Please Tell Us... Your Rights & Responsibilities

What Are Your Advance Directives?

10123 SE Market St.Portland, OR 97216

503-257-2500AdventistHealth.org/NW

www.AdventistHealthNW.com/Homecare

1 MAIN NUMBER: 503-257-2500

10123 SE Market St.Portland, OR 97216

10STAY SAFE

You can contributeto healthcare safety.

17BEFORE YOU LEAVE...

6 things to know before you walk out that hospital door.

IN THIS GUIDE AdventistHealth.org/NW

Welcome to Adventist Medical Center 2Our Mission 2

Telephone Directory 3During Your Stay 4-6

Visiting Hours 4Wireless Internet Service 4Smoking 4 About Your Room 4CaringBridge 4Animals 4What’s Cooking 4Delicious Room Service Dining 5Special Diet Considerations 5Planning for Meals at Home 5Spiritual Care 5Where’s the Cafeteria 5Living Well Bistro 5Balloons 6Gift Shop 6ATM 6TV Channels 6

Please Tell Us... 7Your Rights & Responsibilities 8-9Stay Safe 10-12

Fighting Infections 11Preventing Falls 11Know Your Meds 12Questions for My Doctor 12

Making Decisions About Your Medical Care 13

Patient Services Advance Directives 13Advance Directive or Living Will 13

Healthcare Representative 13Durable Power of Attorney 13POLST 13Other Resources 13Bioethics Committee 13

Your Privacy & Information 14-15

Do You Have Pain? 16

Before You Leave... 17-18

Preparing to Leave the Hospital 19-20Going Home 19Billing: What a Hospital Bill Covers 19When You Are Discharged 19Volunteer 19Uninsured 20Coordination of Benefits 20Medicare 20Commercial Insurance 20For Self-Pay Patients 20

For the Caregiver 21Caregiver Resources 21

Resources 22-23Staff Definitions 22Hospital Resources 23

We Hope to Hear From You 24

Concerns About Your Care 25

Foundation 25

Notice of Privacy Practices 26-31

I Would Like to Recognize 32

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MAIN NUMBER: 503-257-2500 2 Adventist Medical Center

We are pleased that you and your physician have selected this hospital to provide your medical care.

Adventist Medical Center has been named in the top 5 percent nationwide for patient safety. What that means for you as a patient is you can have faith that you have placed your care in highly capable hands. Our entire team is here to help meet your needs.

Your care is of utmost importance to us. It is our desire to provide excellence in healthcare and promote lifelong wellness to every family we serve.

Christian caring for the whole person has always been at the heart of our hospital. We’ve come a long way from our humble beginning in a six-patient house in 1894 to this full-service leading hospital. Today, we are nationally recognized for the care we provide in the Portland metro area with more than 2,000 employees, 325 volunteers and hundreds of outstanding physicians. Adventist Medical Center’s advanced medical technology and dedicated team of professionals are meeting the growing needs of the community.

Please take a few moments to browse through this Patient Information and TV Guide, which offers details about our programs and services.

Please let a member of your healthcare team know if you need anything during your stay. May you and your family find hope and healing as you go through this hospital experience.

Sincerely,

David RussellPresident/Chief Executive OfficerAdventist Medical Center

WE HOPE TO HEAR FROM YOUYour satisfaction with your hospital experience is very important to us. In order for us to be better informed about how we are doing, we’ve asked an outside organization to administer a satisfaction survey to a sampling of our patients. The results of these surveys are compiled and presented to us in summary form; individual responses are kept confidential.

You may receive a survey after being discharged from the hospital. The survey asks for your feedback on many aspects of your hospital stay, including the admitting process, your daily care and living arrangements. If you receive a survey, we ask that you be honest and complete in your responses. Only by hearing your candid comments can we continue to improve. If you wish to give immediate feedback during your hospital stay, please don’t hesitate to contact our patient relations representative. You may send a letter or call us directly at 503-261-6633.

WELCOME TO ADVENTIST MEDICAL CENTER AdventistHealth.org/NW

Our MissionTo demonstrate the human expression of the healing ministry of Jesus Christ.

Living Our Values:INTEGRITY: Ensures our actions are consistent with our values.

QUALITY: Provides care that is safe, reliable and patient-centered.

COMPASSION: Reflects the love of Jesus through care, respect and empathy.

WHOLENESS: Embraces a balanced life—integrating mind, body and spirit.

RESPECT: Recognizes the God-given dignity and individuality of each person.

FAMILY: Supports each other in achieving our shared purpose.

STEWARDSHIP: Serves our community through responsible resource management.

Adventist Medical Center 3 MAIN NUMBER: 503-257-2500

MAIN NUMBER503-257-2500

GARDEN CAFÉMENU LINE503-251-MENU (6368)

PATIENT BUSINESS OFFICE503-251-6170

PATIENT INFORMATION503-257-2500

PATIENT REGISTRATION503-251-6140

Your Opinion CountsSoon after your discharge, an independent company may call you on behalf of this hospital to conduct a confidential patient satisfaction survey. Please take the time to speak with the representative and share your opinions about your hospital stay. Your feedback is an important part of our goal of improving the care and services we provide.

