557/504 coordinator at 1-855-462-4973. You may also file a civil rights complaint at the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue SW
Room 509F, HHH Building
Washington, DC 20201
1–800–868–1019, 800–537–7697 (TDD) complaint forms are available at
www.hhs.gov/ocr/office/file/index.html


Ascension Wisconsin refers to all healthcare organizations wholly owned, controlled and/or managed indirectly or directly by Columbia St. Mary’s, Inc., Ministry Health Care, Inc. or Wheaton Franciscan Healthcare – Southeast Wisconsin, Inc. or their successor organization.

CC261 Revised 5/2017

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