Patient Information Guide

1250 E Almond Ave, Madera, CA 93637 (559) 675-5555 Patient Information Guide Including Patient Rights pages 5-7

TABLE OF CONTENTS Welcome to Madera Community Hospital 2 Welcome to Madera Community Hospital 1 About Us 3 Map 2 Mission 3 About Us 3 Vision 4 Mission Having Statement Visitors 43 Vision Patient Statement Rights in California 54 Having Important Visitors Phone Numbers 84 Facts and Questions 9 Patient Rights 5 Food and Nutrition Services 9 Important Phone Numbers 8 Facts and Additional Questions Hospital Services/Resources 9 Important Things to Know 10 Food and Advance Nutrition Healthcare Services Directives 119 Additional Preventing Hospital Infections Services/Resources 149 Important Information Things to and Know Guidelines 10 for Patients and Families 15 Advance Healthcare Directives 11 Quitting Smoking 16 Preventing Infections 14 Intensive Care Unit 17 Information and Guidelines for Patients and Families 15 Telephone and Television 18 Quitting Notice Smoking of Privacy Practices 19 16 Intensive Volunteers Care Unit (ICU) 24 17 Telephone Giving and Television 24 18 Care from Hospital to Home 25 Notice of Privacy Practices 19 Case Management 25 Volunteers 24 Care for the Caregiver 25 Giving 24 Transitioning to the Next Level of Care from Care Hospital Resources to Home 26 25 Case Management Home Health 26 25 Care for Skilled the Caregiver Nursing 27 26 Frequently Asked Questions about Your Bill 27 Transitioning Advance to Healthcare the Next Level Directives of Care Forms Resources 55-70 26 Mental (English Health and Services Spanish) 27 Skilled Campus Nursing Map/Sudoku 71 27 Crossword Puzzle and Word Search Frequently Asked Questions about Your Bill 72 28 www.maderahospital.org 1

MADERA COMMUNITY HOSPITAL Welcome WELCOME TO MADERA COMMUNITY HOSPITAL Welcome to Madera Community Hospital (MCH). We are pleased you and your physician selected us to provide your medical care. This booklet is customized especially for you to better understand your medical care. You will find information inside describing the services offered at our hospital. You will be given additional information once discharged. We value your comments about your experience as a patient. It is the sincere desire of our entire team to provide you and your family with excellent care. Our goal is that you receive a high level of care with the utmost in courtesy and friendliness. If there is ever a time during your stay with us, however brief or long, that we do not meet those standards, we would like to know. We are constantly striving to improve, and the sooner we are made aware of your concerns, the quicker we can help. Our staff is here to serve you, and we are committed to providing you with excellent service while you are here at Madera Community Hospital. Thank you, John Evan Frye, J. Rayner Jr. Chief Executive Officer Madera Community Hospital maderahospital.org 1 2

Campus Map MADERA COMMUNITY HOSPITAL SUDOKU 3 9 3 4 6 5 7 8 2 9 1 9 8 5 6 1 2 7 3 4 7 1 2 4 3 9 5 6 8 4 5 8 7 9 6 1 2 3 2 6 7 1 5 3 8 4 9 1 9 3 2 8 4 6 5 7 5 7 9 3 2 1 4 8 6 6 3 1 8 4 5 9 7 2 8 2 4 9 6 7 3 1 5 6 6 8 7 5 1 5 7 3 1 8 4 1 2 7 9 7 3 6 8 4 6 8 3 2 5 www.maderahospital.org 71 2

About Us EXCEPTIONAL PEOPLE, EXCEPTIONAL SERVICE Welcome to Madera Community Hospital, where our patients are our first priority. As you are a key member of your health care team, we encourage you to become involved in your health care. Please share with us your concerns, hopes and needs related to your care, treatment, services or any patient safety issues. Your health and comfort are our main concerns while you are with us. Each and every staff member is committed to providing high quality care with warmth, compassion and personal attention. All of our employees share a commitment to patient satisfaction and providing exceptional care. If there is anything we can do to better serve you or make your stay more comfortable, please let us know immediately. Should you have any additional questions or comments about your care or treatment, please feel free to speak to your nurse, physician or a member of your health care team. Mary Farrell, Vice President Patient Care Services ABOUT US Madera Community Hospital (MCH) is a 106-bed, accredited acute care hospital offering a wide range of sophisticated diagnostic and treatment services. We are a private, not-for-profit community hospital that opened on October 1, 1971, and is dedicated to providing quality health care services to residents of western Madera County and parts of Fresno and Merced Counties. MISSION STATEMENT Madera Community Hospital is a not-for-profit community health resource, dedicated to actively promoting and maintaining the health and wellbeing of residents throughout the Central Valley. We are committed to identifying and serving our community s needs with compassion, concern, care and safety for the individual. We will: Be sensitive to the diverse physical, spiritual and psycho-social needs of those we serve, including the alleviation of pain and suffering, and integrally involving the family in care delivery. Periodically assess the health status and needs of our community, determine which health services we can appropriately establish and maintain, and act as a catalyst to ensure that priority health needs are met. Work collaboratively with physicians, other health providers, and community leaders to develop, offer and continuously evolve a comprehensive and integrated continuum of health services. Stimulate high levels of support and participation in educational and outreach initiatives offered to patients, staff and community members in an effort to promote both high levels of individual achievement and community health and well being. Prudently manage and utilize our financial resources, while ensuring the provision of high quality, effectively delivered health services. Accreditations and Memberships Healthcare Facilities Accreditation Program (HFAP). Clinical Laboratory Improvement Act (CLIA) program. Memberships with Hospital Council of Northern and Central California and the California Healthcare Association. maderahospital.org www.maderahospital.org 3 3

