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Mental HealthA Guide to Patient Services

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Relaxation TipsWe understand that coming to the hospital can be stressful. Here are some things you can do to relax and reduce anxiety. You may need to try various activities at different times to get the relaxation you’re looking for. • Deep breathing• Journal writing• Meditation• Exercise (Yoga, Tai Chi, stretching, walking)• Call someone for support• Puzzles or games

• Reading• Crafts• Watch a funny movie• Get a good night’s sleep• Eat healthy foods

Stress Rating Scale Using the stress rating scale helps your care team determine the best way to meet your needs.

0 1 2 3 4 5 6 7 8 9 10

My Coping Skills: 1.

2.

3.

Calm Crisis

Additional ResourcesRegions Hospital is happy to give you these sources of information for after your discharge. We are not, however, responsible for the content of these sites, nor does this listing constitute any endorsement. If you have medical or health concerns, please consult your healthcare professional for advice.

Depression and Bipolar Support Alliance (DBSA) dbsalliance.org, 800-826-3632

Alcoholics Anonymous aastpaul.org, 651-227-5502

Community Crisis Lines Ramsey County 651-266-7900 Washington County 651-777-5222 Dakota County 952-891-7171 Hennepin County (COPE) 612-596-1223

Crisis Connection crisis.org, 612-379-6363

Gamblers Anonymous gamblersanonymous.org, 855-222-5542

HCMC Crisis Intervention Center hcmc.org, 612-873-3161

Mental Health Association of Minnesota mentalhealthmn.org, 651-493-6634

National Alliance on Mental Illness (NAMI) Minnesota Chapter namihelps.org, 651-645-2948

Pride Institute (GLBT Mental Health & CD services) 1-800-547-7433

Ramsey County Mental Health Center 651-266-7999

Regions ED Crisis Program 651-254-1000

St. Paul Domestic Abuse Intervention Project (Domestic Abuse Hotline) 651-645-2824

Suicide Awareness Voices of Education (SAVE) save.org, crisis line 1-800-273-8255

United Way Minnesota Help minnesotahelp.info, 2-1-1 or 1-800-543-7709

Urgent Care for Adult Mental Health 651-266-7900

Women’s Advocates (Domestic Abuse Shelter) 651-227-9966

Patient Promises:•Be honest with staff about

your level of safety

•Follow through with treatment recommendations

•To speak openly and honestly with staff

•Attend groups

•Contact support system

•Respect unit guidelines

•Set future goals

•Involve support system in your discharge planning

“Circle of Support” is the name of our inpatient mental health model of care. At Regions, we engage you with three kinds of support. Support from us at Regions where we provide the best care, best experience possible, support and skills for you to feel empowered to continue taking care of yourself. Support for those closest to you to develop a game plan so they understand the best ways to help. Support for you as you continue your recovery in your home and community. Knowing you have the circle of support is a great feeling.

Circle of SupportRegions Hospital Mental Health

Here are the promises of our staff and our patients, and the promises that we share.

Staff Promises: •Respectfully listen, provide

support, teach and guide

•Provide continuity of care

•Provide a safe and healing environment

•Involve patient’s support system

•Provide hope for the future

•Utilize teamwork & resources to address patient needs

•Provide evidence based, individualized medical care and treatment

Shared Promises:•Safety

•Respect

•Recovery

•Involvement of support system

Regionshospital.com 651-254-3456 Page 1

W E LCO M E

WelcomeWe want to make your hospital stay as pleasant and as comfortable as possible. This guide provides information about our services as well as your rights, responsibilities and choices regarding your health care. It also has helpful information about your meals, visiting hours and special services. We are committed to providing you with the best care and experience during your stay with us. This commitment to you begins with our promises to our patients and customers:

• We will treat you with dignity, respect and compassion.

• We will provide you with accurate and timely information.

• We will actively listen and involve you as you desire in your care.

• We will provide hassle-free access to the services and care you need.

• We will anticipate your needs and provide continuity and coordination of your services.

• We will provide you with a safe, clean and healing environment.

If at any time you feel we are not keeping these promises, please ask to speak to the nurse manager or contact a patient representative at 651-254-2372.

We rely on your feedback and would like to know what you think we are doing well and how we can continue to improve our care and services to you. Ten to 14 days after you leave the hospital, you may receive a survey from us in the mail. I would appreciate it if you could take a few minutes to complete the survey.

Our vision is to take such good care of our patients that we make Regions Hospital our community’s top choice for health care.

Brock D. Nelson President and CEO

Brock D. Nelson

President and CEO

Regions Hospital

651-254-3456 Regionshospital.com

P H O N E D I R E C TO RY & CO R E va Lu E s

Phone Directory

Unit Nursing StationsNortheast 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651-254-2404

Northeast 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651-254-2405

Northeast 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651-254-2406

Northeast 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651-254-2407

Northeast 8 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651-254-2408

Regions Hospital and Mental Health Core ValuesRegions Hospital is a leading, full-service, private hospital that provides outstanding medical care. We offer special heart, cancer, mental health, burn, emergency and trauma programs. Our health professionals are involved in teaching and research that focuses on improving overall health and medical care. Established in 1872, the hospital has served the Twin Cities and surrounding region for more than 135 years. We have a strong tradition of excellence in patient care in an environment that promotes comfort and healing. Regions Hospital is part of the HealthPartners family of care.

The Regions Hospital Foundation develops public awareness, builds community partnerships, and raises charitable contributions for Regions Hospital so we can continue working to promote better health for our patients and community. If you would like to make a contribution to any of the programs or services at Regions Hospital, please contact the Regions Hospital Foundation at 651-254-2376 or [email protected].

The Mental Health staff is here to assist you on your road to recovery. We want your stay to be comfortable and healing. As a health care team, we follow these core values to ensure we are addressing your care needs:

Mental Health Core Values• Patient-centered care

• Safe place to be

• Respect

• Continuity of care

• Stewardship

• Evidence-based practice

• Family and support system involvement

• Teamwork


Ta B L E O F CO N T E N T s

Table of Contents Phone Directory . . . . . . . . . . . . . . . . 2

Regions Hospital and Mental Health Core Values . . . . . . . . . . . . . . . . . . . 2

Getting to Know Regions Hospital Mental Health Services . . . . . . . . . . . 4Visitors . . . . . . . . . . . . . . . . . . . . . . . 4Phone Calls . . . . . . . . . . . . . . . . . . . . . 4Parking . . . . . . . . . . . . . . . . . . . . . . . 4

Rates . . . . . . . . . . . . . . . . . . . . . . . 4Valet. . . . . . . . . . . . . . . . . . . . . . . . 4Frequent Visitors . . . . . . . . . . . . . . . . 4

DayBridge Program . . . . . . . . . . . . . . . . 4

During Your Stay . . . . . . . . . . . . . . . . 5Treatment Program . . . . . . . . . . . . . . . . 5Caring for You . . . . . . . . . . . . . . . . . . . 5Your Rights as a Patient . . . . . . . . . . . . . . 6Ensuring Your Privacy. . . . . . . . . . . . . . . 6Health Care Directives . . . . . . . . . . . . . . 6Restricted and Controlled Items. . . . . . . . . 7Mail . . . . . . . . . . . . . . . . . . . . . . . . . 7Meals . . . . . . . . . . . . . . . . . . . . . . . . 8Notary Public. . . . . . . . . . . . . . . . . . . . 8Personal Clothing and Laundry Facilities. . . . 8Special Occasions . . . . . . . . . . . . . . . . . 8Comfort Rooms . . . . . . . . . . . . . . . . . . 8Community Meetings . . . . . . . . . . . . . . . 8Pain Management . . . . . . . . . . . . . . . . . 9Mental Health Resource Center . . . . . . . . 10Safekeeping of Valuables . . . . . . . . . . . . 10

