Patient Bill of Rights
Legislative Intent
It is the intent of the Legislature and the purpose of this statement to
promote the interests and well-being of the patients of health care facilities.
No health care facility may require a patient to waive these rights as
a condition of admission to the facility. Any guardian or conservator
of a patient or, in the absence of a guardian or conservator, an interested
person, may seek enforcement of these rights on behalf of a patient. An
interested person may also seek enforcement of these rights on behalf
of a patient who has a guardian or conservator through administrative
agencies or in probate court or county court having jurisdiction over
guardianships and conservatorships. Pending the outcome of an enforcement
proceeding, the health care facility may, in good faith, comply with the
instructions of a guardian or conservator. It is the intent of this section
that every patient's civil and religious liberties, including the
right to independent personal decisions and knowledge of available choices,
shall not be infringed and that the facility shall encourage and assist
in the fullest possible exercise of these rights.
Definitions
For the purposes of this statement, "patient" means a person
who is admitted to an acute care inpatient facility for a continuous period
longer than 24 hours, for the purpose of diagnosis or treatment bearing
on the physical or mental health of that person. "Patient" also
means a minor who is admitted to a residential program as defined in Section
7, Laws of Minnesota 1986, Chapter 326. For purposes of this statement,
"patient" also means any person who is receiving mental health
treatment on an outpatient basis or in a community support program or
other community-based program.
Public Policy Declaration
It is declared to be the public policy of this state that the interests
of each patient be protected by a declaration of a patient's bill
of rights which shall include, but not be limited to, the rights specified
in this statement.
1. Information About Rights
Patients shall, at admission, be told that there are legal rights for their
protection during their stay at the facility or throughout their course
of treatment and maintenance in the community and that these are described
in an accompanying written statement of the applicable rights and responsibilities
set forth in this section. In the case of patients admitted to residential
programs as defined in Section 7, the written statement shall also describe
the right of a person 16 years old or older to request release as provided
in Section 253B.04, Subdivision 2, and shall list the names and telephone
numbers of individuals and organizations that provide advocacy and legal
services for patients in residential programs. Reasonable accommodations
shall be made for those with communication impairments and who speak a
language other than English.
Current facilities policies, inspection findings of state and local health
authorities, and further explanation of the written statement of rights
shall be available to patients, their guardians or their chosen representatives
upon reasonable request to the administrator or other designated staff
person, consistent with chapter 13, the Data Practices Act, and Section
626.557, relating to vulnerable adults.
2. Courteous Treatment
Patients have the right to be treated with courtesy and respect for their
individuality by employees of or persons providing service in a health
care facility.
3. Appropriate Health Care
Patients shall have the right to appropriate medical and personal care
based on individual needs. This right is limited where the service is
not reimbursable by public or private resources.
4. Physician's Identity
Patients shall have or be given, in writing, the name, business address,
telephone number and specialty, if any, of the physician responsible for
coordination of their care. In cases where it is medically inadvisable,
as documented by the attending physician in a patient's care record,
the information shall be given to the patient's guardian or other
person designated by the patient as his or her representative.
5. Relationship With Other Health Services
Patients who receive services from an outside provider are entitled, upon
request, to be told the identity of the provider. Information shall include
the name of the outside provider, the address and a description of the
service which may be rendered. In cases where it is medically inadvisable,
as documented by the attending physician in a patient's care record,
the information shall be given to the patient's guardian or other
person designated by the patient as his or her representative.
6. Information about Treatment
Patients shall be given by their physicians complete and current information
concerning their diagnosis, treatment, alternatives, risks and prognosis
as required by the physician's legal duty to disclose. This information
shall be in terms and language the patients can reasonably be expected
to understand. Patients may be accompanied by a family member or other
chosen representative, or both. This information shall include the likely
medical or major psychological results of the treatment and its alternatives.
In cases where it is medically inadvisable, as documented by the attending
physician in a patient's medical record, the information shall be
given to the patient's guardian or other person designated by the
patient as his or her representative. Individuals have the right to refuse
this information.
Every patient suffering from any form of breast cancer shall be fully informed,
prior to or at the time of admission and during her stay, of all alternative
effective methods of treatment of which the treating physician is knowledgeable,
including surgical, radiological or chemotherapeutic treatments or combinations
of treatments and the risks associated with each of those methods.
7. Participation in Planning Treatment
Notification of Family Members:
(a) Patients shall have the right to participate in the planning of their
health care. This right includes the opportunity to discuss treatment
and alternatives with individual caregivers, the opportunity to request
and participate in formal care conferences, and the right to include a
family member or other chosen representative or both. In the event that
the patient cannot be present, a family member or other representative
chosen by the patient may be included in such conferences. A chosen representative
may include a doula of the patient's choice.
(b) If a patient who enters a facility is unconscious or comatose or is
unable to communicate, the facility shall make reasonable efforts as required
under paragraph (c) to notify either a family member or a person designated
in writing by the patient as the person to contact in an emergency that
the patient has been admitted to the facility. The facility shall allow
the family member to participate in treatment planning, unless the facility
knows or has reason to believe the patient has an effective advance directive
to the contrary or knows the patient has specified in writing that they
do not want a family member included in treatment planning.
