Patient Rights & Responsibilities

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Notice for Use and Sharing of Protected Health Information: The federal Office of Civil Rights implemented the Health Insurance Portability and Accountability Act (HIPAA) to promote privacy and trust between patients and their health care providers. As part of these rules, all new patients seeing their health care provider upon their initial visit are required to sign an acknowledgement form to indicate that they have received the Privacy Notice. The Privacy Notice describes how the hospital/provider uses and shares your personal health information.

ORGANIZED HEALTH CARE ARRANGEMENT NOTICE

This notice describes Mass General Brigham’s participation in an Organized Health Care Arrangement. Read about the organized health care arrangement

YOUR RIGHTS AS A PATIENT

As a patient, you have the right to be notified, in writing, of the following rights and responsibilities before services are provided. You have the right to exercise these rights. Your family or guardian may exercise these rights should you be judged incompetent. Health care providers are obligated to protect and promote your rights. You have the right to have a family member or representative of your choice and your own physician notified promptly of your admission.

RIGHT TO DIGNITY AND RESPECT:

You have the right –

To have a family member, friend or other individual present for emotional support during your stay.
To be treated with respect and dignity.
To professional relationships with those caring for you that are based on honesty and ethical standards of conduct.
To medically appropriate services without discrimination based upon your race, color, national origin, citizenship, alienage, religion, creed, sex, sexual orientation, gender identity, age, or disability.

RIGHT TO BE INFORMED:

You have the right –

To an explanation of any rules and regulations pertaining to your care
To know how medical information will be used and discussed in relationship to treatment, payment, or health care operations.
To full information and counseling concerning your diagnosis, treatment, prognosis, and the availability of known resources related to your health care.
To access, inspect, copy, request amendments and corrections, restrict disclosures and request privacy protection to, your medical record.
To be given the names and disciplines of all health care personnel who participate in your care.
To all information contained in your medical records maintained by us, unless prohibited by law, upon written request to: MGH Release of Information, 121 Inner Belt Road, Room 240, Somerville, MA 02143-4453
To receive information in a manner that you understand.

RIGHT TO QUALITY OF CARE:

You have the right –

To receive competent, medically appropriate, quality care provided in a timely manner.
To interpreter services as needed.
To expect compliance with accepted professional standards of care, policies, procedures, and requirements necessary to maintain licensure by the Commonwealth of Massachusetts and Medicare certification.
To expect your health care will be provided in accordance with your physician’s specific orders and that a plan of care specifies the services to be provided, including the expected frequency and duration of those services.
To expect all personnel caring for you are licensed, certified and/or have completed approved courses in their respective field.
To expect all providers of care are supervised by qualified persons to continually maintain high professional standards of care.
To have prompt attention paid to complaints of pain and/or discomfort.
The right to receive care in a safe setting that includes environmental safety, infection control and physical security.
To accommodation of your religious and spiritual needs.
To respect, dignity and comfort.
To be free from all forms of abuse and harassment.

RIGHT TO PRIVACY AND CONFIDENTIALITY:

You have the right –

To every consideration of maintaining your privacy concerning your medical care and confidentiality of information regarding your health, social, and financial circumstances.
To have all records pertaining to your medical care treated as confidential, except as otherwise provided by law or third-party contractual agreements. Information from your records will not be disclosed without your consent, except as necessary to provide services to you and obtain payment for those services, or in response to a valid subpoena or court order.
To personal privacy during medical treatment or other rendering of care within the facility’s capabilities.