Your Care Team . . . . . . . . . . . . . . . . . 11Doctors . . . . . . . . . . . . . . . . . . . . . . . 11Registered Nurses . . . . . . . . . . . . . . . . . 11Mental Health Associates . . . . . . . . . . . . . 11Social Workers . . . . . . . . . . . . . . . . . . . 11Health Unit Coordinators . . . . . . . . . . . . 11Occupational Therapists . . . . . . . . . . . . .12

Certified Peer Specialists . . . . . . . . . . . . .12Pharmacists. . . . . . . . . . . . . . . . . . . . .12Lab Technicians . . . . . . . . . . . . . . . . . .12Chaplains . . . . . . . . . . . . . . . . . . . . . .12Food and Nutrition . . . . . . . . . . . . . . . .12Housekeeping . . . . . . . . . . . . . . . . . . .12Support Services and Complementary Care Therapy. . . . . . . . . .12Financial Counselors . . . . . . . . . . . . . . . 13Ethics Consult Team . . . . . . . . . . . . . . . 13Interpreter Services . . . . . . . . . . . . . . . . 13Patient Representative . . . . . . . . . . . . . . 13Volunteer Services . . . . . . . . . . . . . . . . . 13

Safety and Security . . . . . . . . . . . . . .14Preventing Falls . . . . . . . . . . . . . . . . . .14Patient Safety. . . . . . . . . . . . . . . . . . . .14Help Prevent Infections. . . . . . . . . . . . . .14Safety Drills. . . . . . . . . . . . . . . . . . . . .14Identification Badges . . . . . . . . . . . . . . .14Ask Questions Before You Go . . . . . . . . . . 15Discharge Process . . . . . . . . . . . . . . . . . 15Personal Belongings . . . . . . . . . . . . . . . . 15Hospital Bills and Insurance . . . . . . . . . . .16

If You Are Covered by Health Insurance . . .16 If You Are Covered by Medicare . . . . . . .16If You Are Covered by Medical Assistance . .16If You Have No Insurance . . . . . . . . . . .16

Your Hospital Bill and Doctor Charges . . . . .16

Access to Health Records: Practices and Rights. . . . . . . . . . . . . .17Your Right to Access and Protect Your Health Record . . . . . . . . . . . . . . . .17Patients’ Bill of Rights—Minnesota . . . . . . .17Patients’ Bill of Rights—Federal . . . . . . . . .21

Before I Go: Discharge Checklist . . . . 24

Additional Resources . . . . Inside back cover

Relaxation Tips . . . . . . . . . . . . Back cover

Stress Rating Scale . . . . . . . . . Back cover


g E T T I N g TO k N OW R Eg I O N s H Os PITa L M E N Ta L H E a LT H s E Rv I C E s

Getting to Know Regions Hospital Mental Health Services

VisitorsWe welcome your designated “family” members or support person at any time. Family members are defined by you, the patient, and are not limited to blood relatives. For your recovery and privacy, family members/support person are discouraged from staying overnight with you. However, if you need the support of your family during the night, please talk with your nurse.

General Visiting Hours: 11:00 a.m. – 8:30 p.m.

Visitors under 12 must be accompanied by an adult (other than the patient) who is 18 or older.

Regions Hospital address: 640 Jackson Street, St. Paul, MN 55101

Directions can be found on our web site at regionshospital.com or by calling 651-254-3456.

For your safety, visitors should be in good health and not recently exposed to communicable diseases. Please ask your visitors to wash their hands before and after they visit.

All visitors and family members are required to respect the privacy of other patients, and may be asked to leave if their behavior is disturbing others.

Phone CallsThere are four patient phones available on each unit from 7:00 a.m. – 10:00 p.m. each day. For safety, your cell phone is stored in your locker. If you need to use your cell phone to look up a phone number, please ask a staff member for help.

ParkingVisitors for mental health patients should park in the west ramp off of Jackson Street at the corner of University Avenue. Once in the ramp, follow the signs to the elevator for the Northeast section.

Take the elevator down to the first floor and follow the signs to the Northeast building.

Rates

There is an hourly fee for parking in this ramp.

Valet

Valet parking is available at both the West entrance and the South (Main) entrance,

Cost: Only $1 more per exit than standard parking fees.

Discounts: Senior citizens (age 65 and older) receive a discount when using valet.

Hours: Monday-Friday: 6:00 a.m. – 10:00 p.m. Saturday & Sunday: 7:00 a.m. – 9:00 p.m.* * Note: Valet parking is not available at the West entrance

on Saturdays or Sundays

Frequent Visitors

Reduced-Rate Parking If you have visitors who come to see you often, reduced-rate parking coupons can be purchased at the parking office and the gift shop.

Cost: $15 for five exits.

Parking Office Location: 2nd floor, Central section Hours: Monday – Friday, 8:00 a.m. – 4:00 p.m.

DayBridge ProgramIn Spring of 2013, the Mental Health department plans to open DayBridge. This is a partial hospitalization program in the Northeast section on the second floor. DayBridge will provide groups, therapy and activity during the day. This will allow patients to return home for the evening and night. This program will provide a safe, therapeutic alternative to inpatient care.


D u R I N g YO u R sTaY

During Your Stay

Treatment ProgramOur treatment programs are based on proven research. Upon admission, you will choose a curriculum track based on your symptoms. The track will guide you in choosing the best program groups for your recovery. Each group offers different tools to help you stay healthy. Please attend as many groups as possible to fully benefit from your stay with us.

Our staff are skilled at providing treatment and care to individuals who have experienced trauma or violence. You will be asked about any past trauma in your life, potential triggers that would upset you, and coping skills that can help to calm you.

Caring for YouPlease be respectful when other patients are trying to rest. We also ask that you please follow visiting hours and treat hospital property and equipment with care.

To provide you with the best care, we request that you:

• Tell the doctor and nurse everything about your condition. This includes all symptoms, all medications you are taking (including over-the counter and herbal medications) and your past medical history. If you have coping skills or a recovery plan that you’ve been using, please share that with us.

• Ask questions. We want you to be informed and an active partner with us in your care. When you are admitted, you will be given a handout. Please write down any questions you have during your hospital stay and ask your care team to answer them. If you are given a medicine that you do not know about, ask us to tell you about the medication before you take it.

• Let your doctor or nurse know if you experience changes. This includes any changes to your general condition or any new symptoms such as: nausea, dizziness or lack of appetite. Tell your nurse if you are experiencing pain.

• Speak up. It is important to us that you feel comfortable with tests and procedures being done while you are in the hospital. If you would like another staff person present any time a test or procedure is being performed, please notify your nurse or other staff member before the procedure starts. Talk to your nurse if you have questions about your tests or why they are needed.

• Tell us about things that you feel are unsafe or not right. This includes things that happen to you as well as things you may hear or see around you.

• Respect other patients, the staff and the hospital. We ask that you and your visitors respect other patients’ privacy and treat the staff with respect. Please pay your medical bills on time and treat hospital property and equipment with care.


D u R I N g YO u R s TaY

Your Rights as a PatientThe staff at Regions Hospital Mental Health services is dedicated to serving your needs and providing for your care and comfort.

The hospital may be an unfamiliar place for many people. We want you to know you have certain rights and responsibilities when you stay with us. You can find detailed Minnesota and Federal Patient Bill of Rights information on pages 17–23.