TELEPHONE DIRECTORY AdventistHealth.org/NW

Account Information 503-251-6170Administration 503-251-6150Adventist Health/ Medical Group 503-251-6292Audiology Services 503-251-6350Automated Attendant 503-251-6266Cancer Care Program & Cancer Registry 503-251-6263Cardiac Rehabilitation 503-251-6260CareMark Behavioral Health Services 503-413-4848Chaplains (Spiritual Care) 503-251-6105Class Registration & Physician Referral 503-256-4000 - Portland 360-256-4000 - VancouverContinuing Medical Education 503-251-6196Customer Service 503-251-6189Deaf Patient Services TTY (Deaf Clients Only) 503-251-6300Discharge Planning 503-251-6189Donations & Gifts 503-251-6197Emergency Department 503-251-6155Exercise Class Registration 503-256-4000Family Birth Place (Maternity) 503-251-6399Financial Counselors 503-251-6113Garden Cafe’ Menu Line 503-251-MENU (6368)Gresham Imaging Center 503-489-2600Healthcare Resources NW 503-261-6000Home Care Services 503-251-6301Home Medical Equipment 503-261-6070Hospice 503-251-6192Human Resources 503-251-6130Inspiration Line 503-251-6106Laboratory 503-251-6126Marketing & Public Relations 503-251-6162Maternity Class Registration 503-256-4000 Maternity & Family Birth Place 503-251-6399Medical Records 503-251-6878Medical Staff Office 503-251-6166

Mental Health Services 503-251-6390Nursing Administration 503-251-6150Occupational Therapy 503-251-6350Spiritual Care (Chaplains) 503-251-6105Pathology 503-251-6129Patient Business Office 503-251-6170 Patient Information 503-257-2500Patient Registration 503-251-6140Personal Care Services 503-251-6303Pharmacy 503-251-6141Physical Therapy 503-251-6100Physician Referral Services 503-256-4000Physician Services (Physician Practice Opportunities) 503-251-6310Professional Building 1, 2, 3 Information 503-251-6180Psychiatric Services (Mental Health Services) 503-251-6390Pulmonary Medicine 503-251-6134Quality Resources 503-251-6189Radiology - Information 503-251-6132 Ultrasound 503-251-6165 MRI 503-251-6132 Scheduling 503-251-6137 Radiation Oncology 503-251-6305 Reports 503-251-6223Short Stay Unit 503-251-6139Smoker’s Dial 503-251-6201Specialty Rehabilitation 503-261-6922Speech Therapy 503-251-6350TTY (24-Hour Hearing-Impaired Assistance) 503-261-6610Vascular Lab 503-251-6131Volunteer Services 503-251-6114Walla Walla College School of Nursing Dormitory 503-251-6118 Office 503-251-6115Wellness Services 503-261-6611

Calling a Department WITHIN the Hospital?Dial the last four digits of the number.

MAIN NUMBER: 503-257-2500 4 Adventist Medical Center

VISITING HOURSGeneral 11 a.m. to 8 p.m.

To visit outside these hours, you may need to speak with the nurses’ station. The hospital’s main entrance is locked between 9 p.m. and 5 a.m., and the Pavilion entrance is locked between 7 p.m. and 6 a.m. Entry during these hours is available only through the Emergency Department. Please note: The Family Birth Place is closed to visitors between 2 p.m. and 4 p.m. each day.

Wireless Internet AccessAdventist Medical Center is pleased to offer free public internet access/wireless services to our patients and their family or friends while visiting the hospital. To access the AH Public for the wireless network with your laptop, simply open your internet browser and accept the terms of use.

SmokingFor the health of our patients and team members, AMC is a completely smoke- and tobacco-free campus. This includes the use of e-cigarettes. Family members must leave the campus if they need to smoke.

DURING YOUR STAY AdventistHealth.org/NW

We have policies and procedures in place to help you and your family work with our doctors, nurses and staff to get the most from your hospital stay. Please take a few minutes to review these guidelines with your loved ones.

ABOUT YOUR ROOMWhen you are admitted to your private room, you’ll receive a room orientation. Your nurse will explain such things as how to call your nurse, adjust your bed, turn on the television and more. To prevent a fall, especially at night, use your nurse call button and wait for your nurse to help you. Your nurse also will help adjust the temperature in your room or obtain additional blankets, if needed.

TelephoneThe hospital’s general telephone number is 503-257-2500, and your extension is listed on the care board in your room. The switchboard connects calls to patients from 7 a.m. to 11 p.m. daily. If you expect calls outside of these hours, please inform the nurses desk.

For a local callDial 9 then the phone number.

For long distanceDial 0 and the operator will connect you to a long-distance service. You must use a calling card or make a collect call. If you wish to not take calls, dial 0 and tell the hospital operator not to put calls through for an hour or two, or that you’ll call back when you wish to take calls.

For the Hearing ImpairedAmplified handsets and TDD terminals are available. Ask your nurse to make arrangements.

CARINGBRIDGEIt is difficult to stay connected with family and friends during a health crisis, treatment and recovery. It is usually the time when you need their support the most. Adventist Medical Center is happy to refer patients to CaringBridgeTM, an internet service that helps patients and their families create a free, personalized website to stay in touch with friends and relatives during a hospital stay. This secure service offers an online journal, photo album and guestbook.

ANIMALSIn order to maintain a clean and safe environment for our patients, no animals, other than service animals (e.g. seeing eye dogs), are allowed in the hospital.

WHAT’S COOKINGOnce you are admitted and provided with a diet prescription, you may have the opportunity to choose your own food from a variety of selections on a diet-specific menu. Menus are provided on your breakfast tray for the next day. Please indicate your choices on the menu and leave it on your bed table. A nutritional services or

Adventist Medical Center 5 MAIN NUMBER: 503-257-2500

AdventistHealth.org/NW DURING YOUR STAY continued

WHERE’S THE CAFETERIA?LOCATION: The Garden Café, located on the lower level, serves breakfast, lunch and dinner. HOURS: Monday – Friday: 6:30 a.m. – 7:15 p.m.

Weekends and holidays: 6:30 a.m. – 8:30 a.m.; 11:15 a.m. – 1:15 p.m.; 4:45 p.m. – 6:30 p.m.

Living Well BistroLOCATION: Located off the pavilion lobby at 1000 SE Main St.