MADERA COMMUNITY HOSPITAL Vision / Visitors VISION STATEMENT Madera Community Hospital will distinguish itself as a leader in identifying and meeting our community s health needs by working in partnership with physicians and others to offer and manage an integrated array of health services upon which a majority of individuals and employers in our community will rely. We will: Initiate collaborative relationships and strategic alliances which advance our vision. Meet or exceed our customers expectations through quantifiable clinical and service quality and coordinated care delivery. Actively involve employers and community leaders in our success. Be flexible to change as community needs evolve. Engage a community that recognizes MCH as a vital community health resource. Align hospital and physician interests to better serve our community. Strategically invest in services and technologies, such as information technologies and non-acute care services. Selectively expand our Central Valley presence to serve the growing needs of area residents and purchasers: Madera, Chowchilla, Kerman, and N.W. Fresno. HAVING VISITORS General Visiting Hours: 8:00 a.m. 8:00 p.m. Our visiting hours have been established to be as convenient as possible for family and friends, while providing appropriate time for patients to sleep, be cared for and recover. Madera Community Hospital welcomes all patient visitors. The hospital understands and supports the need of family and friends to visit, however consideration must be given to the medical needs and privacy rights of all patients. Visiting hours are over at 8:00 p.m. and all visitors will be asked to leave at that time. All visitors must present through the ER after 8:00 p.m. Visiting hours are established and enforced to allow patients adequate rest and necessary medical care. Visitors may stop at the front desk to inquire what the patient s room number is and to receive directions and other information. Visiting Children: In an effort to provide a safe environment for you, other patients and our staff, no children under the age of 14 will be allowed in the upstairs hospital departments during the flu season. To find out if it is permissible for children to visit a patient, please check with the patient s nurse. ( To learn more about our Children s Visitor Center turn to page 10.) Emergency Room (ER) Visiting Hours: are dependent on the patient s condition and the ER environment. Upon registration to the ER, a visitor s pass will be issued to one family member. Visitors may exchange this pass with other family members. Visitors are limited to 1 per patient, however if the patient is a minor they may have both parents accompany them. Children will not be allowed in the ER unless being seen by the ED provider. A parent or guardian 18 years or older must stay with children who are not a patient of the ER. Upon discharge from the ER, the visitor pass will be collected. Please note, for the protection of patients, children are not allowed in patient care areas during flu season. Your nurse will advise you if children visitors are permissible. ICU Visiting Hours: are limited to 10 minutes every hour and no more than 2 visitors at one time. (For more information on ICU turn to page 17). Maternity Visiting Hours: Siblings of newborns are allowed to visit during the hours of 6 p.m. to 8 p.m. Fathers or the primary support person may visit at anytime. Only Labor and Delivery coaches are permitted in the birthing room and are required to wear a coach ID bracelet provided by the Labor and Delivery staff. Medical /Surgical Visiting Hours: Only 2 visitors are allowed in one room at a time. One of the 2 may be a child accompanied by an adult. If a 4 4