You have the right to:• Courteous and respectful treatment

• A safe and secure environment

• Appropriate medical care

• Have your family member/support person present

• A clear and understandable explanation of your diagnosis, treatment plan and what to expect

• Be told the names of your doctor(s) and other caregivers

• Privacy and confidentiality

• Participate in planning your care

• Refuse medical treatment

• Refuse participation in any research studies

• An interpreter, if you are hard of hearing, or do not speak or understand English (page 13)

• Practice your religion or culture

• Register complaints (page 21)

• Complete a Health Care Directive or other written document describing your wishes for future medical care

• Treatment that works to control your pain

Ensuring Your PrivacyTo protect your privacy, we will only give out general information about your condition over the phone. Please designate one family member/support person

as the contact person for communication from your doctor, nurse and other members of your care team.

Health Care DirectivesMinnesota law allows you to inform others of your health care wishes. You have the right to state your wishes or appoint someone in writing so that others will know what you want if you are unable to speak for yourself. A written statement of your wishes is called a “health care directive.” Health care directives are not required but they are helpful to you, your family and your health care team when you are in need of medical treatment.

In your health care directive, you can identify the person or persons you want to make decisions about your medical treatment if you are not able to do so. You can note what types of treatments you do or do not want to receive, including artificial nutrition (feeding tubes) and hydration (receiving fluids through tubes). You may also note your wishes for organ, tissue and/or eye donation, or funeral arrangements.

If you already have a written health care directive, please have someone bring it to the hospital. It will be copied and placed into your medical record. If you do not have one, your nurse can provide you with a form to write down your wishes and your values. If you want help filling out these forms, hospital chaplains and social workers are available. While these discussions sometimes happen in a hospital setting we encourage you also to work with your primary-care doctor to complete a health directive. You or your health care agent are strongly advised to discuss your health care directives with your health care team. Regions Hospital attempts to honor all advance instructions as long as they are within reasonable medical practice. You or your health care agent cannot request treatment that will not help you or which the doctor or hospital cannot provide. If we cannot follow your written directives, the doctor should have this discussion with you or your health care agent. The doctor will also document the



discussion in your medical record. You have the right to seek out a doctor and/or hospital that will follow your instructions and may request a transfer to that doctor and/or hospital.

If you are concerned that you may be subject to involuntary psychiatric commitment or treatment at some future time, you can prepare a legal document in advance to express your choices about treatment. The document is called an advance directive for mental health decision-making. If you would like a copy of this document please ask your nurse or call the Patient Representative office at 651-254-2372.

Restricted and Controlled ItemsFor your safety and the safety of others, the following items are restricted in the Mental Health units. Additional items may be prohibited in particular units. Regions Hospital reserves the right to ban any objects we think can be dangerous.

Restricted Items —These are items that patients may not have at any time.• Weapons of any kind

• Alcohol or illegal substances

• Razors

• Cameras or recording devices of any kind

• Keys

• Pagers

• Alcohol-based mouthwash or grooming products

• Medicine including prescription, over-the-counter, vitamins or supplements

• Matches or lighters

• Metal nail files

• Safety pins

• Belts, shoestrings, drawstrings or scarves

• Neck jewelry (unbreakable)

• Pointed toe or steeled-toed shoes or boots

• Open beverage containers

• Plastic bags

• Glass items

• Soda cans

Controlled Items —These are permitted on units, but staff control their use.• Electric shavers

• Mirrors or compacts

• Cans

• Sewing needles, knitting needles and crochet hooks

• Aerosol cans

• Fingernail polish and polish remover

• Money (more than $10), credit cards or valuables

• Scissors, nail clippers and tweezers

• Hair dryers, curling irons or straightening combs

• Perfume and cologne

• Medical equipment with detachable cords (Plant Operations must check all items before use.)

• Cell phones

• Computers, iPods®, MP3 players, CD/DVD players (CDs and DVDs), radios and electronic hand held games

Regions campus and parking ramps are tobacco-free.

Mail Mail will be delivered to your room once per day, except weekends and holidays. After you leave the hospital, your mail will be sent to your home. Please give any outgoing mail to the health unit coordinator who will make sure it gets mailed for you.

Mail can be sent to: (Patient name) c/o Regions Hospital 640 Jackson Street St. Paul, MN 55101



MealsYou will be provided three well rounded healthy meals per day as well as one evening snack. It is important to us that you receive a choice of what to eat. The meals and snacks we provide will be more than enough to meet your daily nutritional needs. A sugar free beverage will also be available throughout the day. Our goal is to provide you with food that is good tasting and healthy.

Your care team will serve meals and snacks to you in the dining room. At meal times please be seated and we will serve you. You are our guest!

We encourage your family and friends to bring in healthy meals and snacks (or your favorites) to enjoy during their visit. For the safety of all, we will not allow you to order food in from outside the hospital.

You may be on medications that increase or decrease your appetite; if you need help dealing with these side effects we encourage you to discuss them with a care provider.

Notary PublicFor notarizing of health care related documents, please inform your nurse and he or she will contact one of the notaries public in the hospital. Do not sign the document(s) until the notary public is present to witness your signature.

Personal Clothing and Laundry FacilitiesYou will begin your hospital stay in a hospital gown or pajamas. We will work to return your personal clothing to you after your admission assessments. Each unit in the mental health department has a washer and dryer for you to use. Please only do laundry during the day and evening to prevent noise at night. Unit staff will give you soap. If you prefer a certain brand ask family members to bring it for you.

Special OccasionsIf you are in the hospital on your birthday or anniversary, we would be happy to help you celebrate. Upon request, we will provide a birthday cake as our gift to you or do whatever else we can to make your day special. Please ask your nurse for details.

Comfort RoomsThere are comfort rooms on all units. These rooms create a nurturing and calming environment to get away from activity of the unit. In the comfort rooms, you can choose restful seating, calming DVDs or music to listen to, as well as relaxing activities to participate in. After being in the comfort rooms, you will feel more relaxed and learn which calming activities you prefer.

Community MeetingsCommunity meetings are held twice daily on each unit. The focus of the community meetings is to check in with you, discuss any concerns about the unit, and to ensure everyone’s safety.

Meals are served during these times:

Breakfast 7:30 a.m.–8:00 a.m.

Lunch 11:30 a.m.–Noon.

Dinner 4:30 p.m.–5:30 p.m.

Snack 8:00 p.m.–9:00 p.m.



Pain ManagementPhysical conditions can cause pain while coping with mental illness. Your care team will work with you on a plan to manage your discomfort.

What is pain?Pain is an uncomfortable feeling that is the body’s natural response to surgery or injuries. Pain tells you that something is wrong in your body. Everyone feels pain differently. It can feel like an ache, burning sensation or stabbing. Pain management helps block these messages or reduce their effect on your brain.

Goals of pain control:• To make you more comfortable

• To allow you to sleep or rest better

• To help you return to activity sooner

• To help you recover and heal faster

What you can do to help control your pain:• Talk to your nurse or doctor when your pain

first begins.

• Find out from your nurse or doctor how much pain you can expect.

• Discuss your pain-control options with your nurse or doctor.

• Tell your nurse or doctor the pain control methods or medications that have worked well for you in the past, including herbal or complementary therapies.

• Tell your nurse or doctor about any allergies or side effects that medicines may cause you.

• Tell your nurse or doctor about any pain that won’t go away.

• Tell your nurse or doctor about any worries or issues you have about taking pain medication or that may cause you more stress and pain.

You have the right to:• An understanding staff that helps you manage

your pain.