HOURS: Monday – Thursday:7 a.m. – 6 p.m.Fridays:7 a.m. – 2 p.m.

nursing staff member will pick it up and answer any questions you may have about your diet. If you would like to make selections for the current day, you may ask your nurse for a copy of your menu.

DELICIOUS ROOM SERVICE DININGA room service menu will be provided to you upon admission. Room service is available between 7 a.m. and 7 p.m. each day. To place your order, contact your host or hostess using the number provided in your menu. Your meal will be delivered within 45 minutes of placing your order.

SPECIAL DIET CONSIDERATIONSIf your physician has placed you on a special diet, or you have been scheduled for certain tests, you might have some menu restrictions to help in your healing process. The host or hostess will be able to assist you in making the appropriate choices.

Our menu includes the number of carbohydrate servings to help you manage your blood sugars. One serving of carbohydrate equals 15 grams. The average diabetic diet includes three to five carbohydrate servings per meal.

Monitoring blood sugars and administrating medications must be timed with food intake to be most effective. For this reason, it is important that you notify nursing staff after ordering each meal.

To assist you in meeting your dietary goals, we have placed a heart alongside certain Heart Healthy menu items. If you have dietary concerns and wish to speak with one of our registered dietitians, please call 16430.

PLANNING FOR MEALS AT HOMEA doctor may advise that you follow a special diet when you return home. Some of these special diets may require knowledge about menu planning, cooking, shopping and eating out. If you have questions, please ask your doctor or nurse to contact your dietitian. A dietitian can help provide a clear explanation and instructions for you. If you don’t understand your diet after you get home, you may call the hospital to schedule an appointment with an outpatient dietitian at 503-261-6678.

SPIRITUAL CARE Your spiritual care person (pastor, priest, rabbi, etc.) is always welcome to visit while you are at Adventist Medical Center. Members of the hospital spiritual care staff also are available to assist, whether for a specific religious tradition, to answer questions, or to offer prayer, communion or other support. Chaplains are available 24 hours a day, seven days a week. Call 503-251-6105 during weekday office hours or 0 all other times.

Weekday office hours:Monday – Thursday, 8 a.m. – 5 p.m.Friday, 8 a.m. – 3 p.m.

Chaplains are on hand to:n Provide assistance and support spiritual needs.n Contact a clergy of your choice to call or visit.n Offer emotional support to family members and patients.

MAIN NUMBER: 503-257-2500 6 Adventist Medical Center

BALLOONSMylar balloons are available in the gift shop. AMC does not permit latex balloons on the hospital campus.

GIFT SHOPThe Rose Petal Gift Shop, ext. 10575, located in the hospital lobby, has a variety of gift items, greeting cards, candy, toiletries, flowers and more. It is staffed by hospital volunteers.

HOURS:Monday – Thursday: 8:30 a.m. – 7 p.m.Friday: 8:30 a.m. – 3:30 p.m.Sunday: 11 a.m. – 3 p.m.

ATMNorthwest Adventist Federal Credit Union is located next to Professional Building 3 and also operates an ATM on the lower level of the hospital between the Atrium and the Garden Café. The machine accepts American Express, Discover, MasterCard and Visa.

DURING YOUR STAY AdventistHealth.org/NW

n Provide baby dedications, communion, anointing and other sacraments.n Conduct worship services on Saturdays and Sundays in the chapel, located

just off the main lobby.We invite you to visit PrayerWorks, a 24/7 online prayer community where you can post your prayer requests, concerns and struggles. You can share your story, read other people’s requests and stories, and even pray for them. Each week, our team prays over each and every request. Visit http://www.AHPrayerWorks.org.

TV CHANNELS 4 Newborn Channel

(English) 5 Newborn Channel

(Spanish) 6 Expansion 7 Chaplain Channel 8 Expansion 9 Lobby Camera10 LLBN11 Esperanza

(Spanish)12 3ABN13 Hope Channel14 Discovery Kids15 Freeform16 Cartoon Network

17 PBS18 Fit TV19 Animal Planet20 Discovery21 OWN22 Planet Green23 National

Geographic24 TLC25 Speed26 Military27 UNI28 ABC29 CBS30 NBC31 FOX

32 Fox News33 Headline News34 CNN35 C-SPAN 236 Weather Channel37 Bloomberg38 AMC39 CW40 USA41 ION42 KPDX43 FX44 TBS45 TNT46 ID

7 MAIN NUMBER: 503-257-2500

Take charge of your care.

SPEAK UP & STEP UP

SPEAK UP Ask questions and voice concerns. It’s your body, and you have a right to know.

PAY ATTENTIONMake sure you’re getting the right treatments and medicines.

EDUCATE YOURSELF Learn about the medical tests you get and your treatment plan.

FIND AN ADVOCATE Pick a trusted family member or friend to be your advocate or support person.

WHAT MEDS & WHYKnow what medicines you take and why you take them.

CHECK BEFORE YOU GOUse a hospital, clinic, surgery center or other type of healthcare organization that meets The Joint Commission’s quality standards.

PARTICIPATE IN YOUR CAREYou are the center of the healthcare team.

During your stay, the doctors, nurses and staff of your hospital will treat you and your family as partners in your own care. One important way that you can be involved is to speak up. Ask questions, voice your concerns, and don’t be afraid to raise any issues relating not only to your care and treatment, but also to overall hospital services.

In the pages that follow, you’ll find a step-by-step guide to making the most of your hospital stay—how to stay safe, get the information you need, ask the right questions and interact effectively with your doctors, nurses and hospital staff.

REMEMBERn Write down any questions

you haven Choose a support person

to communicate with the doctors and staff

n Keep a list of doctors you see and the meds they prescribe

Courtesy of The Joint Commission.

WHO QUESTIONS MUCH, SHALL LEARN MUCH AND RETAIN MUCH. FRANCIS BACON 1561-1626

Please TELL Us...

