Know Your Rights Before You Are Hospitalized

As a patient, you have certain rights when you are in the hospital. Medicare establishes these rights, and hospitals usually grant them to all patients. Knowing your rights before you are hospitalized can provide some comfort and improve your experience. Although you usually will find a Patient Bill of Rights in the hospital’s lobby, it would be more helpful to know and understand your rights in advance. Some of the rights Medicare guarantees include: the right to be admitted if medically necessary; not to be discharged until medically ready; the right to receive quality care, along with understandable information and communications about treatment and billing; privacy of personal information; and the right to file complaints and appeals when the patient disagrees. As a patient, you can request that a hospital send you a copy of its Patient’s Bill of Rights or, in most cases, you can find it on the hospital’s website.

Medicare patients in all states are entitled to the services of an ombudsman (advocate) to provide information and protect their rights for all of the services and drugs covered by Medicare. In Pennsylvania the ombudsman organization is Quality Insights Pennsylvania (QIPA). QIPA’s services include: assistance with wrongful denial of admission to a hospital; hospital discharge of a patient before he is medically ready and premature termination of skilled nursing facility care services, home or outpatient health care, therapy or hospice services. For instance, QIPA advises that if you believe you are being discharged from the hospital too soon and the hospital will not reconsider its decision then you can call QIPA at 1-800-322-1914 to file an appeal. While still in the hospital, you will not be discharged until the appeal is resolved. You do not have to pay QIPA for its services, and while the appeal is being considered, you do not have to pay for your hospital care. By law, you should receive a document titled, “An Important Message from Medicare about Your Rights,” when you are admitted to the hospital. This document also explains your rights as a patient. You can learn more about QIPA at www.qipa.org.

Knowing your rights as a patient is essential. But, it is also important to know how to get the best possible medical care from your team of medical caregivers in the hospital. The two most important things you need to do are: 1) provide accurate information about your health, medications and health goals; and 2) be sure you understand what the hospital staff and doctors are telling you and ask questions about anything you do not understand. The non-profit organization The Empowered Patient Coalition offers significant information and resources for patients, both in and out of the hospital. According to its website, “The Empowered Patient Coalition is dedicated to providing an unprecedented level of information, resources and educational support to the public.” On its website, you will find very useful publications, advice and checklists on how to become an empowered patient including topics such as how to talk to your doctor, prepare for surgery, prevent infections and avoid medical mistakes, many of which have been compiled by respected hospitals and national health organizations. It even offers a patient empowerment video training course. For more details, visit www.empoweredpatientcoalition.org.

In addition to knowing your rights, it is beneficial in many circumstances to have a family member or friend actively participate in your health care decisions while you are in the hospital. Factors such as new drugs, anesthesia from surgery, interrupted sleep, and even the change of routine can make it very difficult for you to be actively involved in your health care. Health care providers will generally welcome the participation of your family but rarely a friend or other third party without some written legal authority. You can give someone legal authority to assist you with making medical decisions by having an attorney prepare a Medical Power of Attorney or an Advance Health Care Directive for you. If you do not know who to appoint as your health care agent, another option is to consider hiring a fee-based health care advocate. The best sources for referral for this might be your primary care doctor or Quality Insights Pennsylvania.