Pomerene

Patient Care & Privacy

Pomerene Hospital collects and maintains a great deal of personal health information about our patients. The federal HIPAA regulations on patient privacy and confidentiality require us to provide notice to our patients and the public about how this information may be used and disclosed by our organization. All employees are required to comply with provisions of this policy. 

Patient Care & Privacy

Visitation Hours

Pomerene Hospital promotes and supports a patient and family centered approach to care. Pomerene has an open visitation policy which means families are welcome 24 hours a day according to the patient's preference and consent.

Privacy Policy

Pomerene Hospital collects and maintains a great deal of personal health information about our patients. The federal HIPAA regulations on patient privacy and confidentiality require us to provide notice to our patients and the public about how this information may be used and disclosed by our organization. All employees are required to comply with provisions of this policy.


Timing of Provision.

The Notice of Privacy Practices was made available, distributed, and posted on or after April 14, 2003. This policy was last reviewed in October 2007.


Availability to the Public. 

A copy of the Notice of Privacy Practices must be made available on request to any person who requests it in each separate building where patients receive treatment.     


Distribution to Patients.

All patients must be provided a copy of the Notice of Privacy practices no later than the date of the first service delivery on or after April 14, 2003, including service delivered electronically, to such patient. A Notice of Privacy Practices must be provided to a patient for each separate admission or outpatient encounter. We are not required to provide Notice to any patient who is also an inmate in a correctional facility.   


E-Mail Delivery of Notice. 

If the first service delivery to a patient is delivered electronically, provide an electronic copy of the Notice of Privacy Practices automatically and contemporaneously in response to the patient's first request for service. The Notice of Privacy Practices may be provided to other patients by e-mail, if the patient agrees to electronic notice and such agreement has not been withdrawn. If you know that the e-mail transmission has failed, you must provide a paper copy of the Notice to the patient. The patient who is the recipient of an electronic notice retains the right to obtain a paper copy of the Notice upon request.


Acknowledgement of Receipt.

After providing the patient with a copy of the Notice of Privacy Practices, obtain the patient's signature on the "Receipt of Notice of Privacy Practices Acknowledgement Form." In the case of an emergency when the patient is not able to sign the acknowledgement form, attempt to obtain the patient's signature as soon as practicable. If the Notice is delivered electronically by e-mail, require the patient to acknowledge receipt of the e-mail electronically by replying to the Notice delivery e-mail. When the patient refuses to sign the form or you are otherwise unable to obtain a signature, document the attempts made to obtain the signature and the reasons why you were unsuccessful. Retain the signed acknowledgement forms and the documentation of failed attempts to obtain the signed form with the medical record. 


Posting the Notice.

Copies of the Notice of Privacy Practices must be posted in each separate building where patients receive treatment. The Notice must be posted in a clear and prominent location where it is reasonable to expect patients to be able to see and read the Notice. 


Website Posting.

A copy of the most current Notice of Privacy Practices must be posted prominently on our website and must be accessible by a link from the front page of the website.


Revisions to the Notice. 

Whenever the Notice of Privacy Practices is revised, make the revised Notice available upon request on or after the effective date of the revision, distribute the revised Notice as required in paragraph 3; promptly post the revised Notice as required in paragraph 5; and post the revised Notice on the website as required in paragraph 6. All patients arriving for treatment after the effective date of a revised Notice must be given the appropriate revised Notice.   

Medical Record Access

Accessing Your Medical Records


A patient may obtain a copy of their medical record by visiting the Health Information Department located on the first floor. You will need to bring one type of identification with you, i.e. driver's license or Social Security card in addition to completing one of our release forms. We also require 48-hour advance notice in order to process and prepare your records for release.



Hours of Operation & Additional Information


Hours of Operation
  • The Health Information Department is open Monday-Friday from 7:30 am to 4:00 pm.


Additional Information
  • Please click here to download our Medical Information Release Form. You may also have your physician fax the completed form to (330) 674-1259.
Request information from other providers to be sent to Pomerene Request your medical records from Pomerene

Your Right as a Patient

  • You have the right to:

    1.   Receive information about our organization, its services, its practitioners and providers, and patients' rights.      


    2.   Considerate and respectful care, recognition of their dignity, and to be made comfortable. You have the right to respect for your cultural, psychosocial, spiritual, and personal beliefs, and preferences.


    3.   Have family members (or another representative of our choosing) and your own physician notified promptly of your admission to the hospital.


    4.   Designate a representative to participate in care and treatment decisions.


    5.   Receive information about your health status, course of treatment, prospects for recovery and outcome of care (including unanticipated outcomes) in terms you can understand. You have the right to effective communication and to participate in the development and implementation of your plan of care. You have the right to participate in ethical questions that arise in the course of your care, including issues of conflict resolution, withholding resuscitative services, and forgoing or withdrawing life-sustaining treatment.


