Your Rights as A Patient

Ensuring Compassionate, Quality Care

To ensure compassionate and quality patient care at Grand Lake Health System, we fully support and recognize our patients’ rights and respect their right to treatment and care. We are committed to treating our patients with the dignity, respect and consideration each person deserves. Our hospital promotes the following patient “Bill of Rights” adopted by the American Hospital Association and the patient rights “Conditions of Participation” adopted by the Centers for Medicare and Medicaid (CMS).

As a patient at Grand Lake Health System, you have the rights to all the following:

You have the right to care when medically indicated regardless of your race, creed, sex, national origin, disability, religion, sexual orientation or source of payment. Minors have the right to care and education that is appropriate to their age and development.

You have the right to consideration for your personal dignity, values or beliefs, and contribute to a positive self-image. You have the right to be free from mental, physical, and sexual retaliation from anyone.

You have the right to personal privacy during your treatment, and assurance that your medical records and discussions or decisions about your care will be kept confidential.

You have the right to receive clear and understandable information about your care, treatment, or services from your physician involving the Informed Consent process, which is your right to know the risks, benefits, side effects, potential problems, and alternatives of the proposed care, including unanticipated outcomes. In an emergency, the Informed Consent process does not apply.

You have the right to be involved in decisions and planning about your care, including resolving care dilemmas by requesting a meeting to resolve any ethical issues that may arise.

You have the right to make informed decisions, or a legally appointed authorized person will make decisions in your behalf, as permitted by law.

You have the right to express your healthcare wishes by completing a Living Will, Healthcare Power of Attorney, Do Not Resuscitate (DNR) Order, Organ and Tissue Donor, or Mental Health Declaration.

You have the right to know the professional status and identity of those involved in your care.

You have the right to refuse care or treatment to the extent permitted by law, and to be informed of the medical consequences of such refusal, involving the informed consent process.

You have the right to referral or second opinion of another provider of healthcare services at your request or expense, without jeopardizing your care. If transferred, information should be explained prior to transfer.

You have the right to request to review your personal health information.

You have the right that personal health information will not be released to anyone without your consent, except when required by law or a third-party payer contract.

You have the right to have your pain assessed, evaluated and treated.

You have the right to participate in clinical trials, research, or educational programs. If you refuse, you are entitled to the most effective care.

You have the right to effective communication with family and visitors, expressed verbally or in writing, unless restricted or limited due to your medical condition or at your request.

You have the right to an interpreter when you do not speak or understand English, or if you are deaf, at no cost to you. You have the right to consider your special religious or cultural requests and practices or to request assistance with any special needs such as vision or hearing impairment.

You have the right to a safe, private and clean environment in the hospital, and assistance in accessing protective and advocacy services as needed.

You have the right to information from your physician about your follow-up care when you are discharged from the hospital. This information will be given to you in writing.

You have the right to information about your rights and hospital rules and procedures affecting your care and conduct. These may include the no-smoking, consent to filming and recording, and safety or visitor policies.

You have the right to know the estimated cost of your treatment choices or payment options. If you have questions about your hospital bill, you can contact Patient Accounts for an explanation

You have the right to express a complaint or file a formal grievance. You are entitled to information about Grand Lake Health System’s mechanism for initiation, review and resolution of complaints.

Ohio Department of Health

Medical Quality Improvement Organization, Ohio KEPRO

246 High Street – Columbus OH 43216-0118
1-800-342-0553 or 1-614-466-3543

5201 West Kennedy Blvd – Suite 900 – Tampa, FL 33609
1-855-408-8557

Fax: 844-834-7130
Email: beneficiary.complaints@hcqis.org

DNV Healthcare

Attn: Hospital Compliant
400 Techne Centre Dr. – Suite 100 – Milford OH 45150
1-866-496-9647

Patients, family members and other concerned parties may use a new web form to submit complaints directly to DNV GL – Healthcare. Complaints may also be submitted by email to hospitalcomplaint@dnvgl.com or fax 1-513-947-1250. If you have questions regarding Medicare Coverage and your rights, you may contact:

Creating a Higher
Level of Care for
Our Patients

A Patient Experience Coordinator is available to answer any questions or concerns regarding your care or service received at our organization. We strive to create a satisfactory experience for all our patients; however, Grand Lake Health System encourages you to share any issues you may have with our staff. If we were unable to resolve your concerns this way, and/or if you prefer, you may contact the Patient Experience Coordinator at 419-394-3335, ext. 2102. The patient experience coordinator will speak with you about your concern or complaint, and serve as an advocate to help communicate with individuals to address any issues and provide resolution. As a patient you also have the right to contact an outside agency to discuss your concerns with our facility.