MAIN NUMBER: 503-257-2500 8 Adventist Medical Center

YOUR RIGHTS & RESPONSIBILITIES AdventistHealth.org/NW

As a patient, you have the right to respectful and considerate care. In addition, there are specific rights and responsibilities you have during your hospital stay.

YOU HAVE THE RIGHT TO: 4 Compassionate care that is respectful of your cultural, psychosocial, spiritual and

personal values, beliefs and preferences.4 Participate in the development and implementation of your plan of care.4 Make informed decisions regarding your care. This includes being informed of your

health status, being involved in care planning and treatment, and being able to request or refuse treatment.

4 Formulate advance directives, and have hospital staff and practitioners who provide care in the hospital comply with these directives.

4 Have a family member or representative of your choice and your own physician notified promptly of your admission to the hospital.

4 Personal privacy.4 Receive care in a safe setting.4 Be free from all forms of abuse or harassment, including physical or mental abuse

and corporal punishment.4 The confidentiality of your clinical records.4 Access information contained in your clinical records within a reasonable

time frame.4 Be free from restraint or seclusion, of any form, imposed as a means of coercion,

discipline, convenience or retaliation by staff. Restraint or seclusion may only be imposed to ensure the immediate physical safety of the patient, a staff member or others, and must be discontinued at the earliest possible time.

4 Receive the visitors whom you designate, including, but not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member or a friend, and the right to withdraw or deny such consent at any time. The hospital shall not restrict, limit or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation or disability. The hospital shall ensure that all visitors enjoy full and equal visitation privileges consistent with patient preferences and hospital visitation policy.

4 Access state survey agencies and quality improvement organizations, protective services, and advocacy groups.

4 Receive information in a manner you can understand.4 Refuse care, treatment and services in accordance with law and regulation.4 Give or withhold informed consent for care.4 Give or withhold informed consent to produce or use recordings, films or other

images of yourself for purposes other than your care. You have the right to rescind consent before the recording, film or image is used.

4 Receive information about the individuals responsible for your care, treatment and services.

4 An environment that preserves your dignity and contributes to a positive self-image.4 Pain management.4 Religious and other spiritual services.4 Have your complaints reviewed by the hospital.

Adapted from guidelines of The Joint Commission and the Centers for Medicare and Medicaid Services.

Adventist Medical Center 9 MAIN NUMBER: 503-257-2500

ConcernsIf you have any concerns about your care, we encourage you to notify your caregivers, the unit manager or hospital administration right away. This communication will usually resolve your concern quickly and effectively.

YOU ARE RESPONSIBLE FOR: 4 Provide relevant information about your health, including: past illnesses,

hospital stays and use of medications.4 Ask questions when you do not understand information or instructions.4 Follow the treatment plan received from your physician or tell your physician

if you believe you cannot follow through with your treatment.4 Be responsible for outcomes if you do not follow the treatment plan. Be

considerate, along with your visitors, toward care providers, other staff members and other patients.

4 Provide insurance information and make arrangements for paying your bills.4 Follow the hospital’s rules and regulations.

FILING A GRIEVANCEIf your concern regarding quality of care issues has not been addressed to your satisfaction by our staff, you may file a grievance by telephone or in writing with:

Customer Service RepresentativeAdventist Medical Center10123 SE Market St.Portland, OR 97216503-251-6189

Or you may file a grievance with:Adventist Health Compliance HotlineAdventist Health2100 Douglas Blvd.Roseville, CA 95661888-366-3833

Grievances are acknowledged within seven business days, and the final resolution of the grievance will be mailed to you in writing within 30 days.

If you still feel your concern has not been resolved, you may contact any of the following agencies:

Health Care Regulation & Quality ImprovementOregon Health Division800 NE Oregon St., Suite 305Portland, OR 97232971-673-0540

Acumentra2020 SW Fourth Ave., Suite 520,Portland, OR 97201-4960503-279-0100

The Joint CommissionOffice of Quality and Patient SafetyOne Renaissance Blvd.Oakbrook Terrace, IL 60181Fax: 630-792-5663

AdventistHealth.org/NW YOUR RIGHTS & RESPONSIBILITIES continued

MAIN NUMBER: 503-257-2500 10

While you are in the hospital, many people will enter your room, from doctors and nurses to aides and orderlies. The following information will help make your hospital stay safe and comfortable.

FEAR IS THE FATHER OF COURAGE AND THE MOTHER OF SAFETY.HENRY H. TWEEDY 1868-1953

You can contribute to healthcare safety.

Stay SAFE

DON’T BE AFRAID TO ASK…A number of people may enter your hospital room. Be sure to:n Ask for the ID of everyone who comes

into your room.n Speak up if hospital staff doesn’t ask to check

your ID.n Ask if the person has washed his or her hands

before he or she touches you.n If you are told you need certain tests or

procedures, ask why you need them, when they will happen and how long it will be before you get the results.

EMPLOYEE IDENTIFICATIONAll hospital employees wear identification badges. Feel free to ask any staff member for his or her name and job classification. If you do not see an ID badge on an employee, please call your nurse immediately.

Check ID

PATIENT IDENTIFICATIONAny time staff members enter your room to administer medications, transport you or perform procedures and treatments, they must check your birth date and name before they proceed. At times, you may be asked the same questions repeatedly. We are aware that this may be annoying. Please understand, however, that this verification process is a critical component in our patient safety program in order to guarantee that all of our patients receive the correct medications and treatments.

