We want to encourage you, as a patient at Valley Healthcare, to speak openly with your health care team, take part in your treatment choices, and promote you own safety by being well informed and involved in your care. Because we want you to think of yourself as a partner in your care, we want you to know your rights as well as your responsibilities while you are under our care. We invite you and your family to join us as active members of your care team.

• You have the right to receive considerate, respectful and compassionate care in a safe setting regardless of your age, gender, race, national origin, religion, sexual orientation, gender identity or disabilities.
• You have the right to be called by your proper name and to be in an environment that maintains dignity and adds to a positive self-image.
• You have the right to be told the names of your doctors, nurses, and all health care team members directing and/or providing your care.
• You have the right to have a family member or person of your choice and your own doctor notified promptly if you are admitted to a hospital.
• You have the right to have someone remain with you during your office visit unless your visitor’s presence compromises your or others’ rights, safety or health.
• You have the right to be told by your doctor about your diagnosis and possible prognosis, the benefits and risks of treatment, and the expected outcome of treatment, including unexpected outcomes. You have the right to give written informed consent before any non-emergency procedure begins.
• You have the right to have your pain assessed and to be involved in decisions about treating your pain.
• You have the right to be free from restraints and seclusion in any form that is not medically required.
• You can expect full consideration of your privacy and confidentiality in care discussions, exams, and treatments. You may ask for an escort during any type of exam.
• You have the right to access protective and advocacy services in cases of abuse or neglect. Valley Healthcare will provide a list of these resources.
• You, your family, and friends with your permission, have the right to participate in decisions about your care, your treatment, and services provided, including the right to refuse treatment to the extent permitted by law. If you leave the office against medical advice, Valley Healthcare nor its doctors will be responsible for any medical consequences that may occur.
• You have the right to agree or refuse to take part in medical research studies. You may withdraw from a study at any time without impacting your access to standard care.
• You have the right to communication that you can understand. Valley Healthcare will provide sign and foreign language interpreters as needed at no cost to you. Spanish speaking interpreters are on staff. Information given will be appropriate to your age, understanding, and language. If you have vision, speech, hearing, and/or other impairments, you will receive additional aids to ensure your care needs are met.
• You have the right to make an advance directive and appoint someone to make health care decisions for you if you are unable. If you do not have an advance directive, we can provide you with information and help you complete one.
• You have the right to receive detailed information about your office charges.
• You can expect that all communication and records about your care are confidential, unless disclosure is permitted by law. You have the right to see or get a copy of your medical records. You have the right to request a list of people to whom your personal health information was disclosed.
• If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by, or for Valley Healthcare. To request an amendment, you request must be made in writing and submitted to the Privacy Officer and you must provide a reason that supports your request. We may deny your request for an amendment.
• You have the right to give or refuse consent for recordings, photographs, films, or other images to be produced or used for internal or external purposes other than identification, diagnosis, or treatment. You have the right to withdraw consent up until a reasonable time before the item is used.
• You have the right to voice your concerns about the care you receive. If you have a problem or complaint you may talk with your provider, the Clinical Coordinator and/or Risk Manager. We request you place all complaints in writing as well as verbally.
• You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care, like a family member or friend. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to the Privacy Officer.
• You have the right to opt out of receiving fundraising communications from Valley Healthcare.
• You have the right to restrict disclosures of PHI to a health plan if the disclosure is for payment of health care operations and pertains to a health care item or service for which you have paid out of pocket in full.
• You have the right to request that we communicate with you about medical matters in a right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.

HOW TO FILE A COMPLAINT OR GRIEVANCE

If you believe your privacy rights have been violated you may file a complaint or grievance. Complaints or grievances may be filed with Valley Healthcare or with the Secretary of the Department of Health and Human Services.

To file a complaint with Valley Healthcare, contact the Risk Manager at (706) 987-8340 and/or 1600 Fort Benning Road, Columbus, GA 31903. All complaints must be submitted in writing.

To file a complaint with the Department of Health and Human Services, go to www.hhs.gov/ocr/privacy/hipaa/complaints/ for instructions on filing a complaint.