• Provide input into your care plan for pain management

• A treatment plan to help you manage your pain

• A treatment plan that assesses and manages pain in a timely manner

• Information about pain and pain relief measures

Other methods that help control pain:

It can be helpful to take medication 30-40 minutes before scheduled activities such as physical therapy, walking, or dressing changes. These other complementary therapies may also help:

• Ice or heat therapy

• Back rubs or massage therapy

• Music therapy

• Repositioning

• Visualization

• Distraction

• Breathing for relaxation

• Reiki

Work with your care team to determine what works best for you.

Pain ScaleUsing the pain scale helps doctors and nurses know how severe your pain is and if your medications are helping. You will frequently be asked to rate your pain on a scale of zero to 10, with zero being no pain and 10 being the worst pain.

0No Pain

2Little Pain

4Mild Pain

6Moderate Pain

8Severe Pain

10Worst Pain



Mental Health Resource CenterThe Mental Health Resource Center is a great source of mental health information. Patients and families are welcome to check out books, take pamphlets, or use a computer with internet access. It is an excellent place to learn more about issues that affect you and your family’s health.

Location: 1st floor Northeast

Hours: 11 a.m. – 8:30 p.m.

Safekeeping of Valuables Please send items of value home. If you have a valuable item at the hospital, please ask your nurse about storing it in the safe at the cashier’s office. The hospital does not accept responsibility for items unless they are deposited in the cashier’s office safe. For lost or missing items, please contact the security office.


YO u R C a R E T E a M

Your Care TeamOur goal is to provide the best healthcare possible. Your care team includes your doctor, registered nurses, social workers, occupational therapists and mental health associates. If you have questions about your care, ask anyone on your care team or write it down on the question handout given to you upon admission.

DoctorsYour attending doctor is a medical doctor who specializes in Psychiatry. He or she may also consult with a variety of other specialists to provide you with the best care. Some attending doctors rotate shifts weekly. During your stay, you may receive visits from other doctors, medical students, residents, physician assistants or nurse practitioners. The attending doctor in charge of your care will supervise any medical student or resident who visits you and is happy to answer any questions you may have.

Regions Hospital is a teaching facility. You may encounter students from any discipline during your stay. A medical student is someone who has not yet graduated and is still in medical school. A resident has graduated from medical school and is a doctor, who works under the supervision of a more experienced doctor.

Registered NursesA registered nurse will be assigned to you each shift. The nurse’s role is to guide and support you, provide nursing care, and promote education about your health issues. A nurse will lead groups during the day and evening.

Mental Health Associates Mental health associates assist with patient care, provide therapeutic groups and conduct community meetings and wrap up groups.

They also ensure that the unit is safe by doing contraband checks and safety rounds. The Mental Health Associates will accompany you off the unit for groups, walks, medical tests, and therapy.

Social WorkersThe role of social workers is to make sure you have information and support for your recovery. They will also help coordinate care with other needs you and your family may require.

Social workers can help with:

• Identify social service and therapeutic needs

• Access and utilize community resources

• Make referrals for services

• Explain treatment options and plans

• Coordinate discharge plans

• Identify ongoing needs of yours and your family

• Ensure your legal status is addressed appropriately and timely

• Coordinate with the counties and courts during the civil commitment process

• Problem solve and alleviate barriers for services and discharge

• Advocate for patients and provide support

• Psycho-education in the form of social work groups

Family members may call the unit social worker for questions about your care and progress. The social worker may coordinate a meeting with family and/or other providers, as needed.

Health Unit CoordinatorsThe health unit coordinator is usually found at the main desk of each patient care unit and can provide general information for you and your family.



Occupational TherapistsAn occupational therapist may assess your ability to function independently and help to determine the best living situation for you. Assessment areas include your strengths, behaviors, social skills, cognitive skills, thought processes, activities of daily living, functional abilities, work skills, goals, and sensory needs. They provide treatment and education in the form of groups and one to one interactions. Occupational therapists will give support, confront inappropriate behavior, provide education, aide in communication, and promote your future plans

Certified Peer SpecialistsCertified peer specialists provide recovery training. They work with you in groups and on a one to one basis providing hope, encouragement, support and self-determination. The certified peer specialist will also provide you with connections to the community.

PharmacistsA hospital pharmacist reviews all your medications while you’re in the hospital to make sure that the dose is correct and to screen for drug interactions. Please let your nurse know if you have questions about the medications you are taking. For your safety, we will provide your medications in the form of a single dose.

Lab TechniciansLaboratory tests help identify and keep track of many medical conditions. Most lab tests are done early in the morning so results can be available for the doctor during the day. Some tests, for a correct reading, require that you do not eat before the test. Regions Pathology Laboratory is accredited by The Joint Commission. If you have concerns about quality patient safety, please contact The Joint Commission at 800-994-6610 (toll free). Your identity will be kept strictly confidential.

ChaplainsChaplains are available to provide spiritual support. They can be called upon for blessings, prayers or rituals. To request a chaplain, simply ask your nurse.

Food and NutritionOur Dietitians and Dietetic Technicians are available for nutrition assessment and education as needed or as ordered by your doctor. You may talk to your doctor to request a visit by a Dietitian or Dietetic Technician. Group classes on general healthy nutrition will also be available.

You also may contact our food and nutrition office at 651-254-9929 for concerns about your nutritional needs or you can simply ask your nurse.

HousekeepingYour room will be cleaned daily by a member of the housekeeping team. Please inform your nurse, or the housekeeping team if you have questions about housekeeping procedures.

Support Services and Complementary Care TherapyComplementary care therapies are offered to help with pain, stress and anxiety. Please ask your nurse or social worker about these therapies.

Complementary Care Services:

• Pet Therapy

• Music Therapy

• Pool Exercise Class



Financial CounselorsPatients with balances due resulting from limited or no insurance coverage may qualify for our financial assistance programs. Regions Hospital financial counselors work closely with patients to discuss insurance coverage, government programs and other payment options. If you are not eligible for any of these programs, Regions Hospital has financial assistance available to uninsured or underinsured people based on income, family size and other economic guidelines. The counselors are able to assist patients in enrolling in government programs, look for other sources of payment, take financial assistance applications and help self-pay patients to set up payment plans.

If you do not have health insurance, a financial counselor from the Admitting department will discuss financial arrangements with you. If you would like to make an appointment with a financial counselor, please let your care team know.

Ethics Consult TeamPatients, their families and health care providers usually agree on the best treatment plan.

However, in some situations, issues may arise that require further discussion or consultation. The Ethics Consult Team is available to any patient, family member or friend to meet this need. If you are experiencing difficulty or uncertainty sorting through ethical decisions, or believe your values are not being fully considered, please feel free to request an ethics consultation by notifying your doctor or nurse, or dial the hospital operator and ask for the on-call ethics consultant.

Interpreter ServicesProfessionally trained medical-language interpreters are on staff at the hospital for the following languages, free of charge:

• American Sign Language

• Amharic

• Cambodian/Khmer

• Hmong

• Oromo

• Somali

• Spanish

• Vietnamese

Additional interpreters are available in up to 150 spoken languages, 24 hours a day. If you need a language interpreter, please contact your nurse.

Patient RepresentativeIf you or your family members have questions or concerns about your medical care while at Regions Hospital, you may contact a patient representative during weekdays at:

651-254-2372

[email protected]

Department leaders and your care team are also available to help. During non-business hours, if you need immediate support and guidance for your concerns, please ask to speak to the charge nurse on your unit. It is important to realize that you, as a patient, have rights and responsibilities. Please refer to the Patients’ Bill of Rights section of this guide.

Volunteer ServicesVolunteers help in a variety of ways: they deliver flowers, transport patients and can provide puzzle books, magazines and other reading materials for patients and guests.


sa FE T Y a N D s ECu R IT Y

Safety and Security

Preventing FallsDepending on your injury, illness or medications, you may be at risk of falling if you try to stand up or get out of bed without help. The nursing staff will assess your risk for falls and implement the appropriate interventions to keep you safe.

