Release of Information Form
- Every employee will be knowledgeable and supportive of all patient rights and responsibilities and will be able to effectively communicate these to patients and family members.
Employees will take responsibility ensuring compliance with the patient rights and responsibilities by:
- educating patients and families about patient rights and responsibilities
- working with Guest Services to resolve patient and family issues
- Admitting personnel will ensure that each in-patient receives a written copy of the patient rights and responsibilities at TMC.
- Ambulatory personnel will maintain a supply of brochures on patient rights and responsibilities in Ambulatory and Emergency Department areas.
Patient Rights at TMC
The patient and/or their legal representative shall expect the following rights:
- Receive medically necessary treatment and the appropriate level of care. regardless of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity of expression, or source of payment for care.
- Be informed of his/her health status, including diagnosis and prognosis.
- Availability of Language Access interpreters, assistive devices such as TDD machines or auxiliary aids at no cost, if the patient has fluency challenges, mental or physical impairments.
- Consult other hospital services for his/her needs, such as Social Work Services (including protective services), Spiritual Health Services, Clinical Nutrition, etc.
- Access, directly or through a representative, to information in his/her clinical records within a reasonable time frame and at a cost within community standards or HIPAA requirements.
- Reasonable continuity of care following hospitalization.
- Patients cannot be denied admission or services solely on grounds of prior treatment, withdrawal from treatment against advice, or continuation or return of symptoms after prior treatment.
- Considerate, honest and respectful care.
- Respect for cultural, psychosocial, spiritual, and personal values, beliefs, and preferences.
Confidentiality and Privacy
- Confidentiality of all medical records and communication to the extent permitted or required by law.
- The highest level of personal privacy and dignity that his/her healthcare team can provide in a hospital setting.
- Be cared for in a safe and clean environment
- Freedom from all forms of abuse, neglect, harassment or indiscretions.
- Be free from seclusion and restraints of any form that are not medically necessary.
- Be notified of unanticipated outcomes.
Involvement in the Patient’s Care
- Be involved in development and implementation of his/her care plan, involved in his/her care planning and treatment , and make informed decisions about his/her care
- To get information and education, in written or verbal communication, about his/her health status in order to make informed decisions. This includes diagnosis, prognosis, risks and benefits of treatment options and services needed.
- To receive written or verbal communication in a way the patient can understand.
- Request an amendment to, and receive an accounting of, disclosures regarding his/her health information.
- Accept or refuse treatment, within the law, be informed of the possible consequences of his/her decision, and be responsible for consequences of that decision.
- Have a family member, representative of the patient’s choice, and/or his/her physician notified promptly of the patient’s admission
- Have his/her questions and concerns heard and addressed by his/her healthcare team.
- Appropriate assessment and management of his/her pain.
- Know the names of those caring for him/her and their roles in providing services and care.
- Review and consideration of any ethical concerns regarding care or treatment.
- Designate someone to make healthcare decisions for him/her in the event the patient is unable to make decisions about his/her own care.
- Be transferred to another facility when medically permissible and to have the reason, benefits, risks and alternatives explained prior to the transfer.
- Make end-of-life decisions, document those decisions (“advance directive”), and have advance directive placed in the patient’s medical record. Be assisted by hospital staff in the explanation or preparation of this document.
- Participate in discharge planning, including being informed of service options available and a choice of agencies.
- The patient or designee may consent or refuse care that involves research, experimental treatment or education projects; have his/her rights protected during research, investigation and clinical trials.
- Receive information about organ donation.
- An explanation of charges for the patient’s medical treatment, regardless of the payment source.
- Not restrict, limit or deny your visitation privileges on the basis of race, color, national origin, sex, gender identity, sexual orientation or disability.
- Have visitors of your choice, including but not limited to spouse, domestic partner, same sex partner, family members or friends, provided that the visitors do not interfere with medical care.
- Withdraw consent to be visited by any visitor at any time.
- TMC does not assume responsibility for the loss of personal belonging brought into TMC
- Patients/patients’ representatives are discouraged from bringing valuables into the hospital.
- If belongings are brought into the hospital and patients are unable to safeguard them, and they inform TMC staff of the need for assistance, staff will take reasonable steps to safeguard the belongings .
