Medicare – Patient Rights While in a Hospital

When a Medicare beneficiary enters a hospital, he or she has certain right guaranteed under federal law. Among them, are the following:

  1. Choice. You may obtain health services from any institution, agency, or person qualified to participate in the Medicare program. 42 U.S.C. § 1395a(a).
  2. Notice of rights. The hospital must inform you of your rights before providing services. 42 C.F.R. § 482.13(a)(1). You should read all documents carefully. If you don’t understand something, then ask about it or contact your lawyer.
  3. Grievance procedure. The hospital must have a process for promptly resolving patient grievances. The process must specify time frames for review of any grievance and for a response. 42 C.F.R. § 482.13(a)(2).
  4. Participate in plan of care. Each patient has the right to participate in the development and implementation of his or her plan of care. 42 C.F.R. § 482.13(b)(1).
    a. Question treating physicians, nurses, social workers, home health care providers, and other care providers about necessary services as the beneficiary’s condition either improves, remains the same, or requires more services. It is important to do this early on so you are informed about the patient’s circumstances BEFORE a discharge occurs.
  5. Right to make informed decisions. You have the right to make informed decisions regarding your care. This includes being informed of your health status, being involved in care planning and treatment, and being able to request or refuse treatment. However, this right does not mean you can demand the provision of treatment or services that are deemed to be medically unnecessary or inappropriate. 42 C.F.R. § 482.13(b)(2).
  6. Advanced directives. You have the right to formulate an advanced directive and to have hospital staff and practitioners who provide care in the hospital comply with your directives. 42 C.F.R. § 482.13(b)(3).
  7. Right to family notification. You have the right to have a family member or representative or your choice notified promptly after your admission to a hospital. 42 C.F.R. § 482.13(b)(4).
  8. Personal rights. You have the right to personal privacy, to receive care in a safe setting and to be free from all forms of abuse or harassment. 42 C.F.R. § 482.13(c). You also have the right to be free from physical or mental abuse, corporal punishment, restraints, seclusion or any type of staff coercion, discipline or retaliation. 42 C.F.R. § 482.13(e).
  9. Access to records. You have the right to keep your clinical records confidential, but you also have the right to access your records. The hospital cannot frustrate your legitimate efforts to gain access to your own records and must actively seek to meet legitimate requests as quickly as its record keeping system permits

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