We ask you to:

• Let us know if you have a history of falling.

• Always wear slippers or shoes when out of bed (slippers are available on request).

• Let us know if you feel dizzy or weak when you get up.

• Keep extra belongings in your closet or dresser.

Patient SafetyRegions Hospital participates in The Joint Commission’s Speak Up™ campaign by encouraging patients to take a role in preventing health care errors by becoming active, involved and informed participants on their health care teams. The campaign encourages you to:

• Speak up if you have questions or concerns, and if you don’t understand, ask again. It’s your body and you have a right to know.

• Pay attention to the care you are receiving. Make sure you’re getting the right treatments and medications from the right health care professionals. Don’t assume anything.

• Educate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.

• Ask a trusted family member or friend to be your advocate.

• Know what medications you take and why you take them. Medication errors are the most common health care errors.

• Use a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards.

• Participate in all decisions about your treatment. You are the center of the health care team.

For more information or to report any concerns, contact The Joint Commission at 800-994-6610.

Help Prevent Spread of Infections• Wash your hands.

• Make sure health care providers clean their hands or use alcohol sanitizer.

• Cover your mouth and nose when coughing or sneezing.

• Ask friends and family members who are sick not to visit you until they feel better.

Safety DrillsFor your protection, we conduct several safety drills throughout the year. If a drill occurs while you are here, please remain in your room unless notified otherwise by your nurse.

Identification BadgesAll hospital staff are required to wear a name tag with photo identification. Between the hours of 9:00 p.m. – 5:00 a.m., family members of patients in the hospital are also required to wear identification.



Ask Questions Before You GoIt is important that you understand your illness or injury, the plan for your follow-up care and anything else that affects your health. If you have any questions, please talk to your care team.

Discharge ProcessYour doctor will discuss discharge plans with you in advance so you can arrange help and/ or transportation. Your plans may include information such as:

• Follow-up appointments and care. Your doctor will discuss with you what kind of care you need after you leave the hospital. You may be referred to your primary care doctor or clinic.

• When to return to normal activities. Please ask your doctor about when you can return to normal activities.

• Medications to take and side effects to monitor. Your discharge instructions will include all medications prescribed by your doctor. The pharmacy at Regions can fill any take-home prescriptions. The pharmacy will fill your order, send it to your room, bill your insurance, and send any co-pay bills to your home address. You can also take your prescriptions to an outside pharmacy. Please tell your nurse or physician if this is your preference.

• Danger signs to watch for.

• Diet recommendations. Nutrition may play an important part in your recovery process. Please listen to the recommendation of your care team.

• Your nurse will provide a written copy of your discharge instructions and go over them with you to make sure you understand everything.

Personal BelongingsBefore leaving, check closets and drawers for your personal belongings. If you have valuables in the hospital safe, pick them up at the cashier window on the 2nd floor, Central section, Monday through Friday from 8:00 a.m. – 4:00 p.m. and Saturday from 10:00 a.m. – 2:30 p.m. If you need items from the safe after hours, please ask your nurse.



Hospital Bills and InsuranceUpon admission, Regions Hospital will assist you with your health insurance coverage, but it is your responsibility to know your health care benefits. You may be visited by a financial counselor when you are admitted.

If You Are Covered by Health Insurance

Please provide a copy of your health insurance card. We may also ask for any special insurance forms that are supplied by your employer or insurance company. You will be asked to assign benefits from the insurance company directly to the hospital. If you are a member of a health maintenance organization (HMO) or preferred provider organization (PPO), we need a copy of your HMO or PPO card. Your plan may state that you need the insurance company to approve treatment before you receive care, or that you need your primary doctor to give you permission to see a specialist. You are responsible for following your insurance plan. If your plan’s requirements are not followed, you will need to pay for the services provided in the hospital. Some doctors may not be included in your plan so their services may not be covered.

If You Are Covered by Medicare

We need a copy of your Medicare card to process your Medicare claim. You should know that the Medicare program will not pay for certain items and services it considers preventative or not medically necessary, such as cosmetic surgery, some oral surgical procedures, personal comfort items, hearing evaluations and other services. You are responsible for deductibles and co-payments.

If You Are Covered by Medical Assistance

We need a copy of your Medical Assistance card. If you have a card supplied by a prepaid Medical Assistance program such as an HMO carrier, we need to see that card as well. Medical Assistance limits the number of

services and items you can receive. Medical Assistance, like most insurance companies, does not pay for the cost of a private room unless it is medically necessary.

If You Have No Insurance

A financial counselor will discuss finances with you. In some cases, it may be possible to apply for Medical Assistance before you are discharged. Sometimes, a referral for assistance may be sent to the county you live in to speed the process. The financial counselor will talk with you about several options that may offer some help with your bill.

Hospital Bill and Doctor ChargesThe hospital will send a bill to your health insurer. Remember, your policy is a contract between you and your health insurance company and you have the final responsibility for payment of your hospital bill. You will receive one summary statement that includes the fees for hospital services and fees from the doctors or other professionals who took care of you. However, these fees will be billed separately to your insurance provider.

The fees for hospital services fall into two categories:

1. A basic daily rate which includes your room, meals, nursing care, housekeeping,

2. Charges for special services such as doctors orders for medications, X-rays or laboratory tests

The fees for your doctor will be billed by the doctor’s employer. If you have certain tests or treatments in the hospital, you may also receive bills from doctors you did not see in person. These bills are for professional services by doctors who diagnose and interpret test results. Pathologists, radiologists, cardiologists, anesthesiologists and other specialists perform these services and are required to submit separate bills. If you have questions about bills, please call the number printed on the statement you receive.


aCC E s s TO H E a LT H R ECO R Ds : P R aC T I C E s a N D R I g H T s

Access to Health Records: Practices and Rights

Your Right to Access and Protect Your Health RecordYou have the following rights relating to your health record under the law:

• A health care provider, or a person who gets health records from a provider, must have your signed and dated consent to release your health record, except for specific reasons in the law.

• You can see your health record for information about any diagnosis, treatment, and prognosis.

• You can ask, in writing, for a copy or summary of your health record, which must be given to you promptly.

• You must be given a copy or a summary of your health record unless it would be detrimental to your physical or mental health, or cause you to harm to another.

• You cannot be charged if you request a copy of your health record to review your current care.

• If you request a copy of your health record and it does not include your current care, you can only be charged the maximum amount set by Minnesota law for copying your record.

To request copies of your medical record, please contact Regions Hospital Release of Information at 651-254-2468. Copies of the medical record are usually provided after discharge to ensure the record is complete. Maximum fees for processing and copying medical records are set by Minnesota law.

If you would like additional information or links to specific laws, visit www.health.state.mn.us and search for “access to health records” or call the Minnesota Department of Health at 651-201-5178.

Patients’ Bill of Rights —Minnesota Legislative Intent

It is the intent of the Legislature and the purpose of this statement to promote the interests and well-being of the patients of health care facilities. No health care facility may require a patient to waive these rights as

a condition of admission to the facility. Any guardian or conservator of a patient or, in the absence of a guardian or conservator, an interested person, may seek enforcement of these rights on behalf of a patient. An interested person may also seek enforcement of these rights on behalf of a patient who has a guardian or conservator through administrative agencies or in probate court or county court having jurisdiction over guardianships and conservatorships. Pending the outcome of an enforcement proceeding the health care facility may, in good faith, comply with the instructions of a guardian or conservator. It is the intent of this section that every patient’s civil and religious liberties, including the right to independent personal decisions and knowledge of available choices, shall not be infringed and that the facility shall encourage and assist in the fullest possible exercise of these rights.