- Voice concerns to any member of the patient’s healthcare team and to expect efforts made to resolve the concern
- Voice concerns regarding quality of care or services and to expect those concerns will be addressed according to the hospital grievance policy
Contact Guest Services to voice concerns:
- At TMC Hospital Hill: (816) 404-3325
- At TMC Lakewood: (816) 404-7840
- At Behavioral Health: (816) 404-6032
- After regular business hours: Director of Shift Operations (DSO), by calling the hospital operator
4. Directly contact outside organizations with concerns regarding patient care:
- Missouri Department of Health and Senior Services, Health Standards and Licensure Section, P.O. Box 570, Jefferson City, Missouri 65102, (573) 751-6303 or 1-800-392-0210
- Missouri Department of Mental Health, P.O. Box 687, Jefferson City, Missouri, 65102, 1-800-364-9687
- The Joint Commission, Office of Quality Monitoring, 1 Renaissance Boulevard, Oakbrook Terrace, Illinois, 60181, 1-800-994-6610
Patient and visitors are expected to comply with the following responsibilities:
- Provide correct and complete information on present and past illnesses, injuries, hospitalizations, medications and other health matters
- Ask questions to his/her healthcare team when he/she doesn’t understand, provide answers to questions asked by the healthcare team, and be involved in his/her care.
- Follow the treatment plan his/her healthcare team has developed. Accept consequences of refusing treatment or not following the healthcare team’s instructions.
- Provide a copy of his/her advance directive at every visit.
- Protect personal items brought into the hospital or send them home.
- Respect the rights and privacy of other patients and hospital personnel, the property of others in the hospital; follow hospital rules and regulations, including the Tobacco Free policy, including no smoking on any TMC property, and insist their visitors do the same.
- Be on time for medical appointments or call in advance to reschedule.
- Provide accurate and complete information in order for TMC to receive payment for services.
- Keep the hospital a quiet and restful place.
- Do not use foul, threatening or inappropriate language. Never hit or threaten another family member another patient or staff. Never bring a weapon into the hospital.
TMC provides multiple methods of communicating patient rights and responsibilities.
- Employees are introduced to patient rights and responsibilities in orientation.
- Patient Rights and Responsibilities are posted in high traffic areas throughout Truman Medical Centers.
- Patients receive a copy of patient rights and responsibilities at the time of admission.
- Patient Rights and Responsibilities brochures are available in the Ambulatory Care and Emergency Department areas.
- Guest Services staffs are available to discuss or explain patient rights and responsibilities or to discuss compliments, concerns, or suggestions.
Truman Medical Centers (TMC) recognizes the importance of visitors in our patients’ healing process. Patients have the right to choose who may visit them during their stay at the Hospital, as well as the right to withdraw such consent at any time. All visitors designated by the patient (or Support Person) shall enjoy visitation privileges that are no more restrictive than those that immediate family members enjoy.
Support Person: A family member, spouse, domestic partner, (including a same sex domestic partner) friend or other individual regardless of age, race, ethnicity, religion, culture language, physical or mental disability , socioeconomic status, sex, sexual orientation, and gender identity or expression who arrives or is designated to support the patient during the course of the patient’s stay. The Support Person has the option to exercise the patient’s visitation rights on the patient’s behalf, if the patient is unable to do so. Such individual may but need not be an individual legally responsible for making medical decisions on the patient’s behalf.
Notice of Privacy Practices
Notice of Privacy Practices
Effective date: September 23, 2013
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
Our Commitment to Your Health Information
We understand that your medical information is very personal. We are committed to protecting information about the healthcare services you receive at TMC. This notice will be followed by every healthcare provider at every location at which TMC provides medical services.
Your Health Information Rights and Limits on Those Rights
Your medical record is the physical property of TMC. You have the right to:
- Inspect and obtain a copy of your medical record;
- Request limits on certain uses and disclosures of the information;
- Request amendments to your medical record;
- Request a record of disclosures other than for payment, treatment or healthcare operations, or as authorized by you;
- Request that a different phone number or address be used for communications or that an alternative method of providing information be utilized; and
- Revoke any authorization to use or disclose your medical record except to the extent that action has already been taken with that information.
We are required to:
- Make sure your medical information is kept private;
- Give you this Notice of Privacy Practices;
- Follow the terms of the Notice of Privacy Practices in effect;
- Notify affected individuals following a breach of unsecured Protected Health Information (PHI);
- Notify you if we are unable to agree to your request to limit the use or disclosure of your health information; and
- Try to meet reasonable requests to communicate your medical information by other means or at other locations.
We reserve the right to change our practices and to be sure the new practices keep all medical information safe. Should this Notice change, we will post a revised Notice on www.trumed.org and throughout our facilities, and will have copies available for you. We will not use your medical information without your permission, except as described in this Notice or allowed by law.