RIGHT TO MAKE INFORMED DECISIONS AND PARTICIPATION:

You have the right –

To be treated by the physician of your choice and to assistance in obtaining consultation.
To participate in the development and periodic review of your plan of care designed to meet your individual needs.
To formulate an advance directive and to have those preferences respected within the extent of the law, and to be informed of and receive information about our policies on advance directives.
To refuse treatment to the extent permitted by law and to be informed of the likely medical consequences of your decisions.
To voice your concerns regarding the quality of care.
To express grievances regarding treatment, or care that is (or fails to be) furnished, or regarding the lack of respect for your dignity, privacy, and safety, and without fear of discrimination or reprisal.
To lodge such concerns or grievances with us by calling the President’s Office at (508) 825-8200.
Timely attention to all your concerns and grievances.
To know the disposition of your complaints in writing.
A written discharge plan.
To refuse to be examined, observed, or treated by staff or students, without jeopardizing access to psychiatric, psychological or other medical care.
To decline to serve as a research subject and decline any care or examination when the primary purpose is educational or informational rather than therapeutic.

RIGHT TO FINANCIAL INFORMATION:

You have the right –

To receive upon request information regarding financial assistance.
Upon request, an estimate of your out of pocket financial responsibility for outpatient treatment

PATIENT RESPONSIBILITIES:

You have the responsibility –

To treat your health care providers with respect and dignity.
To give health care personnel accurate information so that appropriate decisions can be made about your care.
To give your nurse and/or physician accurate information about your health (past and present), medical advice you previously received and/or current treatments you are following, and any medications you are using.
To inform your physician or nurse of changes in your health or reactions to medication and/or treatment.
To inform health care personnel if you do not understand any instructions pertaining to your care.
Follow the plan of care/treatment program agreed upon.
To provide accurate information necessary for payment of services.
To keep your scheduled appointments with your physician.

PATIENT CODE OF CONDUCT

Everyone should expect a safe, caring, and inclusive environment in all our spaces. Our Patient Code of Conduct helps us to meet this goal. Words or actions that are disrespectful, racist, discriminatory, hostile, or harassing are not welcome.

Examples of these include:

Offensive comments about others’ race, accent, religion, gender, sexual orientation, or other personal traits
Refusal to see a clinician or other staff member based on these personal traits
Physical or verbal threats and assaults
Sexual or vulgar words or actions
Disrupting another patient’s care or experience
Read the full Patient Code of Conduct here

For Comments or Complaints:

President’s Office: Nantucket Cottage Hospital
57 Prospect St., Nantucket, MA 02554 | 508-825-8200
VP Quality and Patient Experience: 508-825-8118
24/7 Compliance Line: 1-800-856-1983 or https://app.mycompliancereport.com/report?cid=PHC

Nantucket Cottage Medical Group (NCMG) Complaints
The Compliance Team, Inc.
PO Box 160, 905 Sheble Lane, Suite 102
Spring House, PA 19477
www.thecomplianceteam.org
QA@thecomplianceteam.org
Ph: 1-888-291-5353
Massachusetts Bureau of Health Professions Licensure
239 Causeway Street, Boston, MA 02114
Ph: 617-973-0865 | Fax: 617-973-0985
TTY: 617-973-0988
Massachusetts Department of Public Health
Division of Health Care Quality
67 Forest Street, Marlborough, MA 01752
Ph: 617-753-8000
The Joint Commission Office of Quality Monitoring
Office of Quality and Patient Safety
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Ph: 1-800-994-6610 | Fax: 1-630-792-5636
patientsafetyreport@jointcommission.org

Dialysis Complaints: The ESRD Network of New England, Inc.,
30 Hazel Terrace, Woodbridge, CT 06525 | 203-387-9332
Patients and Families Only: Toll Free: 1-866-286-3773 | Fax: 203-389-9902

Mammography Complaints: American College of Radiology
Fax: 703-648-9176 | Mamm-accred@acr.org or Department of Public Health, Radiation Control Program: 617-242-3035

11 / 12 / 2024

11 / 4 / 2024

10 / 29 / 2024

Patient Rights & Responsibilities

Meet your Nantucket Cottage Hospital clinicians
across more than 30 different subspecialties:

Patient Rights & Responsibilities

Meet your Nantucket Cottage Hospital clinicians across more than 30 different subspecialties:

Meet your Nantucket Cottage Hospital clinicians
across more than 30 different subspecialties: