Rockcastle Regional Hospital and Respiratory Care Center, Inc., Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Rockcastle Regional Hospital and Respiratory Care Center, Inc. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Patients Have the Right To:

1. 1. receive care in a safe, respectful and dignified setting;
2. 2. effective communication and to receive information in manner they understand;
3. 3. participate in the development and implementation of the plan of care, discharge plan, and pain management plan;
4. 4. participate in decisions about your care, treatment, and services;
5. 5. be informed of your health status and provided with information to allow you to make informed decisions about your care;
6. 6. request care, this right does not mean you can demand care or services that are not medically indicated;
7. 7. refuse care, treatment and services;
8. 8. receive information about the individual(s) responsible for providing your care, treatment and services;
9. 9. formulate or review or revise advance directives and have hospital staff and practitioners comply with these directives; (Advance directives are not honored during surgery but will resume upon recovery from anesthesia);
10. 10. have choices about end of life decisions respected;
11. 11. have organ donor wishes honored;
12. 12. give or withhold informed consent;
13. 13. have a family member or support person of your choice and your physician notified promptly of admission to the hospital;
14. 14. be informed of whom to contact at the hospital to file a grievance and to have complaints reviewed by the hospital;
15. 15. personal privacy;
16. 16. religious and other spiritual services;
17. 17. be free from neglect; exploitation; and verbal, mental, physical and sexual abuse and harassment;
18. 18. be free from restraints of any form that are not medically necessary;
19. 19. confidentiality of your clinical records;
20. 20. access, request amendment to, and obtain information on disclosures of your health information, in accordance with law and regulation, within a reasonable time frame;
21. 21. have your questions about any costs or bills answered;
22. 22. to access protective and advocacy services;
23. 23. designate a support person, if needed, to act on your behalf to assist and protect your rights;
24. 24. be informed of your visitation rights, including any clinical restriction or limitation on such rights;
25. 25. based on your consent and preferences to receive visitors whom you designate and to withdraw or deny consent for visitation; and
26. 26. be informed of any continuing healthcare requirements following discharge.

Rockcastle Regional Hospital and Respiratory Care Center, Inc:

Provides free aids and services to people with disabilities to communicate effectively with us, such as:

• Qualified sign language interpreters
• Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provides free language services to people whose primary language is not English, such as:

• Qualified interpreters
• Information written in other languages

If you need these services, contact us at 606-256-2195.

Patient/Patient Representative Responsibilities Include:

1. 1. You are responsible for providing accurate and complete information about your medical history, including past illnesses, hospitalizations, medications, pain, sensitivities or allergies to drugs and other agents, and other matters related to your health.
2. 2. You are responsible for informing your healthcare providers of any change in your condition or reaction to your treatment.
3. 3. You are responsible for asking questions if you do not understand your plan for care, treatment or services.
4. 4. You are responsible for following the care, treatment, and service plan established by your physician, including the instructions of other health professionals.
5. 5. You are responsible for expressing concerns about your ability to follow and comply with the proposed care, treatment and services.
6. 6. You are responsible for accepting the consequences for refusing treatment or not following healthcare providers’ instructions.
7. 7. You are responsible for providing accurate insurance information for processing bills and ensuring that financial obligations are fulfilled.
8. 8. You are responsible for following hospital rules and regulations affecting your care and conduct. SMOKING IS PROHIBITED WITHIN THE HOSPITAL. You are responsible for accepting medical consequences if you choose to go outside to smoke.
9. 9. You are responsible for showing consideration and respect for other patients, staff and property. This includes limiting the number of visitors when this interferes with others rights, observing the NO SMOKING Policy, and avoiding noisy, threatening, or disruptive behavior.
10. 10. You are responsible for informing the hospital of advance directives and the appointment of a surrogate on your behalf.
11. 11. You are responsible for informing healthcare providers if your pain has not been relieved and working with them to develop and follow a pain management plan.
12. 12. You are responsible for notifying healthcare providers as soon as possible if your rights have been or may be violated.

Complaints and Concerns (Patient Grievance Process):

At Rockcastle Regional Hospital and Respiratory Care Center, Inc., we strive to make your stay as pleasant as possible. In the event that there is a conflict concerning your care or treatment, every effort will be made to resolve the conflict in a way that best meets your needs. If problems do arise during your stay, please contact a nurse (or staff assisting with care), a quality representative Tammy Brock at 606-256-7733, or administration at 606-256-7703.

It is the policy of Rockcastle Regional Hospital and Respiratory Care Center, Inc. not to discriminate on the basis of race, color, national origin, sex, age or disability. Rockcastle Regional Hospital and Respiratory Care Center, Inc. has an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 of the Affordable Care Act (42 U.S.C. 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S. Department of Health and Human Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities. Section 1557 and its implementing regulations may be examined in the office of Tammy Brock, 145 Newcomb Ave, Mount Vernon, KY 40456; 606-256-7733; Facility TTY number 1-606-256-0556; who has been designated to coordinate the efforts of Rockcastle Regional Hospital and Respiratory Care Center, Inc. to comply with Section 1557.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

You also have the right to file a complaint with the state survey agency, Cabinet for Health Services, Office of Inspector General, Division for Community Health Services or Division of Long-Term Care, 85 State Police Road, London, KY 40741-9008; Phone 606-330-2030; Fax 606-330-2054. For your Convenience, patient advocacy agencies are listed below.

Adult Protective Services 606-256-2138
Ombudsman 606-864-7391 or 1-800-372-7391
Medicaid Fraud 502-696-5405
Medicare Fraud 1-800-447-8477
Joint Commission 1-800-994-6610

Español (Spanish)
ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-606-256-2195 (TTY: 1-606-256-0556).

(Chinese)
1-606-256-2195(TTY: 1-606-256-0556)

Deutsch (German)
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-606-256-2195 (TTY: 1-606-256-0556).

Ting Vit (Vietnamese)
CHÚ Ý: Nu bn nói Ting Vit, có các dch v h tr? ngôn ng min phí dành cho bn. Gi s 1-606-256-2195 (TTY: 1-606-256-0556).

(Arabic)
: . 1-606-256-2195 ( : 1-606-256-0556).

Srpsko-hrvatski (Serbo-Croatian)
OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezike pomoi dostupne su vam besplatno. Nazovite 1-606-256-2195 2195 (TTY: 1-606-256-0556).

(Japanese)
1-606-256-2195 (TTY: 1-606-256-0556).

Français (French)
ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-606-256-2195 (TTY: 1-606-256-0556).

(Korean)
?: , ? . 1-606-256-2195 (TTY: 1-606-256-0556).

Deitsch (Pennsylvania Dutch)
Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-606-256-2195 (TTY: 1-606-256-0556).

(Nepali)
: 1-606-256-2195 (TTY: 1-606-256-0556).

Oroomiffa (Cushite – Oromo)
XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-606-256-2195 (TTY: 1-606-256-0556).

(Russian)
: , . 1-606-256-2195 (TTY: 1-606-256-0556).

Tagalog (Philipino)
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-606-256-2195 (TTY: 1-606-256-0556).

Ikirundi (Bantu – Kirundi)
ICITONDERWA: Nimba uvuga Ikirundi, uzohabwa serivisi zo gufasha mu ndimi, ku buntu. Woterefona 1-606-256-2195 (TTY: 1-606-256-0556).