Definitions

For the purposes of this statement, “patient” means a person who is admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for the purpose of diagnosis or treatment bearing on the physical or mental health of that person. “Patient” also means a minor who is admitted to a residential program as defined in Section 7, Laws of Minnesota 1986, Chapter 326. For purposes of this statement, “patient” also means any person who is receiving mental health treatment on an out-patient basis or in a community support program or other community- based program.

Public Policy Declaration

It is declared to be the public policy of this state that the interests of each patient be protected by a declaration of a patient’s bill of rights, which shall include but not be limited to the rights specified in this statement.

1. Information About Rights Patients shall, at admission, be told that there are legal rights for their protection during their stay at the facility or throughout their course of treatment and maintenance in the community and that these are described in an accompanying written statement of the applicable rights and responsibilities set forth in this section. In the case of patients admitted to residential programs as defined in Section 7, the written statement shall also describe the right of a person 16 years old or older to request release as



provided in Section 253B.04, Subdivision 2, and shall list the names and telephone numbers of individuals and organizations that provide advocacy and legal services for patients in residential programs. Reasonable accommodations shall be made for those with communication impairments, and those who speak a language other than English. Current facilities policies, inspection findings of state and local health authorities, and further explanation of the written statement of rights shall be available to patients, their guardians or their chosen representatives upon reasonable request to the administrator or other designated staff person, consistent with chapter 13, the Data Practices Act, and Section 626.557, relating to vulnerable adults.

2. Courteous Treatment Patients have the right to be treated with courtesy and respect for their individuality by employees of or persons providing service in a health care facility.

3. Appropriate Health Care Patients shall have the right to appropriate medical and personal care based on individual needs. This right is limited where the service is not reimbursable by public or private resources.

4. Physician’s Identity Patients shall have or be given, in writing, the name, business address, telephone number, and specialty, if any, of the physician responsible for coordination of their care. In cases where it is medically inadvisable, as documented by the attending physician in a patient’s care record, the information shall be given to the patient’s guardian or other person designated by the patient as his or her representative.

5. Relationship With Other Health Services Patients who receive services from an outside provider are entitled, upon request, to be told the identity of the provider. Information shall include the name of the outside provider, the address, and a description of the service which may be rendered. In cases where it is medically inadvisable, as documented by the attending physician in a patient’s care record, the information shall be given to the patient’s guardian or other person designated by the patient as his or her representative.

6. Information about Treatment Patients shall be given by their physician’s complete and current information concerning their diagnosis, treatment, alternatives, risks and prognosis as required by the physician’s legal duty to disclose. This information shall be in terms and language the patients can reasonably be expected to understand. Patients may be accompanied by a family member or other chosen representative, or both. This information shall include the likely

medical or major psychological results of the treatment and its alternatives. In cases where it is medically inadvisable, as documented by the attending physician in a patient’s medical record, the information shall be given to the patient’s guardian or other person designated by the patient as his or her representative. Individuals have the right to refuse this information. Every patient suffering from any form of breast cancer shall be fully informed, prior to or at the time of admission and during her stay, of all alternative effective methods of treatment of which the treating physician is knowledgeable, including surgical, radiological, or chemotherapeutic treatments or combinations of treatments and the risks associated with each of those methods.

7. Participation in Planning Treatment Notification of Family Members: a. Patients shall have the right to participate in the

planning of their health care. This right includes the opportunity to discuss treatment and alternatives with individual caregivers, the opportunity to request and participate in formal care conferences, and the right to include a family member or other chosen representative, or both. In the event that the patient cannot be present, a family member or other representative chosen by the patient may be included in such conferences. A chosen representative may include a doula of the patient’s choice.

b. If a patient who enters a facility is unconscious or comatose or is unable to communicate, the facility shall make reasonable efforts as required under Paragraph (c) to notify either a family member or a person designated in writing by the patient as the person to contact in an emergency that the patient has been admitted to the facility. The facility shall allow the family member to participate in treatment planning, unless the facility knows or has reason to believe the patient has an effective advance directive to the contrary or knows the patient has specified in writing that they do not want a family member included in treatment planning. After notifying a family member but prior to allowing a family member to participate in treatment planning, the facility must make reasonable efforts, consistent with reasonable medical practice, to determine if the patient has executed an advance directive relative to the patient’s health care decisions. For purposes of this paragraph, “reasonable efforts” include:

i. examining the personal effects of the patient;

ii. examining the medical records of the patient in the possession of the facility;



iii. inquiring of any emergency contact or family member contacted whether the patient has executed an advance directive and whether the patient has a physician to whom the patient normally goes for care; and

iv. inquiring of the physician to whom the patient normally goes for care, if known, whether the patient has executed an advance directive. If a facility notifies a family member or designated emergency contact or allows a family member to participate in treatment planning in accordance with this paragraph, the facility is not liable to the patient for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient’s privacy rights.

c. In making reasonable efforts to notify a family member or designated emergency contact, the facility shall attempt to identify family members or a designated emergency contact by examining the personal effects of the patient and the medical records of the patient in the possession of the facility. If the facility is unable to notify a family member or designated emergency contact within 24 hours after the admission, the facility shall notify the county social service agency or local law enforcement agency that the patient has been admitted and the facility has been unable to notify a family member or designated emergency contact. The county social service agency and local law enforcement agency shall assist the facility in identifying and notifying a family member or designated emergency contact. A county social service agency or local law enforcement agency that assists a facility is not liable to the patient for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient’s privacy rights.

8. Continuity of Care Patients shall have the right to be cared for with reasonable regularity and continuity of staff assignment as far as facility policy allows.

9. Right to Refuse Care Competent patients shall have the right to refuse treatment based on the information required in Right No. 6. In cases where a patient is incapable of understanding the circumstances but has not been adjudicated incompetent, or when legal requirements limit the right to refuse treatment, the conditions and circumstances shall be fully documented by the attending physician in the patient’s medical record.

10. Experimental Research Written, informed consent must be obtained prior to patient’s participation in experimental research. Patients have the right to refuse participation. Both consent and refusal shall be documented in the individual care record.

11. Freedom From Maltreatment Patients shall be free from maltreatment as defined in the Vulnerable Adults Protection Act. “Maltreatment” means conduct described in Section 626.5572, Subdivision 15, or the intentional and nontherapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce mental or emotional distress. Every patient shall also be free from nontherapeutic chemical and physical restraints, except in fully documented emergencies, or as authorized in writing after examination by a patients’ physician for a specified and limited period of time, and only when necessary to protect the patient from self-injury or injury to others.

12. Treatment Privacy Patients shall have the right to respectfulness and privacy as it relates to their medical and personal care program. Case discussion, consultation, examination, and treatment are confidential and shall be conducted discreetly. Privacy shall be respected during toileting, bathing, and other activities of personal hygiene, except as needed for patient safety or assistance.

13. Confidentiality of Records Patients shall be assured confidential treatment of their personal and medical records, and may approve or refuse their release to any individual outside the facility. Copies of records and written information from the records shall be made available in accordance with this subdivision and Section 144.335. This right does not apply to complaint investigations and inspections by the department of health, where required by third party payment contracts, or where otherwise provided by law.

14. Disclosure of Services Available Patients shall be informed, prior to or at the time of admission and during their stay, of services which are included in the facility’s basic per diem or daily room rate and that other services are available at additional charges. Facilities shall make every effort to assist patients in obtaining information regarding whether the Medicare or Medical Assistance program will pay for any or all of the aforementioned services.



15. Responsive Service Patients shall have the right to a prompt and reasonable response to their questions and requests.