Patient Rights PATIENT S RIGHTS: family member or support person needs to be You with have a patient the right after to: 8 p.m. or overnight due to the 1. patient s Considerate medical and condition, respectful a wristband care, and visitor s pass be will made be comfortable. authorized and You provided have the by right the House Supervisor. to respect for your cultural, psychosocial, Family spiritual, members and personal of surgery values, patients beliefs are asked and to wait preferences. in the surgery waiting area. Family members 2. will Have be notified a family when member the patient (or other returns representative of your choosing) and your own physi- to their room. cian notified promptly of your admission to MCH the hospital. strives to ensure that all visitors enjoy full and equal visitation privileges consistent with 3. patient Know preferences the name and of your hospital licensed policies. health care practitioner acting within the scope of his Exceptions or her professional to these guidelines licensure are who at the has discretion primary the responsibility patient care area for and/or coordinating made by your the care, nurse of manager. and the names and professional relationships of physicians Cell Phones are not permitted and nonphysicians in patient care who areas. You will may see only you. use The your right cell to phone know in the the reasons main hospital for any lobby. proposed change in the Professional Staff responsible for your care. The right to know the reasons for your transfer either PATIENT within or outside RIGHTS the hospital IN and the relationship(s) of the hospital to other persons CALIFORNIA or organization participating in the provision of your care. You have the right to: 4. Receive information about your health 1. Considerate and respectful care, and to be status, diagnosis, prognosis, course of treatment, prospects for recovery and outcomes made comfortable. You have the right to respect for your cultural, psychosocial, spiritual, and of care (including unanticipated outcomes) personal values, beliefs and preferences. You in terms you can understand. You have the have the freedom to exercise your religious right to effective communication and to beliefs or spiritual practices within the limits participate in the development and implementation of your plan of care. You have of the law. 2. the Have right a family to participate member (or in other ethical representative questions that of your arise choosing) the course and your of your own care, physician including notified issues promptly of conflict of your resolution, admission withholding hospital. resuscitative services, and forgoing or to the withdrawing life-sustaining treatment. 3. Kn ow the name of the physician who has 5. Make primary decisions responsibility regarding for coordinating medical care, and your receive care and as the much names information and professional about any proposed relationships treatment of other or physicians procedure and as nonphysicians need in who order will to see give you. informed consent you may or to refuse a course of treatment. Except in 4. emergencies, Receive information this information about your shall health include status, a diagnosis, description prognosis, of the procedure course of or treatment, prospects for recovery and outcomes of care (including unanticipated outcomes) in terms you can understand. You have the right to the medically significant risks involved, effective alternate communication courses of treatment and to participate or non-treatment development and the risks and involved implementation in each, of and your in the plan the of name care. of You the have person the right who to will participate carry out in the ethical procedure questions or treatment. that arise in the course of 6. your The care, patient s including representative issues of conflict (as allowed resolution, withholding under state resuscitative law) has the services, right to and make forgoing informed or withdrawing decisions life-sustaining regarding his treatment. or her care. 5. Ma The ke patient s decisions rights regarding include medical being care, informed and of his receive or her as much health information status, being about involved any proposed in care planning treatment and or procedure treatment, as and you being may need able in to order request to give of refuse informed treatment. consent This or to right refuse must a course not be of treatment. construed Except as a mechanism to demand this information the provision shall of include treatment a in emergencies, description or services of deemed the procedure medically or treatment, unnecessary the medically or inappropriate. significant risks involved, alternate 7. courses Request of treatment or refuse treatment, or non-treatment to the extent and the permitted risks involved by law. in However, each, and the you name do not of the person have the who right will carry to demand out the inappropriate procedure or or treatment. medically unnecessary treatment or services. You 6. Request or refuse have treatment, the right to to leave the extent the hospital even against permitted by law. However, the advice you of do members not have of the the right medical to demand staff, to inappropriate the extent permitted or medically by unnecessary law. treatment or services. You have 8. the Be right advised to leave if the the hospital/licensed even against health the advice care practitioner of physicians, acting to the within extent permitted the scope of by law. his or her professional licensure proposes to engage in or perform human experimenta- e advised affecting if the your hospital/personal care or treatment. physician You 7. Btion proposes have the to right engage to refuse in or perform to participate human in experimentation such research projects affecting without your care compromising your You access have to the services. right to refuse to or treatment. participate in such research projects. 9. Reasonable responses to any reasonable 8. Reasonable requests made responses for service. to any reasonable requests 10. made Appropriate for service. assessment and management 9. Appropriate of your pain, assessment information and management about pain, pain of relief your measures pain, information and to participate about pain, in pain pain relief management measures and decisions. to participate You may in pain request management or reject the decisions. use of any You or may all modalities request or to reject relieve the pain, use of including any or all opiate modalities medication, to relieve pain, if you including suffer from opiate severe medication, chronic if intractable you suffer from pain. severe The chronic doctor may intractable refuse pain. to prescribe The doctor the may opiate refuse medication, to prescribe but the if opiate so, must medication, inform but you if so, that must there inform are physicians you that there who are specialize physicians in the treatment who specialize of severe in the chronic treatment pain of with severe methods chronic that pain include with the methods use of that opiates. include the use of opiates. maderahospital.org www.maderahospital.org 5 5