After notifying a family member but prior to allowing a family member to
participate in treatment planning, the facility must make reasonable efforts,
consistent with reasonable medical practice, to determine whether the
patient has executed an advance directive relative to the patient's
health care decisions. For purposes of this paragraph, "reasonable
efforts" include:
(1) examining the personal effects of the patient;
(2) examining the medical records of the patient in the possession of
the facility;
(3) inquiring of any emergency contact or family member contacted whether
the patient has executed an advance directive and whether the patient
has a physician to whom the patient normally goes for care; and
(4) inquiring of the physician to whom the patient normally goes for care,
if known, whether the patient has executed an advance directive. If a
facility notifies a family member or designated emergency contact or allows
a family member to participate in treatment planning in accordance with
this paragraph, the facility is not liable to the patient for damages
on the grounds that the notification of the family member or emergency
contact or the participation of the family member was improper or violated
the patient's privacy rights.
(c) In making reasonable efforts to notify a family member or designated
emergency contact, the facility shall attempt to identify family members
or a designated emergency contact by examining the personal effects of
the patient and the medical records of the patient in the possession of
the facility. If the facility is unable to notify a family member or designated
emergency contact within 24 hours after the admission, the facility shall
notify the county social service agency or local law enforcement agency
that the patient has been admitted and the facility has been unable to
notify a family member or designated emergency contact. The county social
service agency and local law enforcement agency shall assist the facility
in identifying and notifying a family member or designated emergency contact.
A county social service agency or local law enforcement agency that assists
a facility is not liable to the patient for damages on the grounds that
the notification of the family member or emergency contact or the participation
of the family member was improper or violated the patient's privacy rights.
8. Continuity of Care
Patients shall have the right to be cared for with reasonable regularity
and continuity of staff assignment as far as facility policy allows.
9. Right to Refuse Care
Competent patients shall have the right to refuse treatment based on the
information required in Right No. 6. In cases where a patient is incapable
of understanding the circumstances but has not been adjudicated incompetent,
or when legal requirements limit the right to refuse treatment, the conditions
and circumstances shall be fully documented by the attending physician
in the patient's medical record.
10. Experimental Research
Written, informed consent must be obtained prior to patient's participation
in experimental research. Patients have the right to refuse participation.
Both consent and refusal shall be documented in the individual care record.
11. Freedom From Maltreatment
Patients shall be free from maltreatment as defined in the Vulnerable Adults
Protection Act. Maltreatment means conduct described in Section 626.5572,
Subdivision 15, or the intentional and nontherapeutic infliction of physical
pain or injury, or any persistent course of conduct intended to produce
mental or emotional distress. Every patient shall also be free from nontherapeutic
chemical and physical restraints, except in fully documented emergencies,
or as authorized in writing after examination by a patients' physician
for a specified and limited period of time, and only when necessary to
protect the patient from self-injury or injury to others.
12. Treatment Privacy
Patients shall have the right to respectfulness and privacy as it relates
to their medical and personal care program. Case discussion, consultation,
examination and treatment are confidential and shall be conducted discreetly.
Privacy shall be respected during toileting, bathing and other activities
of personal hygiene, except as needed for patient safety or assistance.
13. Confidentiality of Records
Patients shall be assured confidential treatment of their personal and
medical records, and may approve or refuse their release to any individual
outside the facility. Copies of records and written information from the
records shall be made available in accordance with this subdivision and
Section 144.335. This right does not apply to complaint investigations
and inspections by the Department of Health, where required by third-party
payment contracts, or where otherwise provided by law.
14. Disclosure of Services Available
Patients shall be informed, prior to or at the time of admission and during
their stay, of services which are included in the facility's basic
per diem or daily room rate and that other services are available at additional
charges. Facilities shall make every effort to assist patients in obtaining
information regarding whether the Medicare or Medical Assistance program
will pay for any or all of the aforementioned services.
15. Responsive Service
Patients shall have the right to a prompt and reasonable response to their
questions and requests.
16. Personal Privacy
Patients shall have the right to every consideration of their privacy,
individuality and cultural identity as related to their social, religious
and psychological well-being.
17. Grievances
Patients shall be encouraged and assisted, throughout their stay in a facility
or their course of treatment, to understand and exercise their rights
as patients and citizens. Patients may voice grievances and recommend
changes in policies and services to facility staff and others of their
choice, free from restraint, interference, coercion, discrimination or
reprisal, including threat of discharge. Notice of the grievance procedure
of the facility or program, as well as addresses and telephone numbers
for the Office of Health Facility Complaints and the area nursing home
ombudsman pursuant to the Older Americans Act, Section 307 (a)(12), shall
be posted in a conspicuous place.
Every acute care inpatient facility, every residential program as defined
in Section 7 and every facility employing more than two people that provides
outpatient mental health services shall have a written internal grievance
procedure that, at a minimum, sets forth the process to be followed; specifies
time limits, including time limits for facility response; provides for
the patient to have the assistance of an advocate; requires a written
response to written grievances; and provides for a timely decision by
an impartial decision maker if the grievance is not otherwise resolved.