FIGHTING Infections

PREVENTING Falls

STAY SAFE

PLEASE HELP US KEEP YOU SAFE BY FOLLOWING THESE GUIDELINES DURING YOUR HOSPITAL STAY:

n Do not get out of bed by yourself. Your hospital bed is probably higher and narrower than your bed at home, and you can easily fall while trying to get in or out of it. Please use your nurse call button and ask for assistance.

n Keep often-used items—call button, tissues, water, eyeglasses, telephone, TV remote—within easy reach.

n Do not walk in bare feet. Wear nonskid socks or slippers.n Make sure your robe or pajamas don’t drag on the floor; they can cause you to trip.n Use the handrails in your bathroom and throughout the hospital at all times.n Ask your nurse to show you how to properly walk with your IV pole, drainage bags or any other equipment.n Be sure your wheelchair is locked when getting in or out of it. Never step on the footrest.n If you see a spill on the floor, report it at once.

It also is important that your healthcare providers wash their hands with either soap and water or an alcohol-based hand cleaner every time, before and after they touch you. Healthcare providers know to practice hand hygiene, but sometimes they forget. You and your family should not be afraid or embarrassed to speak up and ask them to wash their hands.

NO SOAP? NO PROBLEM.Alcohol-based hand cleaners are as effective as soap and water in killing germs. To use, apply the cleaner to the palm of your hand and rub your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry.

HAPPY BIRTHDAY TO YOU!Wash your hands with soap and warm water for 15 to 20 seconds. That’s about the same amount of time that it takes to sing the “Happy Birthday” song twice.

While you’re in the hospital to get well, there is the possibility of developing an infection. The single most important thing you can do to help prevent infections is to wash your hands and make sure that everyone who touches you—including your doctors and nurses—washes his or her hands, too.

YOU, YOUR FAMILY AND FRIENDS SHOULD WASH HANDS:

1. after touching objects or surfaces in the hospital room2. before eating3. after using the restroom

11 MAIN NUMBER: 503-257-2500

Hospital patients often fall because they are weak or unsteady due to illness or medical procedures, their medications make them dizzy, or they’ve been sitting or lying down for too long. Adventist Medical Center cares about our patients’ safety.

PATIENTS OF ALL AGES ARE AT RISK OF FALLS BECAUSE OF MEDICATIONS THAT MAY MAKE THEM DIZZY, WEAK OR UNSTEADY

Stay SAFE

MAIN NUMBER: 503-257-2500 12

Use this checklist to help you get the information you need from your doctor:

What is the name of the medicine? What is its generic name? Why am I taking this medicine? What dose will I be taking? How often, and for how long? When will the medicine begin to work? What are the possible side effects? Can I take this medicine while taking my other medications

or dietary supplements? Are there any foods, drinks or activities that I should avoid

while taking this medicine? Should I take my medicine at meals or between meals? Do I need to take the medicine on an empty stomach

or with food or a whole glass of water? What should I do if I forget to take the medicine

and miss a dose?

PREVENTING MEDICATION ERRORS

By taking part in your own care, you can help the members of your healthcare team avoid medication errors. Here’s how:

Be sure that all of your doctors know what medications you have been taking, including prescription drugs, over-the-counter medications, herbal and vitamin supplements, natural remedies and recreational drugs.

Be sure that all of your doctors know of any allergies you may have—to medications, anesthesia, foods, latex products, etc.

When you are brought medications or IV fluids, ask the person to check to be sure you are the patient who is supposed to receive the medications. Show that person your ID bracelet to double-check.

Remember—you play an important role in helping to reduce medication errors. Know Your MEDS:

QUESTIONS for My Doctor

While you are hospitalized, your doctor may prescribe medications for you. Be sure that you understand exactly what they are and why they are being prescribed.

ABOUT MY MEDICINES: Once you are discharged from the hospital, your pharmacist can help answer your questions about medications, including what the label on the medicine bottle means. Ask your pharmacist to put your medicines in easy-to-open containers, and ask for large-print labels. Also see “Know Your Meds” above.

ABOUT MY MEDICAL TESTSn Why do I need this test?n What will this test show about my health?n What will the test cost? Will my insurance cover the costs?n What do I need to do to get ready for the test?n How is the test done? What steps does the test involve?n Are there any dangers or side effects?n How will I find out the results of my test? How long will

it take to get the results?n What will we know after the test?n Will I get a written copy of the test results?

BE INFORMED: You and your caregiver need to stay informed about your medical condition and treatments while you are hospitalized. Once you are released from the hospital, it is important to have this information available

so you can share it with your primary care physician during your next visit. These checklists will help you ask questions while in the hospital and keep track of vital health and medication information.

ABOUT MY CONDITIONn What effect did my hospitalization have

on my condition? Is it cured or just under control for now?

n How can my condition be treated, managed or made better?

n How will this condition affect me? Will I need to change some of my activities?

n Are there long-term effects of my condition?n How can I learn more about my condition?

Adventist Medical Center 13 MAIN NUMBER: 503-257-2500

MAKING DECISIONS ABOUT YOUR MEDICAL CAREDocuments That Reflect Your Medical Care DecisionsAn advance directive/living will, healthcare representative/proxy and durable power of attorney are legal documents that allow you to give direction to medical personnel, family and friends concerning your future care when you cannot speak for yourself. You do not need a lawyer in order to complete advance directives.

Each time you are admitted to the hospital, your nurse and/or physician will discuss your advance directive preferences with you to ensure that the hospital has the most current information.

FYIFor more information about advance directives or to obtain forms, please speak with your physician, nurse, chaplain, discharge coordinator, palliative care representative or customer service representative. You also may request a copy of the Oregon Health Directives booklet from the registration staff.

Bioethics CommitteeCheck with hospital staff for more information. An Ethics Committee is available to address controversies that may arise while making healthcare decisions.

Patient Services Advance DirectivesYou have the right to make decisions about your own medical treatment. These decisions become more difficult if, due to illness or a change in mental condition, you are unable to tell your doctor and loved ones what kind of healthcare treatments you want. That is why it is important for you to make your wishes known in advance.