MADERA COMMUNITY HOSPITAL Patient Rights CONT D 10. Formulate advance directives. This includes 11. designating Formulate a advance decision directives. maker if you This become includes incapable designating of understanding a decision maker a proposed if you become treatment incapable or of become understanding unable to a communicate proposed your treatment wishes or regarding become care. unable Hospital to communicate your wishes staff and practitioners who provide regarding care care. in the Hospital hospital shall staff comply and practitioners with these directives. who provide All patients care rights in the apply hospital to the shall person comply who with has legal these responsibility directives. All to patients make decisions rights regarding apply to the medical person care who on has your legal behalf. responsibility (See page to 11 make for more decisions information regarding on an medical Advance care Directive on your for behalf. health care). Additionally, your family has 12. the Have right personal of informed privacy consent respected. for donation Case of organs discussion, and tissues. consultation, examination and treatment are confidential and should be 11. Have conducted personal discreetly. privacy respected. You have Case the right discussion, to be told consultation, the reason for examination the presence and of treatment any individual. are confidential You have and the should right to be have conducted visitors leave discreetly. prior to You an have examination the right to and be when told the treatment reason for issues the are presence being of discussed. any individual. Privacy curtains You have will the be right used to in have semi-private prior rooms. to an examination and when visitors leave treatment issues are being discussed. Privacy 13. curtains Confidential will be treatment used in semi-private of all communications and records pertaining to your care rooms. 12. Confidential and stay in the treatment hospital. of all You communications will receive a and separate records Notice pertaining of Privacy to your Practices care and stay that in explains the hospital. your You privacy will rights receive in a separate detail and Notice how we of may Privacy use Practices and disclose that your explains protected health privacy information. rights detail and how we your 14. may Receive use and care disclose in a safe your setting, protected free health from information. mental, physical, sexual or verbal abuse and 13. Receive neglect, care exploitation in a safe setting, or harassment. free from mental, You physical, have the sexual right or to verbal access abuse protective and neglect, and advocacy services or harassment. including You notifying have the govern- right exploitation to ment access agencies protective of neglect and advocacy or abuse. services 15. including Be free from notifying restraints government and seclusion agencies of of any neglect form used or abuse. as a means of coercion, discipline, 14. Be free from convenience restraints or and retaliation seclusion by of staff. any 16. form Reasonable used a continuity means of coercion, of care and discipline, to know convenience in advance or the retaliation time and by location staff. of appointments as well as the identity of the 15. Reasonable persons providing continuity the of care. and to know in advance the time and location of appointments 17. as Be well informed as the identity by the of physician, the persons or a providing delegate the of care. the physician, of continuing health care requirements and options following discharge from the hospital. You have the right to be involved in the development and implementation of your discharge plan. Upon 16. B e informed by the physician, or a delegate of the your physician, request, of a friend continuing or family health member care may requirements be provided and this options information following also. 18. discharge Know from which the hospital. rules You and have policies the right apply to be to involved your conduct in the development while a patient. and 19. implementation Designate a support of your discharge person as plan. well Upon visitors your of request, your choosing, a friend or if you family have member decision-making capacity, this information whether not also. the visitor is may be provided 17. Knrelated ow which by hospital blood, marriage, rules and policies or registered apply to your domestic conduct partner while status, a patient. unless No visitors are allowed. 18. Designate visitors of your choosing, if you have decision-making The facility reasonably capacity, whether determines or not the that visitor the is presence related by of blood a particular or marriage, visitor unless: would endanger the health or safety of a patient, a member of the health facility staff or other visitor to the health No visitors are allowed. Th e facility, reasonably or would significantly determines that disrupt the the presence operations of a particular of the facility. visitor would endanger the health or safety of a patient, a member You have of the told health the health facility facility staff or staff other that visitor you to no the longer health want facility, a particular or would significantly person to disrupt visit. the operations of the However, facility. a health facility may establish reasonable Yo u have restrictions told the health upon facility visitation, staff that including you restrictions no longer want upon a particular the hours person of visitation and to visit. number However, of visitors. a health The facility health may facility must establish inform reasonable you (or restrictions your support upon person, where visitation, appropriate) including of restrictions your visitation upon rights, the including hours of visitation any clinical and restrictions number of visitors. or limitations. The health facility is not permitted to 19. Have restrict, your wishes limit, considered, or otherwise if deny you lack visitation decision-making privileges the capacity, basis for of race, the purposes color, national origin, who religion, may visit. sex, The gender method identity, of determining of that sexual consideration orientation, will or be disability. disclosed in the hospital The visitation policy on rights visitation. of patients At a minimum, at Madera hospital Community shall include Hospital, any persons including living those in the your setting household. forth any clinically necessary or 20. Examine reasonable and receive restriction an explanation or limitation of the that the hospital s hospital bill may regardless need to of place the source on such of rights payment. and the reason for the clinical restriction or limitation will: Inform each patient (or support person, where appropriate) of his or her visitation rights, including any clinical restriction or limitation on such rights, when he or she is informed of his or her other rights under this section. 482.13(h)(1) 6 6