16. Personal Privacy Patients shall have the right to every consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being.

17. Grievances Patients shall be encouraged and assisted, throughout their stay in a facility or their course of treatment, to understand and exercise their rights as patients and citizens. Patients may voice grievances and recommend changes in policies and services to facility staff and others of their choice, free from restraint, interference, coercion, discrimination, or reprisal, including threat of discharge. Notice of the grievance procedure of the facility or program, as well as addresses and telephone numbers for the Office of Health Facility Complaints and the area nursing home ombudsman pursuant to the Older Americans Act, Section 307 (a) (12) shall be posted in a conspicuous place. Every acute care in-patient facility, every residential program as defined in Section 7, and every facility employing more than two people that provides outpatient mental health services shall have a written internal grievance procedure that, at a minimum, sets forth the process to be followed; specifies time limits, including time limits for facility response; provides for the patient to have the assistance of an advocate; requires a written response to written grievances; and provides for a timely decision by an impartial decision-maker if the grievance is not otherwise resolved. Compliance by hospitals, residential programs as defined in Section 7 which are hospital-based primary treatment programs and outpatient surgery centers with Section 144.691 and compliance by health maintenance organizations with Section 62D.11 is deemed to be in compliance with the requirement for a written internal grievance procedure.

18. Communication Privacy Patients may associate and communicate privately with persons of their choice and enter and, except as provided by the Minnesota Commitment Act, leave the facility as they choose. Patients shall have access, at their expense, to writing instruments, stationery, and postage. Personal mail shall be sent without interference and received unopened unless medically or programmatically contraindicated and documented by the physician in the medical

record. There shall be access to a telephone where patients can make and receive calls as well as speak privately. Facilities which are unable to provide a private area shall make reasonable arrangements to accommodate the privacy of patients’ calls. This right is limited where medically inadvisable, as documented by the attending physician in a patient’s care record. Where programmatically limited by a facility abuse prevention plan pursuant to the Vulnerable Adults Protection Act, Section 626.557, Subdivision 14, Paragraph (b), this right shall also be limited accordingly.

19. Personal Property Patients may retain and use their personal clothing and possessions as space permits, unless to do so would infringe upon rights of other patients, and unless medically or programmatically contraindicated for documented medical, safety, or programmatic reasons. The facility may, but is not required to, provide compensation for or replacement of lost or stolen items.

20. Services for the Facility Patients shall not perform labor or services for the facility unless those activities are included for therapeutic purposes and appropriately goal-related in their individual medical record.

21. Protection and Advocacy Services Patients shall have the right of reasonable access at reasonable times to any available rights protection services and advocacy services so that the patient may receive assistance in understanding, exercising, and protecting the rights described in this section and in other law. This right shall include the opportunity for private communication between the patient and a representative of the rights protection service or advocacy service.

22. Right to Communication Disclosure and Right to Associate Upon admission to a facility, where federal law prohibits unauthorized disclosure of patient identifying information to callers and visitors, the patient, or the legal guardian or conservator of the patient, shall be given the opportunity to authorize disclosure of the patient’s presence in the facility to callers and visitors who may seek to communicate with the patient. To the extent possible, the legal guardian or conservator of the patient shall consider the opinions of the patient regarding the disclosure of the patient’s presence in the facility. The patient has the right to visitation by an individual the patient has appointed as the patient’s health care agent under chapter 145C and the right to visitation and health care decision making by an individual designated by the patient under paragraph 22. Upon admission to a facility, the patient or the legal guardian or conservator of the patient, must be given the opportunity to designate a person who is not related who will have the status of the patient’s next of kin with respect to visitation and making a health care decision. A designation must be included in the patient’s health record.



With respect to making a health care decision, a health care directive or appointment of a health care agent under chapter 145C prevails over a designation made under this paragraph. The unrelated person may also be identified as such by the patient or by the patient’s family. (statute date: 7/1/07)

TO OUR PATIENTS: Your satisfaction is important to us. The Patient Relations Department at Regions Hospital is here to respond to any concerns, complaints, compliments or suggestions regarding your care:

Patient Relations Regions Hospital 640 Jackson Street St. Paul, MN 55101 651-254-2372

Inquiries or complaints regarding medical treatment or the Patients’ Bill of Rights may be directed to:

Office of Quality Monitoring The Joint Commission Renaissance Boulevard Oakbrook Terrace, IL 60181 800-994-6610

Minnesota Board of Medical Practice 2829 University Ave. S.E., Suite 500 Minneapolis, MN 55414-3246 800-657-3709

Office of Health Facility Complaints 85 E. Seventh Place, Suite 220 P.O. Box 64970 St. Paul, MN 55164-0970 800-369-7994

Office of Ombudsman for Long-Term Care P.O. Box 64971 St. Paul, MN 55164-0971 800-657-3591

Laboratory Quality/Safety Concerns College of Accredited Pathologists 866-236-7212 (toll free) Text provided by the Minnesota Hospital Association.

The MN Attorney General 1400 Bremer Tower St. Paul, MN 55101 651-296-3353 800-657-3787

Patients’ Bill of Rights — Federal Patient Rights Under Federal Law

A hospital must protect and promote each patient’s rights.

1. Standard: Notice of rights.

a. A hospital must inform each patient, or when appropriate, the patient’s representative (as allowed under State law), of the patient’s rights, in advance of furnishing or discontinuing patient care whenever possible.

b. The hospital must establish a process for prompt resolution of patient grievances and must inform each patient whom to contact to file a grievance. The hospital’s governing body must approve and be responsible for the effective operation of the grievance process and must review and resolve grievances, unless it delegates the responsibility in writing to a grievance committee. The grievance process must include a mechanism for timely referral of patient concerns regarding quality of care or premature discharge to the appropriate Utilization and Quality Control Quality Improvement Organization. At a minimum: (i) The hospital must establish a clearly explained procedure for the submission of a patient’s written or verbal grievance to the hospital. (ii) The grievance process must specify time frames for review of the grievance and the provision of a response. (iii) In its resolution of the grievance, the hospital must provide the patient with written notice of its decision that contains the name of the hospital contact person, the steps taken on behalf of the patient to investigate the grievance, the results of the grievance process, and the date of completion.

2. Standard: Exercise of rights.

a. The patient has the right to participate in the development and implementation of his or her plan of care.

b. The patient or his or her representative (as allowed under State law) has the right to make informed decisions regarding his or her care. The patient’s rights include being informed of his or her health status, being involved in care planning and treatment, and being able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate.



c. The patient has the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives, in accordance with § 489.100 of this part (Definition), § 489.102 of this part (Requirements for providers), and § 489.104 of this part (Effective dates).

d. The patient has the right to have a family member or representative of his or her choice and his or her own physician notified promptly of his or her admission to the hospital.

3. Standard: Privacy and safety.

a. The patient has the right to personal privacy.

b. The patient has the right to receive care in a safe setting.

c. The patient has the right to be free from all forms of abuse or harassment.

4. Standard: Confidentiality of patient records.

a. The patient has the right to the confidentiality of his or her clinical records.

b. The patient has the right to access information contained in his or her clinical records within a reasonable time frame. The hospital must not frustrate the legitimate efforts of individuals to gain access to their own medical records and must actively seek to meet these requests as quickly as its recordkeeping system permits.