Here is a brief description of each kind of directive:

Advance Directive or Living WillA set of instructions documenting your wishes about life-sustaining medical care. It is used if you become terminally ill, incapacitated, or unable to communicate or make decisions. A living will protects your rights to accept or refuse medical care and removes the burden for making decisions from your family, friends and medical professionals.

Healthcare Representative A person (agent) you appoint to make your medical decisions if you are unable to do so. Choose someone you know well and trust to represent your preferences. Be sure to discuss this with the person before naming him or her as your agent. Remember that an agent may have to use his or her judgment in the event of a medical decision for which your wishes aren’t known.

Durable Power of AttorneyFor healthcare: A legal document that names your healthcare representative or proxy. Once written, it should be signed, dated, witnessed, notarized, copied and put into your medical record.

For finances: You also may want to appoint someone to manage your financial affairs when you cannot. A durable power of attorney for finances is a

separate legal document from the durable power of attorney for healthcare. You may choose the same person for both, or choose different people to represent you.

POLSTA POLST form (or physician orders for life-sustaining treatment) is used to write orders indicating life-sustaining treatment wishes for seriously ill patients when they cannot speak for themselves. The POLST form complements the advance directive, but is not intended to replace it. An advance directive is necessary to appoint a legal healthcare representative and provide instructions for future life-sustaining treatments. A POLST form is completed by a healthcare professional after understanding your values and goals of care before a hospitalization. This form is signed by a physician.

Other ResourcesThe American Hospital Association offers a web resource with easy-to-use, helpful information about advance directives, www.putitinwriting.org. Elements of the site include:n Wallet card—a printable card that

alerts healthcare workers that the card-carrying patient has filled out an advance directive. The card also provides emergency contact names and numbers.

n Put It In Writing brochure.n Glossary—simple explanations of

frequently used terms like living will, advance directive and durable power of attorney for healthcare.

n Advance directives links and toolkit —links include the National Palliative and Hospice Care Organization’s free, state-specific advance directives list. Also highlighted is the American Bar Association’s Web guide, 10 Legal Myths About Advance Medical Directives and toolkit.

MAIN NUMBER: 503-257-2500 14 Adventist Medical Center

PRIVACY & YOUR HEALTH INFORMATION AdventistHealth.org/NW

A separate law provides additional privacy protections to patients of alcohol and drug treatment programs. For more information, go online to www.samhsa.gov.

Read all consent forms carefully; pay attention to the details.

Adapted from U.S. Department of Health & Human Services Office for Civil Rights

You have privacy rights under a federal law that protect your health information. These rights are important for you to know. Federal law sets rules and limits on who can look at and receive your health information.

WHO MUST FOLLOW THIS LAW?4 Most doctors, nurses, pharmacies, hospitals, clinics, nursing homes and many

other healthcare providers and their vendors4 Health insurance companies, HMOs and most employer group health plans4 Certain government programs that pay for healthcare, such as Medicare

and Medicaid

WHAT INFORMATION IS PROTECTED?4 Information your doctors, nurses and other healthcare providers put in your

medical records4 Conversations your doctor has with nurses and others regarding your care

or treatment4 Information about you in your health insurer’s computer system4 Billing information about you at your clinic4 Most other health information about you held by those who must follow this law

YOU HAVE RIGHTS OVER YOUR HEALTH INFORMATION. Providers and health insurers who are required to follow this law must comply with your right to:4 Ask to see and get a copy of your health records4 Have corrections added to your health information4 Receive a notice that tells you how your health information may be used and shared4 Decide if you want to give your permission before your health information can be

used or shared for certain purposes, such as for marketing4 Get a report on when and why your health information was shared for

certain purposes4 File a complaint

To make sure that your health information is protected in a way that doesn’t interfere with your healthcare, your information can be used and shared:4 For your treatment and care coordination4 To pay doctors and hospitals for your healthcare and help run their businesses4 With your family, relatives, friends or others you identify who are involved with

your healthcare or your healthcare bills, unless you object4 To make sure doctors give good care and nursing homes are clean and safe4 To protect the public’s health, such as by reporting when the flu is in your area4 To make required reports to the police, such as reporting gunshot wounds

Without your written permission, your provider cannot:4 Give your health information to your employer4 Use or share your health information for marketing or advertising purposes4 Share private notes about your mental health counseling session

Adventist Medical Center 15 MAIN NUMBER: 503-257-2500

AdventistHealth.org/NW PRIVACY & YOUR HEALTH INFORMATION continued

If you believe your health information was used or shared in a way that is not allowed under the privacy law, or if you weren’t able to exercise your rights, you can file a complaint with your provider or health insurer. You also can file a complaint with the U.S. government. Go online to www.hhs.gov/ocr/privacy for more information.

How do I get copies of my medical records?If you would like a copy of your medical records, please contact the Medical Records department at 503-251-6878.

YOUR PRIVACY RIGHTSWe understand that medical and behavioral health information about you is personal. We are committed to protecting this information. Our Notice of Privacy Practices (NPP) describes how medical and behavioral health information about you may be used and disclosed and how you can get access to this information. The NPP also describes your rights and certain obligations we have regarding the use and disclosure of your health information. Generally, we are permitted to use and disclose information for treatment, payment and healthcare operations.

Please refer to the NPP for additional information. If you would like a copy of the NPP, please ask your nurse. You have a right to be excluded from our facility directory. If you choose this option, we will not disclose that you are a patient here. If you are listed in the facility directory and someone asks for you by name, we may disclose your presence within the facility and a one-word description of your condition.