Patient Rights CONT D 21. Exercise these rights without regard to sex, Inform race, each color, patient religion, (or ancestry, support national person, origin, where age, appropriate) disability, of medical the right, condition, subject to marital his or her status, consent, sexual to orientation, receive the educational visitors background, whom he or economic she designates, status including, or the source but of payment not limited for care. to, a spouse, a domestic partner 22. Exercise (including of his/her a same rights sex domestic while receiving partner), care another or treatment family in member, the hospital or a without friend, and coercion, his or discrimination her right to withdraw or retaliation. or deny such consent at any time. 482.13(h)(2) 23. The Not right restrict, to access limit information otherwise contained deny visitation or her privileges clinical records on the basis within of a race, reasonable col- in his time or, national frame. The origin, hospital religion, must sex, not frustrate gender the legitimate identity, sexual efforts orientation, of individuals or to disability. 482.13(h)(3) their own medical records and must actively gain access to seek to meet these requests as quickly as its record Ensure keeping that all system visitors permits. enjoy full and equal visitation privileges consistent with patient 24. The preferences. right to know 482.13(h)(4) the reasons for any proposed Decisions change to restrict in the or Professional limit presence Staff must responsible be discussed for with his/her the care. patient and documented right in to the know medical the reasons record. for his/her 25. The 20. Have transfer your wishes either inside considered, or outside even the if you hospital. lack decision-making 26. The relationship(s) capacity, of the for hospital the purposes or other of determining persons or who organizations may visit. participating The method in of his/ that consideration her care. will comply with federal law and be disclosed in the hospital policy on visitation. At 27. a The minimum, right to be the informed hospital of shall the include source of any the persons hospital s living reimbursement in your household for his/her and any services, support and person of any pursuant limitations to federal which may law. be placed 21. Examine upon his/her and receive care. an explanation of the hospital s 28. File bill a grievance. regardless If of you the want source to file of a payment. grievance 22. The with right this to access hospital, information you may do contained so by writing in or your by clinical calling: record within a reasonable time frame. The hospital must not frustrate the Madera Community Hospital legitimate efforts of individuals to gain access Attn: Community Relations to their own medical records and must actively seek to meet these requests as quickly as its 1250 E. Almond Ave. Madera, CA 93637 record keeping system permits. 559-675-5503 23. The patient s family has the right of informed consent for donation of organs and tissues. 24. Exercise these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, sexual orientation, disability, medical condition, marital status, registered domestic partner status, or the source of payment for care. The grievance committee will review each grievance 25. File and a grievance. provide you If you with want a written to file response a grievance within with 30 days. this The hospital, written you response may do will so by contain writing or the name by calling: of a person to contact at the hospital, the steps taken to investigate the grievance, the results Madera of the grievance Community process, Hospital and the date of completion Attn: of Community the grievance Relations process. If you are a Medicare 1250 patient, E. Almond concerns Ave., regarding Madera, quality CA 93637 of care or 559-675-5503 premature discharge will also be referred to the appropriate The grievance Utilization committee and Quality will review Control each Peer Review grievance Organization and provide (PRO). you with a written response within 30 days. The written response 29. File will a complaint contain the with name the California of a person to contact at Department the hospital, of Public the steps Health taken regardless to investigate the of grievance, whether you the use results the hospital s of the grievance process, process. and the The date state of Department completion of of Public the grievance Health s process. phone Concerns number regarding and address quality is: of care or California premature Dept. discharge of Public will also Health be referred to the Licensing appropriate and Utilization Certification and Quality Control 285 Peer W. Review Bullard Organization Ave. Suite 101 (PRO). 26. Fresno, File a complaint CA 93704with the California Department of Public Health regardless of whether 559-437-1500 you use the hospital s grievance process. Their Questions and Concerns: If you have concerns contact information is listed below: about the care you have received, we encourage you or California a family member Dept. of to Public speak with Health your physician Licensing or with and the Certification nursing supervisor. If you feel that 285 your W. issue Bullard wasn t Ave. resolved, Suite 101, contact Fresno, the CA Community 93704 Relations Director at 559-675-5503 (extension 559-437-1500 5503 from a hospital phone), from 8:30 This a.m. Patient to 5:00 Rights p.m., document Monday through incorporates Friday, the excluding requirements holidays. of HFAP (Healthcare Facilities Accreditation Program); Title 22, California Code of Regulations, Section 70707; Health and Safety Code Sections 1262.6, 1288.4 and 124960; and 42 C.F.R. Section 482.13 (Medicare Conditions of Participation). Questions and Concerns: If you have concerns about the care you have received, we encourage you or a family member to speak with your physicians or with the nursing director/supervisor. If you feel that your issue was not resolved, please contact the Patient Liaison at (559) 675-2519 from 8:30 a.m. -4:30 p.m., Monday through Friday, excluding holidays. maderahospital.org www.maderahospital.org 7 7

MADERA COMMUNITY HOSPITAL Phone Directory IMPORTANT PHONE NUMBERS AND SERVICES Madera Community Hospital Health Care Services Include: 24-hour Emergency Department 675-5520 Admissions/Registration 675-5589 Baby Steps /Sweet Success 675-2664 Case Management/Discharge Planning 675-2855 Children s Visitors Center 675-5402 Chowchilla Medical Center Clinic 665-3768 Community Relations 675-5503 Credit 675-5514 Diagnostic Imaging 675-5540 (Including x-ray, computed topography (CT), magnetic resonance imaging (MRI), ultrasound, digital mammography and nuclear medicine) Family Health Services Clinic Madera 675-5530 Volunteer Desk (M-F 9 a.m. 5 p.m. er 5:00 p.m. dial 0 ) 675-2739 Intensive Care Unit (ICU) 675-5570 Intensive Care Unit Waiting Room 675-5310 Laboratory Services 675-5542 Maternity Care 675-5575 Medi-Cal ce 675-5528 Medical Records 675-5515 Medical and Surgical Nursing Care Nurses Station 675-5580 Medical 675-5512 (Comprised of a wide range of physician specialists to include; surgeons, cardiologists, emergency physicians, obstetricians, pediatricians, internal medicine, radiologists and pathologists) Nutritional Services 675-2743 Outpatient Center Services & Registration 675-5535 Respiratory erapy 675-2756 Specialty Clinic 675-2664 Surgery (Inpatient and Outpatient) 675-5550 Volunteer/Foundation 675-5503 Hospital Operator Assistance Dial 0 Hospital Operator Assistance 675-5555 8 8

