12
speak to the Nursing Supervisor if you have a
concern. Concerns may also be addressed to
the Georgia Department of Human Resources,
Office of Regulatory Services at 404-657-5728.
In addition, you may contact DNV for any
patient care and safety concerns that are not
resolved by the hospital by calling 1-866-496-
9647 or completing the online form at http://
dnvglhealthcare.com/patient-complaint-report.
• Have a family member or representative of your
choice or own physician notified promptly of
your admission to the hospital.
• Receive care in a safe and secure environment.
• Be free from all forms of abuse including
mental, physical, sexual, and or verbal abuse,
neglect, harassment, or exploitation.
• Be free from seclusion or restraints of any form
that are not medically necessary.
• Receive information about pain and pain
relief measures as appropriate to the medical
diagnosis or surgical procedure.
• A concerned staff committed to pain
prevention and management.
• Effective communication. If you need a
translator, one will be provided for you for
language interpreting and translation services.
• Have information provided to you if you
have vision, speech, hearing, or cognitive
impairments in a manner that meets your
needs.
• Consent or refuse to participate in any research
or treatment that is considered experimental in
nature and to have those studies fully explained
prior to consent.
• Participate in decisions regarding ethical
issues surrounding your care, treatment,
and services, including issues of conflict
resolution, withholding resuscitation, forgoing
or withholding of life sustaining treatment
and participations in investigational studies
or clinical trials. You may ask your nurse or
physician to consult the Ethics Committee
for resolution of conflicts in decision making
regarding your care.
• Have your spiritual, psychosocial and cultural
beliefs respected.
• Have access to protective, and advocacy
services, if necessary.
• Access information contained in your medical
records (inspect and obtain a copy), within a
reasonable time frame and have information
explained or interpreted as necessary, except as
restricted by law.
• Request restrictions on the hospital’s use and
disclosure of protected health information.
• Receive confidential communications about
your protected information in a certain way or
at a certain location. The hospital will grant any
reasonable request.
• An accounting of disclosures of your protected
health information made in the 6 years prior to
the date of request, except for disclosures to
carry out treatment, payment and healthcare
operations.
• Request that your medical information be
amended. The hospital will respond to all
requests. The hospital may deny a patient’s
request if the medical information is accurate
and complete, or if the request pertains to
information the hospital did not create.
• Receive a copy of Evans Memorial Hospital’s
Notice of Privacy Practices for Protected Health
Information.
• Examine and receive an explanation of your
hospital bill, regardless of the source of
payment.
• Respect patient’s right to refuse care,
treatment, and services, in accordance with law
and regulations.
/patient-complaint-report