ADVANCE DIRECTIVES & DO NOT RESUSCITATE ORDERS
Advance Directives and DNR Orders
Statement of Illinois Law on Advance Directives and DNR Orders
You have the right to make decisions about the healthcare you can get now and in the future. An advance directive is a written statement you prepare about how you want your medical decisions to be made in the future, if you are no longer able to make them for yourself. A do not resuscitate order (DNR order) is a medical treatment order that says cardiopulmonary resuscitation (CPR) will not be used if your heart or breathing stops. Federal law requires that you be told of your right to make an advance directive when you are admitted to a health care facility. Illinois law allows for the following three types of advance directives: health care power of attorney, living will, and mental health treatment preference declaration. In addition, you can ask your physician to work with you to prepare a DNR order. You may choose to discuss with your doctor different types of advance directives and DNR orders. After reviewing information regarding advance directives and DNR orders, you may decide to make more than one. For example, you could make a health care power of attorney and a living will. If you make one or more advance directives and/or a DNR order, tell your doctor and other health care providers and provide them with a copy. You may also want to provide a copy to family members, and to those you appoint to make these decisions for you. State law provides copies of sample advance directives forms and DNR forms
MEDICARE INFORMATION
YOUR RIGHTS AS A HOSPITAL PATIENT
You have the right to receive necessary hospital services covered by Medicare, or covered by your Medicare Health Plan (“your Plan”) if you are a Plan enrollee. You have the right to know about any decisions that the hospital, your doctor, your Plan, or anyone else makes about your hospital stay and who will pay for it. Your doctor, your Plan, or the hospital should arrange for services you will need after you leave the hospital. Medicare or your Plan may cover some care in your home (home health care) and other kinds of care, if ordered by your doctor or by your Plan. You have a right to know about these services, who will pay for them, and where you can get them. If you have any questions, talk to your doctor or Plan, or talk to other hospital personnel.
YOUR HOSPITAL DISCHARGE & MEDICARE APPEAL RIGHTS
Date of Discharge: When your doctor or Plan determines that you can be discharged from the hospital, you will be advised of your planned date of discharge. You may appeal if you think that you are being asked to leave the hospital too soon. If you stay in the hospital after your planned date of discharge, it is likely that your charges for additional days in the hospital will not be covered by Medicare or your Plan. Your Right to an Immediate Appeal without Financial Risk: when you are advised of your planned date of discharge, if you think you are being asked to leave the hospital too soon, you have the right to appeal to your Quality Improvement Organization (also known as a QIO). The QIO is authorized by Medicare to provide a second opinion about your readiness to leave. You may call Medicare toll-free, 24 hours a day, at 1-800-MEDICARE (1-800-633-4227), or TTY/TTD: 1-877-486-2048, for more information on asking your QIO for a second opinion. If you appeal to the QIO by noon of the day after you receive a noncoverage notice, you are not responsible for paying for the days you stay in the hospital during the QIO review, even if the QIO disagrees with you. The QIO will decide within one day after it receives the necessary information. Other Appeal Rights: If you miss the deadline for filing an immediate appeal, you may still request a review by the QIO (or by your Plan, if you are a Plan enrollee) before you leave the hospital. However, you will have to pay for the costs of your additional days in the hospital if the QIO (or your Plan) denies your appeal. You may file for this review at the address or telephone number of the QIO (or of your Plan).
OMB Approval No. 0938-0692. Form No. CMS-R-193 (January 2003)
PATIENTS RIGHTS & RESPONSIBILITIES
You have the right to reasonable access to care and to receive care regardless of your race, color, religion, sex, national origin, age or the source of payment for your care.
You have the right to considerate and respectful care that safeguards your personal dignity and comfort and respects your personal, cultural, psychosocial and spiritual values.
You have the right to be informed of the hospital rules and regulations applicable to your conduct as a patient.
You have the right to be provided with considerate and respectful care by others and have your privacy and individuality respected.
You have the right to expect that all aspects of your health care will be kept confidential. You may expect that only those directly involved in your care, or in the monitoring of its quality, shall have access to your medical record, communication or other information and that discussion or consultation involving your case will be conducted discreetly.
You have the right to receive care that safeguards your personal dignity and respects your cultural, psychosocial, spiritual and personal values and belief.
You have the right to be placed in protective privacy when considered necessary for personal safety and security. You have the right to access protective services. You have the right to expect reasonable safety and security insofar as hospital practices and environment are concerned.
You have the right to be informed about and participate in decision making regarding your care including treatment decisions, acceptance and referral of care, ethical questions, conflict resolution, withholding resuscitative services, foregoing or withdrawal of life sustaining treatment and participation in investigation studies or clinical trails. You can expect that appropriate treatment for your injury/illness will be provided, pain will be managed aggressively and that you and your family will be included in every aspect of care.
You have the right to know the names of the physicians who care for you and the right to receive an explanation from your doctors, in terms you can understand, about the nature of your problem and the course of treatment. If an operation is to be performed, you have the right to an explanation of the operation, in terms you can understand, its risks and consequences and the alternatives available.
You have the right to have your medical record read only by individuals directly involved in your treatment or in the monitoring of its quality. Other individuals may only read your medical record on your written authorization or that of your legally authorized representative.
You have the right to be interviewed and examined in surroundings designed to assure reasonable visual and auditory privacy. This includes the right to have a person of the same sex present during certain parts of a physical examination, treatment or procedure performed by a health professional of the opposite sex and the right not to remain disrobed any longer than is required for accomplishing the medical purpose for which the patient was asked to disrobe. You have the right to a complete explanation from your physician(s), in terms you can understand, about the nature of your illness/injury, and the expected course of treatment. In the event that surgery or a complex procedure may be required, you have the right to an explanation of the procedure and its risks and possible consequences in terms you understand. You may also expect an explanation of all alternatives available to the proposed procedure.
You are entitled to information about the mechanism of the hospital for the initiation, review and resolution of patient complaints.
You have the right to reasonable, informed participation in decisions involving your health care.