Chapter 14 Test 3 Flashcards
________ does not provide a right to healthcare, but various statutes and regulations do provide this right
US Constitution
________ providers may be required to provide some charity care per the IRS community benefit standard
Tax-exempt
No obligation to treat non-emergency cases as long as anti-discrimination laws are not violated
Elective treatment
Provided hospitals and other healthcare facilities with federal money use towards construction and modernization however hospitals were obligated to provide some uncompensated care
- Community Service Assurance
This obligation has ceased in 1997, but many _______ hospital retain a mission to provide uncompensated care
Hill-Burton Act
Provider is the authority; patient is passive recipient
Paternalistic relationship
Provider dispenses information; patients makes the decisions
Informative relationship
Shared decision making between provider and patient
Interpretive relationship
Ability to receive high-quality health care
Skillful care with desired clinical outcomes
Respectful and compassionate care
Provider-patient partnership
Patient empowerment
Consideration of family involvement
Ensure patients are educated and knowledgeable about their conditions
Informed about health information use, disclosure, protection, and individual rights
Patient Rights
At its most basic level, patient rights addresses conduct ________.
Between healthcare provider and patient
Passed to eliminate “patient dumping” for inability to pay
Applies to hospitals that
Participate in the Medicare program and
Offer emergency services
If ______ applies, hospitals must treat all patients who present for emergency treatment equally
Required steps for patients who present for emergency services:
Conduct medical screening exam (MSE)
If emergency medical condition (EMC) is found:
Treat and stabilize the condition without delay
May transfer without stabilization only if:
Patient requests
Medical benefits of transfer outweigh risks
Emergency Medical Treatment and Active Labor Act (EMTALA)
Competent adults have the right to accept or refuse treatment, even if death may result
A patient has this right per the Patient Self-Determination Act
A court may find a compelling state interest to preserve the person’s life despite refusal
Right to accept or refuse treatment
Competent adult patients may discharge themselves unless considered danger to self or others
May be a discharge against medical advice (AMA)
Right to discharge
Patient signs a form acknowledging potential consequences
Patient signs a form acknowledging health insurance may refuse to pay for care provided
Risks are discussed with the patient when possible
Documentation of the _______ in the patient’s medical record
AMA Discharge Procedure
Formerly known as ‘Patients’ Bill of Rights’
Helps patients understand their expectations, rights and responsibilities when receiving hospital services
American Hospital Association (AHA) Patient Care Partnership
Policies and procedures must exist to address patient rights and responsibilities
Joint Commission Standards
Provides healthcare coverage rights and protections
Requires individuals to have health insurance
Coverage of pre-existing conditions still remains a hot topic of debate
Affordable Care Act (ACA)
State specific rights for patients
State laws
Should address applicable requirements of external bodies such as Medicare Conditions of Participation and accrediting body standards
Patients should be given a notice of their rights upon first encounter
Includes personal rights and rights regarding patient property
Organizational patient rights policies
Involuntary civil commitment permitted if patient is a danger to self or others
Patients have right to procedural due process
Substantive rights (shelter, nutrition, etc.)
Right to consent or refuse treatment
Civilly committed patients must be distinguished from patients charged with crimes
Rights of patients with mental illnesses
________ does not automatically equate to mental incompetence
Mental illness
Involuntary confinement of a patient alone in a room or area; patient is prevented from leaving
Seclusion
Device or drug that restricts an individual’s freed of movement; is not for diagnosis, treatment, or patient protection
Restraint
___________ limits seclusion and restraint and provide reporting requirements for related injury or death
Medicare Conditions of Participation
Individual _______ and ________ of information shared with a healthcare provider are longstanding mandated rights
Privacy and confidentiality
Access one’s own PHI
Request amendment to PHI
Request accounting of disclosures of PHI
Request restrictions regarding use and disclosure of PHI for treatment, payment and operations
Request alternative location or method of communications
HIPAA individual rights
Provider-hosted secure websites that allow patients to access their own health information
_________ can include personal health records (PHRs), repositories where patients add their own health information
The most widely used feature is viewing test results
Does not replace a physician relationship but does provide more timely access to results for patients
Patient portals
________ consistent with HIPAA and furthers AHIMA’s commitment to support and protect people’s rights regarding their health information
AHIMA Consumer Health Information Bill of Rights
Capacity of an individual to obtain, process, and understand health information needed to make appropriate healthcare decisions
Health literacy
How an organization functions effectively in cross-cultural situations
Cultural competence
_______ and ________ must be considered as part of patient rights and patient-centered care because they encompass barriers to understanding health information including:
Educational levels
Reading proficiency and technological competency
Language barriers
English as a second language
Health literacy and Cultural Competence
Act on behalf of patient to negotiate and lower medical bills
Billing advocates
Teresa is a billing advocate. NetHealth is an insurance company. StarServe is a provider. Bob is a patient. Which of the following roles will Teresa serve?
A. Making sure that Bob pays the StarServe bill in a timely manner
B. Negotiating with hospitals on behalf of NetHealth to obtain optimal rates
C. Negotiating with StarServe to lower Bob’s medical bills
D. Making sure that Bob pays his NetHealth premiums in a timely manner
Negotiating with StarServe to lower Bob’s medical bills
In addition to being given rights, patients also have responsibilities in the patient-provider relationship
Codes of _________ typically require patients to:
Provide full and honest information
Ask questions if they do not understand
Work with providers to carry out agreed-on treatment plan
Respect providers and other patients
Make good-faith efforts to meet financial obligations
patient responsibilities