How We May Use and Disclose Medical Information
For each category of uses or disclosures, we will explain what we mean and try to give examples. All of the ways we are permitted to use and disclose information will fall into one of the categories.
Treatment: Your health information may be shared with others who provide you with medical treatment or services. For example, upon discharge from an inpatient hospitalization TMC may provide information to outside healthcare providers who are following up with you on your medical condition.
Payment: Your health information may be shared with insurance companies and other third parties to collect payment for the services received. For example, TMC may give your insurance company information about your surgery so they will pay for the treatment.
EXCEPTION: You have the right to restrict disclosure for payment purposes when you agree to be self pay and pay for the services in full.
Healthcare Operations: Your health information may be shared in order to support business activities that are considered necessary to TMC. For example, TMC may use your health information to conduct quality assessment and improvement activities, to review competence or qualifications of healthcare professionals or for reviews by external agencies for licensure, accreditation or auditing.
Appointment Reminders: We may provide reminders by mail, secure email, text messages, or phone, or by leaving messages according to your specifications.
Treatment Alternatives: We may provide you with information about treatment alternatives and other health related benefits and services.
Required by Law: We disclose information as required by federal, state or local law. For example, we are required to report gunshot wounds to the police.
Law Enforcement: We may disclose health information for law enforcement purposes as required by law, pursuant to a court order, warrant, subpoena or summons.
To prevent a serious threat to health or safety: We may use or disclose health information about you to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Hospital Directory: Unless you object, we will place your name, your location in the hospital, general condition and religious affiliation in a hospital directory. If you do not want to be included in this directory, please tell a Patient Access Representative when you are admitted.
Individuals involved in your care or payment for your care: Unless you object, TMC may share your medical information with your family, friends or others identified by you who are involved in your medical care or payment. TMC may also share your medical information for disaster relief efforts and with family members, or others so that they can be told about your location or condition.
Disaster Relief/Emergencies: Unless you object, TMC may share your medical information in emergencies, tell you later, and give you the right to object to future sharing.
Public Health: As required by law, TMC may disclose your health information to public health agencies or authorities charged with preventing or controlling disease, injury or disability, or to report a suspected case of abuse or neglect.
Organ and Tissue Procurement Organizations: TMC may disclose health information to organizations that handle organ, eye and tissue transplantation or to an organ bank as necessary to facilitate organ or tissue donation.
Marketing: We will ask your permission to use or disclose your medical information for marketing purposes.
Fundraising: Unless you object by telling the TMC Charitable Foundation at 816-444-3430 the Foundation may contact you for fundraising purposes.
Research: TMC may disclose your medical information to researchers when their research has been approved by an institutional review and privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.
Business Associates: We may contract with outside businesses to provide some services for us. For example, we may use the services of transcription or billing agencies. Under such contracts, we may share your medical information with them to do the job we have asked them to do. These contracts require businesses to protect the medical information we share with them.
Coroners and Funeral Directors: We may disclose information to coroners or medical examiners for the identification of a body or to determine cause of death. We may also disclose information to funeral directors to carry out their duties.
Correctional Institutions: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your health information to the institution or official.
Health Oversight Activities: Your health information may be disclosed to governmental agencies and boards for investigation, audits, licensing and compliance purposes.
Legal Proceedings: If you are involved in a lawsuit or dispute, we may disclose health information about you in response to a subpoena, court order or administrative order.
Military and Veterans: If you are a member of the armed forces, we may release health information about you as required by the military.
National Security Efforts: We may disclose medical information about you to authorized federal officials so that they may provide protection to the President and other authorized individuals or for the purposes of intelligence, counterintelligence and other national security activities authorized by law.
Other Uses and Disclosures of Medical Information: Other uses and disclosures of medical information not covered by this notice or required by law may require your approval.
Use of Health Information Exchanges
A health information exchange is an electronic method to share medical information about your care with other health care providers who have an established treatment relationship with you. We participate in health information exchanges and may use or disclose your information with those health information exchanges. You may obtain more information about the exchange or begin the opt-out process by contacting TMC Health Information Management at 816-404-3125.
For More Information or to Report a Problem
If you feel that your privacy rights have been violated, you can file a complaint by calling our toll-free Compliance Concern line at 1-866-494-3600, or you may file a complaint with the Secretary of the United States Department of Health and Human Services. You will not be penalized for filing a complaint.