Legalities in health care

1. Legalities in health care

2. Patients’ bill of rights • First adopted by the American Hospital Association in 1973 • Revised in 1992

3. Rights—in summary • 1. Receive considerate and respectful care • 2. Receive complete current information concerning his/her diagnosis, treatment, and prognosis. • 3. Receive information necessary to give informed consent prior to the start of any procedure and/or treatment. • 4. Refuse treatment to the extent permitted by law. • 5. Receive every consideration of his or her privacy. • HIPAA (Health Insurance Portability and Accountability Act) • 6. Be assured of confidentiality. • 7. Obtain reasonable responses to requests for services. • 8. Obtain information about his or her health care. • 9. Know whether treatment is experimental. • 10. Expect reasonable continuity of care. • 11. Examine his/her bill and have it explained. • 12. Know which hospital rules and regulations apply to patient conduct.

4. Informed Consent: a legal condition in which a person agrees to terms after he or she understands all the facts and implications of an event or action

5. Patient Responsibilities • To follow any instructions given by the physician and to cooperate as much as possible. • To give all relevant information to the physician in order to reach a correct diagnosis • If an incorrect diagnosis is made because the patient fails to give the physician proper information, the physician may not be liable. • To follow the physician’s orders for treatment, provided the treatment meets the accepted standard of care. • If patient willfully or negligently fails to follow the physician’s instructions, that patient may have little legal recourse. • To pay fees charged for services rendered.

6. Legislation • HIPAA • Health Insurance Portability and Accountability Act • Law regulating the sharing of medical information • Information in medical records • Conversations between health providers about patient care of treatment • Health insurance information • Patient billing information • Most other information about patient health • However, there are exceptions • Suspected fraud, births, deaths, injuries caused by violence • Drug abuse, communicable disease, and STDs

7. Legislation • Advanced Directives • A legal contract designed o help patients communicate their wishes about medical treatment at a time in which illness/injury makes them unable to make their wishes known • Two types • Living Wills • Healthcare Durable Power of Attorney

8. Living wills • Legal document prepared by a patient • Instruction about the health care to be provided if the patient becomes terminally ill or falls into a permanent coma or vegetative state • Specifies life support • Feeding tubes • IV hydration • Resuscitation

9. Power of Attorney • A patient can legally appoint a health care professional, family member, or friend to make health care decisions on behalf of the patient • Goes into effect when the patient can no longer think clearly or communicate • Patient regains the right to make health care decisions when they are able to communicate

10. Long-term care bill of rights • Guaranteed rights under Omnibus Budget Reconciliation Act (OBRA) of 1987 • Rights must be posted and visible in all long-term care facilities

11. ltcbor • PARAPHRASE the following: • Free choice regarding physician, treatment, care, and participation in research • Freedom from abuse and chemical/physical restraints • Privacy and confidentiality • Accommodation of needs and choice regarding activities, schedules, and health care • Voice grievances without fear of retaliation or discrimination • Organize and participate in family/resident groups and in social/religious/community activities • Information on medical benefits, records, survey results and deficiencies of the facility and advocacy groups who check on resident care and violation of rights • Manage personal funds and use personal possessions • Unlimited access to immediate family or relatives

12. Compare and contrast

13. Post-comparison questions • What do you notice about the difference between the two Bills of Rights • Why do you think the LTRBoR specifies rights about belongings and family members, while this is omitted from the PBoR? Aren’t residents patients as well?