Other Hospital Services FACTS AND QUESTIONS How often will I see my physician(s)? This is dependent on your doctor s schedule. You can expect to see him or her on a daily basis. If you have a question or concern that cannot be answered by your nurse, your nurse can contact the physician in charge of your care anytime by telephone. Can my family and friends call for updates regarding my condition? In 1996, the Health Insurance Portability and Accountable Act (HIPAA) became law. This law has had a significant impact on the way your healthcare providers communicate with you, your family, and with each other. Both your nurse and doctor understand and respect the need for patient confidentiality; however, they are frequently put in the tenuous position of being asked for information by families and well-wishers. Please understand that details of your condition cannot be shared with family and friends without your designation and authorization. Please refer to the Notice of Privacy Practices information in this packet. (Notice of Privacy Practices can be found beginning on page 19) Where can I go to learn more about my condition and treatment? There are several ways to learn more about your condition. Both your nurse and doctor can provide information regarding your health condition. For admitted patients, Madera Community Hospital offers a Patient Education System, which is accessible through your television in your hospital room. This education system can be found on channels 32, 33, 34, or 35, and it offers a wide variety of health care topics to choose from. May I make special nutritional requests? Prior to eating any foods or candy brought in by visitors, please check with your nurse. Your daily meals are planned and prepared by our Nutrition Services Department according to your doctor s orders. Because certain foods may interfere with a medication s desired action, we ask that you not eat foods outside your daily menu without checking with your nurse. This includes food from home, from vending machines or food brought in from guests. FOOD AND NUTRITION SERVICES Nutrition is an important aspect of your overall medical care. Your doctor has prescribed a diet for you that is carefully planned to fit your individual needs and to help you recover quickly. You may also be assigned a hospital registered dietitian who will be responsible for your nutritional care and who will participate as an active member of your health care team. The Cafeteria is located on the first floor across from the elevators. Meal times are as follows: Breakfast:... 6:00 a.m. 6:00am 10:00 a.m. 10:00am Lunch:... 11:00 a.m. 11:00am 2:30 p.m. 2:30pm Dinner:... 3:00 p.m. 3:00pm 8:00 p.m. 8:00pm Hours Late Shift of operation: Dinner... 6:00 a.m. 10:00pm 12:30 a.m. 1:30am Closed: Hours of Operation... 1:30 a.m. 6:00am a.m. 1:30am Closed... 1:30am 6:00am ADDITIONAL HOSPITAL SERVICES/RESOURCES Banking: For your convenience, an automated teller machine is available in the main lobby of MCH. Chapel: The hospital chapel is located on the first floor, adjacent to the main lobby. Chaplain/Spiritual Care: Our Pastoral Care Care Team Team is comprised comprised of a Hospital of a group Chaplain of volunteer and a group ministers, of volunteer who ministers, are available who are to all available patients to and all their patients families. and their Th families. ey are trained They are to provide trained to spiritual provide spiritual care to persons care to persons of all religious of all religious faiths, including faiths, including those without those without religious religious affi affiliation. Please contact your nurse or any member of of your care team to request this service. The e hospital chapel is located on the first rst floor, oor, adjacent to to the the main main lobby. lobby. maderahospital.org www.maderahospital.org 9 9

Other Hospital Services CONT D MADERA COMMUNITY HOSPITAL Gift Shop: Our volunteer run gift shop is located off of the main lobby by the front entrance of the hospital. All proceeds from the gift shop are donated back to the hospital and are used to purchase medical equipment. A wide variety of gifts and snacks are available for purchase cash and credit cards are accepted. The Gift Shop can be reached at 675-2738. Hours of operation: 9:00am 5:00pm a.m. 8:00 p.m. Monday Friday Friday 11:00pm 3:00pm 1:00 p.m. 5:00 p.m. Saturday and Sunday Closed Sunday Internet Access: As a patient or family member of Internet a patient, Access: access free As a internet patient services or family by member dialing of 0 a from patient, a hospital access free phone. internet The MCH services operator with username will provide (lowercase) you with a mch-guest user name and password. (capital Technical M) support Madera123. is available Technical Monday support through is available Friday from Monday Friday 8:00 a.m. to 5:00 8:00am 5:00pm. p.m. Interpreter: Should you need an interpreter for a patient who does not speak English, please contact your Nurse Supervisor for assistance, and an interpreter will be provided. Mail Service: If you are the recipient of incoming mail or flowers, a hospital volunteer will deliver them to you. Give outgoing mail to your nurse, who will see that it is picked up promptly and mailed. If MCH receives mail for you after discharge, your mail will be forwarded to your address on record. Please note: Flowers are prohibited in intensive care units and isolation rooms. Postage stamps may be purchased in the main lobby at the cashier window. Special Needs: Any special care that handicapped patients may require will be taken care of by the Nurse Supervisor. There are automatic doors at all major entrances to the hospital, as well as wide elevators allowing wheelchairs access to all areas of MCH. Telephones Phone amplifiers are equipped are available with to volume patients control and for visitors patients who who have have difficulty difficulty hearing, hearing. and TTY (Teletypewriter) systems are available for the phones of hearing-impaired patients. Hearingimpaired patients my request closed captioned equipment for television sets in their rooms. Children s Visitor Center: Madera Community Hospital operates a Children s Visitors Center located next to the Family Health Services Clinic. Patients and visitors are encouraged to drop their children off at the center while they receive services on the hospital campus, or visit patients here. (For location see campus map on page 55) The center offers a fun learning environment designed for children. Phone: Open 675-5402 Monday Friday, Cell: 706-5766 Hours 8:00 of operation: a.m. 5:00 8:00am 4:00pm p.m. Monday Friday Closed Closed for lunch on weekends 12:30 1:30 and holidays. Closed weekends & holidays IMPORTANT THINGS TO KNOW Medical Transitioning is a critical component of health care safety concerning your medications as you transition from your home, throughout your hospital stay, and upon discharge from the hospital. (For more information on your discharge from the hospital see Care From Hospital to Home on page 25). Herbal Supplements: Please tell your nurse and doctor if you have been taking any herbal supplements. Although herbs seem harmless, they can be potentially dangerous, especially for anyone requiring surgery or taking prescription medication. Pain Management: Your report of pain is essential. Your nurse or doctor will ask you to use the Pain Assessment Scale to describe your pain and work with you to make you as comfortable as possible. Adequate pain control can help you: Enjoy greater comfort while you heal. G e t well faster with less pain: You can start walking, do your breathing exercises, and get strength back more quickly so you may leave the hospital sooner. How would you describe your pain? 0 No Hurt 2 Hurts Little Bit 4 Hurts Little More 6 Hurts Even More 8 Hurts Whole Lot 10 Hurts Worst 0 1 2 3 4 5 6 7 8 9 10 www.maderahospital.org 35 10 10

