Rights

1. You have the right to receive information in a manner that you understand. Please tell us if you need an interpreter, hearing aid or glasses to communicate effectively.
2. You have the right to courteous treatment.
3. You have the right to be informed of your proposed treatment, including the potential risks and benefits of the proposed treatment, the likelihood of achieving your goals, and potential problems that may occur during recuperation. 
4. You have the right to be informed of reasonable alternatives to your proposed treatment and the freedom to choose the type of treatment you want. 
5. You have the right to receive an explanation of your medical treatment and to participate in decisions made. You may refuse treatment if you desire. We will tell you about possible outcomes of refusing care.
6. You have the right to privacy, security, and personal dignity and to be free from all forms of abuse and harassment.
7. You have the right to be provided a safe and secure environment, including your personal property.
8. You have the right to freedom from the inappropriate use of all restraints and seclusion, in all hospital settings.
9. You have the right to have your care and medical record kept confidential.
10. You have the right to receive the care you need by a qualified medical care provider, even if that means you need to be transferred to another hospital.
11. You have the right to receive adequate information about the practioner(s) responsible for the delivery of your care, treatment, and services.
12. You have the right to be told, and to refuse, if your doctor or hospital wants to participate in medical research related to your care.
13. You have the right to receive an explanation of your bill and the charges you are responsible for. It is your responsibility to provide us information about your insurance. You are responsible for prompt payment of your bill.
14. You have the right to a family member, friend, or other individual to be present during the course of your stay, unless there is a concern of safety or rights of others, or when medically or therapeutically unadvised. 
15. You have the right to have a family member or representative of your choice and your own physician notified promptly of your admission to the hospital, unless there is a concern of safety or rights of others, or when medically or therapeutically unadvised. 
16. You have the right to have effective pain relief — or to refuse it.
17. You have the right to pastoral care or any other spiritual services.
18. You have the right to have your cultural, psychosocial, spiritual, and personal values, beliefs, and preferences respected.
19. You have the right to resolution of your concerns and/or complaints. Our complaint and grievance process is listed on the back.
20. You have the right to freely voice complaints and recommend changes without being subject to coercion, discrimination, reprisal, or unreasonable interruption of care, treatment, and services.
21. You have the right to access protective and advocacy services.
22. You have the right to access your medical record in accordance with hospital policy and State & Federal regulations.
23. You have the right to access, request amendment to, and receive an accounting of disclosures regarding your own health information as permitted under applicable law.
24. You have the right to have your Advance Directives honored; however certain orders such as Do Not Resuscitate (DNR) may be suspended during anesthesia. In these situations, you would be informed before anesthesia is administered.
25. You have the right to accept or refuse medical or surgical treatment; including forgoing or withdrawing life-sustaining treatment or withholding resuscitative services.

1. You have the responsibility to provide information needed to plan and facilitate your care.
2. You have the responsibility to ask questions when you do not understand the course of your treatment or care decision.
3. You have the responsibility to follow instructions, policies, rules, and regulations in place to support quality care for patients and a safe environment for all individuals in the hospital.
4. You have the responsibility to meet your financial commitments.
5. Your health care provider and staff have the right to be treated with courtesy and respect.

If we are not exceeding your expectations, please share your concerns with an employee or a member of our management team. If you have voiced your concerns at the point of service and they have not been resolved; or if you have concerns after discharge; or if you wish to file a grievance, please contact:

Fairbanks Memorial Hospital
Attention: Patient Experience
1650 Cowles Street, Fairbanks, AK 99701
(907) 458-5154

and/or

State of Alaska/Dept. of Health and Social Services
Division of Public Health
Certification and Licensing
4501 Business Park Blvd.
Suite 24, Building L, Anchorage, AK 99503
1-888-387-9387

and/or

Visit www.jointcommission.org. Click on the Report a Patient Safety Event link in the Action Center bar on the right side of the home page

or fax: (630) 792-5636 

or mail to:
Office of Quality and Patient Safety
The Joint Commission
One Renaissance Blvd., Oakbrook Terrace, IL 60181

and/or for quality of care issues, coverage decisions, or to appeal a premature denial for Medicaid patients

Qualis Health Alaska
P.O. Box 243609, Anchorage, AK 99524
1-888-578-2547

and/or for quality of care issues, coverage decisions, or to appeal a premature denial for Medicare patients

KEPRO
5700 Lombardo Center Dr., Suite 100, Seven Hills, OH 44131
1- 888-305-6759
TTY: 1-855-843-4776
Toll-free fax: 1-844-878-7921