    6.   Make decisions regarding medical care, and receive as much information about any proposed treatment or procedure as you may need in order to give informed consent or to refuse a course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or non-treatment, and the risks involved in each, and the name of the person who will carry out the procedure or treatment.


    7.    A candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost of benefit coverage.


    8.    Request or refuse treatment, to the extent permitted by law. However, you do not have the right to demand inappropriate or medically unnecessary treatment or services. You have the right to leave the hospital even against the advice of physicians, to the extent permitted by law.


    9.    Reasonable responses to any reasonable requests made for services.


    10.  The right, subject to your consent, to receive the visitors whom he or she designates, including, but not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member, or a friend, and his or her right to withdraw or deny such consent at any time, and to be informed of any clinical restriction or limitation on such rights.


    11.   Appropriate assessment and management of your pain, information about pain, pain relief measures and to participate in pain management decisions. You may request or reject the use of any or all medication, if you suffer from severe chronic intractable pain. The doctor may refuse to prescribe opiate medication, but if so, must inform you that there are physicians who specialize in the treatment of severe chronic pain with methods that include the use of opiates.


    12.   Formulate advance directives. This includes designating a decision maker if you become incapable of understanding a proposed treatment or become unable to communicate your wishes regarding care. Hospital staff and practitioners who provide care in the hospital shall comply with these directives. All patient rights apply to the person who has legal responsibility to make decisions regarding medical care on your behalf.


    13.   Have personal privacy respected. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly. You have the right to be told the reason for the presence of any individual. You have the right to have visitors leave prior to an examination and when treatment issues are being discussed. Privacy curtains will be used in semi-private rooms.


    14.   Confidential treatment of all communications and records pertaining to your care and stay in the hospital. You will receive a separate "Notice of Privacy Practices" that explains your privacy rights in detail and how we may use and disclose your protected health information.


    15.   Receive care in a safe setting, free from mental, physical, sexual or verbal abuse and neglect, exploitation or harassment. You have the right to access protective and advocacy services including notifying government agencies of neglect or abuse.


    16.   Be free from restraints and seclusion of any form used as a means of coercion, discipline, convenience, or retaliation by staff.


    17.   Reasonable continuity of care and to know in advance the time and location of appointments as well as the identity of the persons providing the care.


    18.   Be informed, by the physician, or a delegate of the physician, of continuing health care requirements following discharge from the hospital.


    19.   Know which hospital rules and policies apply to your conduct while a patient.


    20.   Have your wishes considered, if you lack decision-making capacity, for the purposes of determining who may visit. Designate a support person to be present throughout the stay unless restricted by policy and to make decisions regarding visitation.


    21.   Examine and receive an explanation of the hospital's bill regardless of the source of payment.


    22.   Exercise these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, sexual orientation or marital status of the source of payment for care.


    23.   File or voice a complaint, grievance, and appeal or seek independent assessment about the organization, the care provided, or their rights as a patient; and to receive a timely response from the organization without reprisal or prejudicial treatment.


    24.   File a complaint with the hospital or directly to the State Department of Health Services regardless of whether you use the hospital's grievance process.


    25.   Receive, in accordance with 42 CFR 489.27 (b), as a Medicare beneficiary the "An Important Message from Medicare Notice" (IM) within two days of admission. In addition, the IM is to also be given to each Medicare beneficiary within two days of their anticipated discharge when the length of stay is longer than two days. This is a message that explains your right to appeal your discharge.


    26.   Access information contained in your medical record in a timely manner.



Comments and Concerns

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Contact Us

The following links provide information about available healthcare coverage for those who are eligible:       


Patient Concerns/Patient Care Representative
  • Pomerene Hospital strives to resolve concerns and complaints in a timely manner.
  • Pomerene Hospital's patient representative is here to be your advocate - to communicate your questions or concerns and to help you get prompt answers.
  • If you have any concerns about patient care or safety, please contact our Patient Care Representative listed below or dial extension 8675 from any Pomerene Hospital phone.


If your concerns cannot be met at this level, please contact:

Center for Improvement in Healthcare Quality

Address:
P.O. Box 1540

Mexia, TX 76667-1540
ATTN: Chief Executive Officer

Phone: (512) 661-2813 
Fax: (805) 934- 8588
Online


Ohio Department of Health

Address:
246 North High Street 
PO Box 118
Columbus, OH 43266-0118 

Phone: 800-669-3534

Confidentiality will be maintained, unless otherwise requested.


Accreditation Commission for Healthcare 

Address:
139 Weston Oaks Court
Cary, NC 27513

Phone: 919-785-1214
Fax: 919-785-3011
Online



CALL FOR MORE INFORMATION

For general billing questions or to arrange a payment plan, please call 330-674-1584, ext. 1744

330-674-1584 (ext 1744)