Advance Healthcare Directive ADVANCE HEALTHCARE DIRECTIVES The Advance Healthcare Directive forms can be found on page 55-62 (English) and page 63-70( Spanish) of this book. You may be asked if you have a Durable Power of Attorney for Health Care, Advance Healthcare Directive, and/or POLST Form. What is an Advance Healthcare Directive (AHD)? An AHD is a document that allows you to make a decision in advance of the need for that decision. It is designed to direct medical care for you if you are unable to do so. This is helpful for adults of all ages and is useful in situations where you cannot speak for yourself. Completing the AHD does not mean you do not want treatment. It is designed to give specific direction to your physicians and your family. What is a Power of Attorney? A power of attorney, on the other hand, is a document that gives somebody else the right to make a decision for you. What is a POLST? A Physician Orders for Life Sustaining Treatment is a physician s order that honors the patient s end of life treatment preferences either to have or to limit treatment, even when transferred from one care setting to another. The POLST form is most appropriate for seriously ill persons with lifelimiting, also called terminal, illnesses or advanced frailty characterized by significant weakness and extreme difficulty with personal care activities. Why do I need an AHD? An AHD can help put your mind at ease and enhance your doctor s and your family s knowledge regarding your wishes for medical treatment. An AHD can prevent treatment that you would not choose for yourself and decrease feelings of helplessness and guilt for your family. What should I include in my AHD? Consider what is important to you what are your goals for medical treatment? What things are important to you? (Independence, self-sufficiency things of that nature.) How do you imagine you would handle serious illness or disability? How might your personal relationships affect medical decision-making? What role should doctors and other health professionals play in such decisions? What kind of living environment is important to you if you become seriously ill or disabled? What role do religious beliefs play in your decisions? Should cost to your family be a part of the decision-making process? In considering these questions you should choose someone that you trust to carry out these wishes. It is also recommended that you also select an alternate. Go over carefully with them what your wishes are and ask them if they would be willing to follow through with your choices. YOUR RIGHT TO MAKE DECISIONS ABOUT MEDICAL TREATMENT This section outlines your right to make healthcare decisions and demonstrates how you can plan now for your medical care if you are unable to speak for yourself in the future. A federal law requires us to give you this information. We hope this will help increase your control over your medical treatment. Here are questions you might ask: 1. W ho decides about my treatment? Your doctors will give you information and advice about treatment. You have the right to choose. You can say Yes to treatments you want. You can say No to any treatment that you don t want - even if the treatment might keep you alive longer. maderahospital.org www.maderahospital.org 11 11

Advance Healthcare Directive CONT D MADERA COMMUNITY HOSPITAL 2. How do I know what I want? Your doctor must tell you about your medical condition and about what different treatments and pain management alternatives can do for you. Many treatments have side effects. Your doctor must offer you information about problems that medical treatment is likely to cause you. Often, more than one treatment might help you - and people have different ideas about which is best. Your doctor can tell you which treatments are available to you, but your doctor can t choose for you. That choice is yours to make and depends on what is important to you. 3. Can other people help with my decisions? Yes. Patients often turn to their relatives and close friends for help in making medical decisions. They can help you think about the choices you face. You can ask the doctors and nurses to talk with your relatives and friends. They can ask the doctors and nurses questions for you. 4. Can I choose a relative or friend to make healthcare decisions for me? Yes. You may tell your doctor that you want someone else to make healthcare decisions for you. Ask the doctor to list that person as your healthcare surrogate in your medical record. The surrogate s control over your medical decisions is effective only during treatment for your current illness or injury or, if you are in a medical facility, until you leave the facility. 5. W hat if I become too sick to make my own healthcare decisions? If you haven t named a surrogate, your doctor will ask your closest available relative or friend to help decide what is best for you. Most of the time that works. But sometimes, everyone doesn t agree about what to do. That s why it is helpful if you can say in advance what you want to happen if you can t speak for yourself. 6. D o I have to wait until I am sick to express my wishes about healthcare? No. In fact, it is better to choose before you get very sick or have to go into a hospital or nursing home, or other healthcare facility. You can use an Advance Healthcare Directive to say who you want to speak for you and what kind of treatments you want. In California, the part of an advance directive you can use to appoint an agent to make healthcare decisions is called a Power of Attorney for Healthcare. The part where you can express what you want done is called an Individual Healthcare Instruction. 7. W ho can make an advance directive? You can if you are 18 years or older and are capable of making your own medical decisions. You do not need a lawyer. 8. W ho can I name as my agent? You can choose an adult relative or any other person you trust to speak for you when medical decisions must be made. 9. W hen does my agent begin making my medical decisions? Usually, a healthcare agent will make decisions only after you lose the ability to make them yourself. But, if you wish, you can state in the Power of Attorney for Healthcare that you want the agent to begin making decisions immediately. 10. How does my agent know what I would want? After you choose your agent, talk to that person about what you want. Sometimes, treatment decisions are hard to make, and it truly helps if your agent knows what you want. You can also write your wishes down in your advance directive. 12 12