NOTES

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MAIN NUMBER: 503-257-2500 16

COURAGE IS RESISTANCE TO FEAR, MASTERY OF FEAR, NOT ABSENCE OF FEAR. MARK TWAIN 1835-1910

In addition, there are other nonmedicinal ways to relieve pain. Speak with your doctor about whether any of these treatments may be right for you:n Acupuncture, which uses

small needles to block painn Physical therapyn Massagen Exercisen Heat or coldn Electrical nerve stimulation,

which uses small jolts of electricity to block pain

n Relaxation

You are the expert about how you are feeling. Be sure to tell your doctor or nurse when you have any kind of pain.

TO HELP DESCRIBE YOUR PAIN, BE SURE TO REPORT:n When the pain began.n Where you feel pain.n How the pain feels—sharp, dull, throbbing, burning, tingling.n If the pain is constant, or if it comes and goes.n What, if anything, makes the pain feel better.n What, if anything, makes the pain feel worse.n How much pain, if any, your medicine is taking away.n If your medicine helps with the pain, how many hours of relief do you get?

MEDICATIONS FOR PAINPain medication may be given in different forms:n Tablet or liquidn Injections into your skin or a muscle (IM)n Injections into a vein (IV)n Through a small tube in your back (an epidural)n Via Patient-Controlled Analgesia (PCA): A method of giving medicine into

the vein with a pump that you control so you receive medicine when you need it

WHAT YOU CAN DOIf your current pain treatment is not working, talk with your caregiver about finding other methods that will help reduce or relieve your pain. Some things you can do:n Hold the incision or painful area with a blanket or pillow when coughing or movingn Walk if your doctor allows n Take your mind off the pain by watching a movie, reading or playing a game

Do You Have PAIN?Manage your pain so your hospital stay is as comfortable as possible.

Are you afraid that you’ll become addicted to pain medicine? This is a common concern of patients. Studies show that addiction is unlikely, especially if you have never had a history of addiction to drugs or alcohol. Talk to your doctor or nurse about your fears.

USE THE PAIN RATING SCALE BELOW TO TELL YOUR DOCTOR OR NURSE HOW YOUR PAIN IS AFFECTING YOU.

National experts, local care.OHSU Knight Cancer Institute is part of your neighborhood.At Adventist Health in East Portland, OHSU’s nationally recognized experts are on your care team. With a wide array of clinical trials and streamlined access to Oregon’s only academic medical center, the best cancer care is also the closest to home.

O H S U K N I G H T C A N C E R I N S T I T U T E

VISIT: WWW.OHSUKNIGHTCANCER .COM /EASTPORTL AND APPOINTMENTS: 97 1 -262- 98 00

Don’t let your heart quit on you. If you are living with high blood pressure, just knowing and doing the minimum isn’t enough. Uncontrolled high blood pressure could lead to stroke, heart attack or death.

Get yours to a healthy range before it’s too late. Find out how at heart.org/BloodPressure

Check. Change. Control.™

I QUIT!

Dear Sam, The pressure you’re putting me under is too much.

Sincerely,

Your Heart

Your care is our priority, so we’re preparing tomorrow’s nurses with rigorous training in a caring, Christian environment. Learn more about our personalized attention, advanced courses and opportunities to serve around the world at:

School of Nursingwallawalla.edu/nursing

(503) 251-6115

Called to Care

aarp.org/caregiving or call

1-877-333-5885®

Only those who care for others know what it’s really

like to care for others. That’s why AARP created a community with experts and other caregivers to help us better care for ourselves and for the

ones we love.

PROFESSIONALCENTER PHARMACYCOMPOUNDING PROFESSIONALS

Professional Center Pharmacy is always just a visit or phone call away from excellent service. We offer free consultations that range from questions about your

current medications and over-the-counter supplements to specific treatments for compounded medications. We have one of the most knowledgeable staffs in the country with over 100 years of pharmacy experience.

Please feel free to contact us at any time regarding your information needs.

503-255-2546

Consultation is free of charge!

10000 SE Main Street, #118 • Portland, OR 97216www.professionalcenterpharmacy.com

©2015 American Cancer Society, Inc. No. 030890

The American Cancer Society is here for you when you need us, where you need us.

Spot a Stroke

F. A.S.T.Arm. Speech. Time to call 911.Face.

StrokeAssociation.org

Learn how you can help stop diabetes by losing weight, eating healthy and staying active.

Visit checkupamerica.org or call 1-800-DIABETES.

With every step, you lower your risk for type 2 diabetes and heart disease.

It’s not easy. But it is worth it.

but very much worth the effort.

Losing weight’s a lot harder than gaining it…

6 things to know before you walk out that hospital door.

BE SURE TO MEET WITH THE HOSPITAL’S DISCHARGE PLANNER EARLY IN YOUR STAY TO ENSURE A SMOOTH DISCHARGE PROCESS LATER ON.

17 MAIN NUMBER: 503-257-2500

IN THE FIELD OF OBSERVATION, CHANCE FAVORS ONLY THE PREPARED MIND.LOUIS PASTEUR 1822-1895

When it’s time to be released from the hospital, your physician will authorize a hospital discharge. This doesn’t necessarily mean that you are completely well—it only means that you no longer need hospital services. If you disagree, you or your caregiver can appeal the decision (see If You Disagree, below).

On the other hand, you may be pleased to learn that your doctor has approved your discharge. But before you can leave the hospital, there are several things that you or your caregiver must attend to.

The first step is to know who will be involved in your discharge process. This starts with the hospital’s discharge planner, case management nurse or social services. You and your caregiver should meet this person relatively early in your hospital stay; if not, find out who this person is and be sure to meet with him or her well before your expected discharge date.

HAVE THE FOLLOWING INFORMATION BEFORE YOU LEAVE THE HOSPITAL:

1. Discharge summary. This is an overview of why you were in the hospital, which healthcare professionals saw you, what procedures were done and what medications were prescribed.