Compliance by hospitals, residential programs as defined in Section 7
which are hospital-based primary treatment programs and outpatient surgery
centers with Section 144.691 and compliance by health maintenance organizations
with Section 62D.11 are deemed to be in compliance with the requirement
for a written internal grievance procedure.
18. Communication Privacy
Patients may associate and communicate privately with persons of their
choice and enter and, except as provided by the Minnesota Commitment Act,
leave the facility as they choose. Patients shall have access, at their
expense, to writing instruments, stationery and postage. Personal mail
shall be sent without interference and received unopened unless medically
or programmatically contraindicated and documented by the physician in
the medical record. There shall be access to a telephone where patients
can make and receive calls as well as speak privately. Facilities which
are unable to provide a private area shall make reasonable arrangements
to accommodate the privacy of patients' calls. This right is limited
where medically inadvisable, as documented by the attending physician
in a patient's care record. Where programmatically limited by a facility
abuse prevention plan pursuant to the Vulnerable Adults Protection Act,
Section 626.557, Subdivision 14, Paragraph (b), this right shall also
be limited accordingly.
19. Personal Property
Patients may retain and use their personal clothing and possessions as
space permits, unless to do so would infringe upon rights of other patients,
and unless medically or programmatically contraindicated for documented
medical, safety or programmatic reasons. The facility may, but is not
required to, provide compensation for or replacement of lost or stolen items.
20. Services for the Facility
Patients shall not perform labor or services for the facility unless those
activities are included for therapeutic purposes and appropriately goal-related
in their individual medical record.
21. Protection and Advocacy Services
Patients shall have the right of reasonable access at reasonable times
to any available rights protection services and advocacy services so that
the patient may receive assistance in understanding, exercising and protecting
the rights described in this Section and in other law. This right shall
include the opportunity for private communication between the patient
and a representative of the rights protection service or advocacy service.
22. Right to Communication Disclosure and Right to Associate
Upon admission to a facility, where federal law prohibits unauthorized
disclosure of patient-identifying information to callers and visitors,
the patient, or the legal guardian or conservator of the patient, shall
be given the opportunity to authorize disclosure of the patient's
presence in the facility to callers and visitors who may seek to communicate
with the patient. To the extent possible, the legal guardian or conservator
of the patient shall consider the opinions of the patient regarding the
disclosure of the patient's presence in the facility.
The patient has the right to visitation by an individual the patient has
appointed as the patient's health care agent under chapter 145C and
the right to visitation and health care decision making by an individual
designated by the patient under paragraph 22.
Upon admission to a facility, the patient, or the legal guardian or conservator
of the patient, must be given the opportunity to designate a person who
is not related who will have the status of the patient's next of kin
with respect to visitation and making a health care decision. A designation
must be included in the patient's health record. With respect to making
a health care decision, a health care directive or appointment of a health
care agent under chapter 145C prevails over a designation made under this
paragraph. The unrelated person may also be identified as such by the
patient or by the patient's family.
ADDITIONAL RIGHTS IN RESIDENTIAL PROGRAMS THAT PROVIDE TREATMENT TO CHEMICALLY
DEPENDENT OR MENTALLY ILL MINORS OR IN FACILITIES PROVIDING SERVICES FOR
EMOTIONALLY DISTURBED MINORS ON A 24-HOUR BASIS:
23. Isolation and Restraints
A minor patient who has been admitted to a residential program as defined
in Section 7 has the right to be free from physical restraint and isolation
except in emergency situations involving likelihood that the patient will
physically harm the patient's self or others. These procedures may
not be used for disciplinary purposes, to enforce program rules or for
the convenience of staff. Isolation or restraint may be used only upon
the prior authorization of a physician, psychiatrist or licensed consulting
psychologist, only when less restrictive measures are ineffective or not
feasible and only for the shortest time necessary.
24. Treatment Plan
A minor patient who has been admitted to a residential program as defined
in Section 7 has the right to a written treatment plan that describes
in behavioral terms the case problems, the precise goals of the plan and
the procedures that will be used to minimize the length of time that the
minor requires inpatient treatment. The plan shall also state goals for
release to a less restrictive facility and follow-up treatment measures
and services, if appropriate. To the degree possible, the minor patient
and his or her parents or guardian shall be involved in the development
of the treatment and discharge plan.
Inquiries or complaints regarding medical treatment or the Patients'
Bill of Rights may be directed to:
Minnesota Board of Medical Practice
2829 University Ave. SE, Suite 400
Minneapolis, MN 55414-3246
Phone:
612.617.2130
or
800.657.3709
Office of Health Facility Complaints
P.O. Box 64970
St. Paul, MN 55164-0970
Phone:
651.201.4201 or
800.369.7994
Inquiries regarding access to care or possible premature discharge may
be directed to:
Ombudsman for Long-Term Care
PO Box 64971
St. Paul, MN 55164-0971
Phone:
651.431.2555 or
800.657.3591
Text provided by the Minnesota Hospital and Healthcare Partnership. Translation
financed by the Minnesota Department of Health. For more information on
this translation, contact the Minnesota Department of Health at 651.201.3701.