Advance Healthcare Directive CONT D 11. W hat if I don t want to name an agent? You can still write out your wishes in your advance directive, without naming an agent. You can say that you want to have your life continued as long as possible. Or you can say that you would not want treatment to continue your life. Also, you can express your wishes about the use of pain relief or any other type of medical treatment. Even if you have not filled out a written Individual Healthcare Instruction, you can discuss your wishes with your doctor, and ask your doctor to list those wishes in your medical record. Or you can discuss your wishes with your family members or friends. But it will probably be easier to follow your wishes if you write them down. 12. W hat if I change my mind? You can change or cancel your advance directive at any time as long as you can communicate your wishes. To change the person you want to make your healthcare decisions, you must sign a statement or tell the doctor in charge of your care. 13. W hat happens when someone else makes decisions about my treatment? The same rules apply to anyone who makes healthcare decisions on your behalf - a healthcare agent, a surrogate whose name you gave to your doctor, or a person appointed by a court to make decisions for you. All are required to follow your Healthcare Instructions or, if none, your general wishes about treatment, including stopping treatment. If your treatment wishes are not known, the surrogate must try to determine what is in your best interest. The people providing your healthcare must follow the decisions of your agent or surrogate unless a requested treatment would be bad medical practice or ineffective in helping you. If this causes disagreement that cannot be worked out, the provider must make a reasonable effort to find another healthcare provider to take over your treatment. 14. W il l I still be treated if I don t make an advance directive? Absolutely. You will still get medical treatment. We just want you to know that if you become too sick to make decisions, someone else 21 or older will have to make them for you. Remember that: A Power of Attorney for Healthcare lets you name an agent to make decisions for you. Your agent can make most medical decisions, not just those about life-sustaining treatment, when you can t speak for yourself. You can also let your agent make decisions earlier, if you wish. You can create an Individual Healthcare Instruction by writing down your wishes about healthcare or by talking with your doctor and asking the doctor to record your wishes in your medical file. If you know when you would or would not want certain types of treatment, an Instruction provides a good way to make your wishes clear to your doctor and to anyone else who may be involved in deciding about treatment on your behalf. These two types of Advance Healthcare Directives may be used together or separately. 15. How can I get more information about making an advance directive? Ask your doctor, nurse, social worker, or healthcare provider to get more information for you. You can have a lawyer write an advance directive for you, or you can complete an advance directive by filling in the blanks on a form. Please note: To best serve you and your medical needs, these forms should be completed in advance of being admitted for medical needs. maderahospital.org www.maderahospital.org 13 13

MADERA COMMUNITY HOSPITAL Preventing Infections PREVENTING INFECTIONS IN THE HOSPITAL AND WHAT YOU CAN DO Consumer Fact Sheet Provided with permission by National Patient Safety Foundation ) Infections can occur after many types of medical procedures. This is particularly true if you are having surgery. There are several things you can do to help protect yourself from infections in the hospital. Planning Ahead For Surgery (If applicable) Don t be afraid to ask questions about your care so that you may fully understand your treatment plan and expected outcomes. You and your family/friends will be able to better facilitate your recovery. If you have diabetes, be sure that you and your doctor discuss the best way to control your blood sugar before, during, and after your hospital stay. High blood sugar increases the risk of infection noticeably. If you are overweight, losing weight will reduce the risk of infection following surgery. If you are a smoker, you should consider a smoking cessation program. This will reduce the chance of developing a lung infection while in the hospital and may also improve your healing abilities following surgery. Hand Washing Why is Hand Hygiene Important? Hospital patients are generally unwell; recovering from an operation may have decreased immunity leaving them at increased risk of infection from germs. We want to help stop patients from getting these infections, because they often cause lengthy and serious infection in people who are already unwell. One of the easiest and most effective ways to reduce infection is for all staff, patients, and visitors to practice good hand hygiene. What is Good Hand Hygiene? Good hand hygiene means washing using either alcohol-based hand rubs or soap and water to help stop the spread of germs. By stopping the spread of germs we can reduce infections among patients. Our Commitment to You MCH employees take hand hygiene seriously because we know this is one of the easiest ways to help keep patients as safe and healthy as possible. Our staff should clean their hands at each contact or, put more simply, before and after touching each patient. During your stay as a patient or visitor at this hospital we invite you to join us in the fight against infection by achieving the best hand hygiene possible. Hand Hygiene is Everyone s Business Patients and visitors have an important role to play in ensuring hand hygiene throughout the hospital. Visitors should clean their hands each time they enter or leave a patient s room. Patients and visitors should never touch wounds, dressings, intravenous lines or other tools being used to treat a patient. Patients should have good personal hygiene, especially while in the hospital. This includes cleaning their hands after using the toilet and before meals. It s OK to Ask From time to time our staff can become very busy, and patients may wonder if their doctor, nurse or other health care provider cleaned their hands before and after touching them. As part of your role in the fight against infection we hope you will remember that it is OK to ask. If you are in doubt, do not hesitate to remind hospital staff about this important practice. 14 14