5. Standard: Restraint for acute medical and surgical care.

a. The patient has the right to 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. The term ‘‘restraint’’ includes either a physical restraint or a drug that is being used as a restraint. A physical restraint is any manual method or physical or mechanical device, material, or equipment attached or adjacent to the patient’s body that he or she cannot easily remove that restricts freedom of movement or normal access to one’s body. A drug used as a restraint is a medication used to control behavior or to restrict the patient’s freedom of movement and is not a standard treatment for the patient’s medical or psychiatric condition.

b. A restraint can only be used if needed to improve the patient’s wellbeing and less restrictive interventions have been determined to be ineffective.

c. The use of a restraint must be— (i) Selected only when other less restrictive measures have been found to be ineffective to protect the patient or others from harm; (ii) In accordance with the order of a physician or other licensed independent practitioner permitted by the State and hospital to order a restraint. This order must—

i. Never be written as a standing or on an as needed basis (that is, PRN); and

ii. Be followed by consultation with the patient’s treating physician, as soon as possible, if the restraint is not ordered by the patient’s treating physician; (iii) In accordance with a written modification to the patient’s plan of care; (iv) Implemented in the least restrictive manner possible; (v) In accordance with safe and appropriate restraining techniques; and (vi) Ended at the earliest possible time.

d. The condition of the restrained patient must be continually assessed, monitored, and reevaluated.

e. All staff who have direct patient contact must have ongoing education and training in the proper and safe use of restraints.

6. Standard: Seclusion and restraint for behavior management.

a. The patient has the right to be free from seclusion and restraints, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff. The term ‘‘restraint’’ includes either a physical restraint or a drug that is being used as a restraint. A physical restraint is any manual method or physical or mechanical device, material, or equipment attached or adjacent to the patient’s body that he or she cannot easily remove that restricts freedom of movement or normal access to one’s body. A drug used as a restraint is a medication used to control behavior or to restrict the patient’s freedom of movement and is not a standard treatment for the patient’s medical or psychiatric condition. Seclusion is the involuntary confinement of a person in a room or an area where the person is physically prevented from leaving.

b. Seclusion or a restraint can only be used in emergency situations if needed to ensure the patient’s physical safety and less restrictive interventions have been determined to be ineffective.

c. The use of a restraint or seclusion must be— (i) Selected only when less restrictive measures have been found to be ineffective to protect the patient or others from harm; (ii) In accordance with the order of a physician or other licensed independent practitioner permitted by the State and hospital to order seclusion or restraint. The following requirements will be superseded by existing State laws that are more restrictive: (A) Orders for the use of seclusion or a restraint must never be written as a standing order or on an as needed basis (that is, PRN). (B) The treating physician must be consulted as soon as possible, if the restraint or seclusion is not ordered by the patient’s treating physician. (C) A physician or other Patients’ Bill of Rights – Federal licensed independent practitioner must see and evaluate the need for restraint or seclusion within 1 hour after the initiation of this intervention. (D) Each written order for a physical restraint or seclusion is limited to 4 hours for adults; 2 hours for children and adolescents ages 9 to 17; or 1 hour for patients under 9. The original order may only be renewed in accordance with these limits for up to a total of 24 hours. After the original order expires, a physician or licensed independent practitioner (if allowed under State law) must see and assess the patient before issuing a new order. (iii) In accordance with a written modification to the patient’s plan of care; (iv) Implemented in the least restrictive manner possible; (v) In accordance with safe appropriate restraining techniques; and (vi) Ended at the earliest possible time.

d. A restraint and seclusion may not be used simultaneously unless the patient is—(i) Continually monitored face-to-face by an assigned staff member; or (ii) Continually monitored by staff using both video and audio equipment. This monitoring must be in close proximity the patient.



e. The condition of the patient who is in a restraint or in seclusion must continually be assessed, monitored, and reevaluated.

f. All staff who have direct patient contact must have ongoing education and training in the proper and safe use of seclusion and restraint application and techniques and alternative methods for handling behavior, symptoms, and situations that traditionally have been treated through the use of restraints or seclusion.

g. The hospital must report to CMS any death that occurs while a patient is restrained or in seclusion, or where it is reasonable to assume that a patient’s death is a result of restraint or seclusion.

[64 FR 36088, July 2, 1999 – 10/01/2005 edition]

Federal Rights

Starting Aug. 2, 1999, patients have rights afforded them under Code of Federal Regulations at 42 CFR § 482.13. Patients have the right to file a grievance and information on whom to contact to file a grievance; participate in the development and implementation of his or her plan of care; make decisions regarding his or her care; be informed of his or her status, involved in care planning and treatment, and the ability to refuse treatment; formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives, in accordance with § 489.100, § 489.102, and § 489.104; personal privacy; receive care in a safe setting, free from verbal or physical abuse or harassment; confidentiality of his or her clinical records and the ability to access information contained in his or her clinical records within a reasonable time frame; and be free from restraints and seclusion of any form used as a means of coercion, discipline, convenience, or retaliation by staff. Patients who believe they have been aggrieved under their federal rights should refer to Right #17 in this document. The text of the federal law can be obtained by contacting the hospital patient representative. (Last statute change: 7/1/07)


D I s C H a Rg E P RO C E s s

Before I Go: Discharge ProcessThroughout your stay, your care team will be working with you to plan your discharge and follow-up care. We hope that you will involve a close family member or friend in a conference with your team at least once during your hospitalization, as well as when the nurse reviews your discharge summary. We know that it can be difficult to get to follow-up outpatient appointments. We may ask you to personally call the physician or therapist to schedule your follow-up outpatient appointment so it will be set up for the day and time that works best for you. Your care team will work to make the discharge process as efficient as possible for you.

Discharge planning helps to make sure that you leave the hospital safely and smoothly.

I know my wellness recovery goals.

I’ve arranged my ride home.

I have all the signatures I need to return to work, file for disability insurance, etc.

I’ve let my doctor know where I want my discharge medications filled.

I understand how to take my medications.

I’ve received my written discharge instructions.

I have all of my personal belongings, including any medications I brought from home.

My follow up appointment is (date/time/location/provider):

Questions before I leave:

Mental HealthA Guide to Patient Services

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Relaxation TipsWe understand that coming to the hospital can be stressful. Here are some things you can do to relax and reduce anxiety. You may need to try various activities at different times to get the relaxation you’re looking for. • Deep breathing• Journal writing• Meditation• Exercise (Yoga, Tai Chi, stretching, walking)• Call someone for support• Puzzles or games

• Reading• Crafts• Watch a funny movie• Get a good night’s sleep• Eat healthy foods

Stress Rating Scale Using the stress rating scale helps your care team determine the best way to meet your needs.

0 1 2 3 4 5 6 7 8 9 10

My Coping Skills: 1.

2.

3.

Calm Crisis


















Patient Promises:•Be honest with staff about

your level of safety

•Follow through with treatment recommendations

•To speak openly and honestly with staff

•Attend groups

•Contact support system

•Respect unit guidelines

•Set future goals

•Involve support system in your discharge planning

“Circle of Support” is the name of our inpatient mental health model of care. At Regions, we engage you with three kinds of support. Support from us at Regions where we provide the best care, best experience possible, support and skills for you to feel empowered to continue taking care of yourself. Support for those closest to you to develop a game plan so they understand the best ways to help. Support for you as you continue your recovery in your home and community. Knowing you have the circle of support is a great feeling.

Circle of SupportRegions Hospital Mental Health

Here are the promises of our staff and our patients, and the promises that we share.

Staff Promises: •Respectfully listen, provide

support, teach and guide

•Provide continuity of care

•Provide a safe and healing environment

•Involve patient’s support system

•Provide hope for the future

•Utilize teamwork & resources to address patient needs

•Provide evidence based, individualized medical care and treatment

Shared Promises:•Safety

•Respect

•Recovery

•Involvement of support system

relaxation tips mental health - healthpartnershp/... · 2014-11-22 · additional resources regions...

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