2. Medications list. This is a listing of what medications you are taking, why, in what dosage and who prescribed them. Having a list prepared by the hospital is a good way to double-check the information you should already have been keeping track of.

3. Rx. A prescription for any medications you need. Be sure to fill your prescriptions promptly so you don’t run out of needed medications.

4. Follow-up care instructions. Make sure you have paperwork that tells you:n what, if any, dietary restrictions you need to follow

and for how longn what kinds of activities you can and can’t do, and for

how longn how to properly care for any injury or incisions you haven what follow-up tests you may need and when you need

to schedule themn what medicines you must take, why and for how longn when you need to see your physiciann any other home-care instructions for your caregiver,

such as how to get you in and out of bed, how to use and monitor any equipment and what signs and symptoms to watch out for

n telephone numbers to call if you or your caregiver has any questions pertaining to your after-hospital care.

Before You LEAVE...

IF YOU DISAGREEYou or your support person can appeal your doctor’s discharge decision and a review will occur. If you are a Medicare patient, be sure you are given “An Important Message from Medicare” from the hospital’s discharge planner or caseworker. This details your rights to remain in the hospital for care and provides information on who to contact to appeal a discharge decision.

MAIN NUMBER: 503-257-2500 18

BEFORE YOU LEAVE...

AFTER-HOSPITAL CARE THAT IS TAILORED TO YOUR NEEDS CAN SPEED YOUR RECOVERY AND HELP YOU GET BACK TO YOUR NORMAL ROUTINE.

Here’s a brief explanation of the various services that you may use during your recovery.

Home HealthcareWe may recommend home visit-based healthcare provided by medical professionals in a patient’s home to maintain or restore health. It includes a range of services, including part-time nursing care, therapy, and depending on your health plan, assistance with daily activities and homemaker services, such as cleaning and meal preparation. Medicare defines home healthcare as intermittent, physician-ordered medical services or treatment.

Durable Medical Equipment (DME)Medical equipment may be ordered by a doctor for use in a patient’s home. Examples are walkers, crutches, wheelchairs and hospital beds. DME is paid for under Medicare Part B and Part A for home health services.

Independent Living/Retirement CenterThis is a community for seniors who are very independent and have few medical problems. Residents live in private apartments. Meals, housekeeping, maintenance, social outings and events are provided.

Assisted LivingWhen someone can no longer live on his or her own, an apartment or living situation for elderly or disabled people may be recommended. Assisted living is for those who don’t need a high level of care. Assisted living facilities provide

assistance with medications, meals in a cafeteria or restaurant-like setting, and housekeeping services. Nursing staff is on-site. Most facilities have social activities and provide transportation to doctor’s appointments, shopping, etc.

Nursing FacilityA nursing facility is for people who need assistance with most or all of their daily living activities such as bathing, dressing and toileting. They have nursing staff available 24 hours a day. There are two levels available at most nursing facilities: skilled (SNF) and intermediate (ICF).

Skilled nursing level is for those needing a short stay specifically for rehabilitation or a complex nursing need. There are strict guidelines and, if this level is required, it is usually covered by most insurances including Medicare (with possible daily co-pays required), if qualifying criteria is met.

Intermediate care (sometimes called custodial care) is for those who need help with daily care or want to have a nurse available, but who do not meet the guidelines for skilled. This level is not covered by medical insurances. If this level is needed, your discharge planner can discuss costs and resources.

HospiceHospice care emphasizes the management of pain and discomfort and addresses the physical, spiritual, emotional, psychological, financial and legal needs of the patient and his or her family. Hospice services can be provided at home, in a hospice or other freestanding facility, or within a hospital. It is a licensed or certified program that provides care for people who are terminally ill and their families.

5. Other services. When you leave the hospital, you may need to spend time in a rehabilitation facility, nursing home or other institution. Or you may need to schedule tests at an imaging center, have treatments at a cancer center or have in-home therapy. Be sure to speak with your nurse or physician to get all the details you need before you leave.

6. Community resources. You and your caregiver may feel unprepared for what will happen after your discharge. Make sure your discharge planner provides you with information about local resources, such as agencies that can provide services like transportation, equipment, home care and respite care.

Adventist Medical Center 19 MAIN NUMBER: 503-257-2500

When You Are DischargedYour physician determines when you are ready to be discharged. Your physician and nurse will give you discharge instructions and answer any questions you have about managing your treatment and medications once you are home. If you are confused or unsure about what you need to do, what medications you must take or if you have to restrict your diet or activities, don’t be afraid to ask and take notes.

Be sure you understand any instructions you have been given before you leave the hospital.

VolunteerVolunteers can offer assistance with writing a letter, reading to you or just visiting when you want companionship. Volunteers are not trained to deal with grief, crisis or trauma. For more information about volunteering, call the Volunteer Department from 8 a.m. to 8:30 p.m., seven days a week, at 503-251-6114, ext. 1.

GOING HOMEWhen your doctor feels that you are ready to leave the hospital, he or she will authorize a hospital discharge. Please speak with your nurse about our discharge procedures. Here are few tips to make the discharge process run smoothly:n Be sure you and/or your caregiver has spoken with the Case Management Team and

you understand what services you may need after leaving the hospital. (See Before You Leave… on page 17 for more discharge advice.)

n Verify your discharge date and time with your nurse or doctor.n Have someone available to pick you up. (Check out time is 11 a.m.)n Check your room, bathroom and bedside table carefully for any personal items.n Make sure you or your caregiver has all necessary paperwork for billing, referrals,

prescriptions, etc.n Retrieve any valuables placed in the hospital’s safe.

Checkout time is 11 a.m. It is helpful to have a family member or significant other present to help with the discharge process. A volunteer will help carry your belongings and accompany you to the front door.

BILLING: WHAT A HOSPITAL BILL COVERSThe hospital bill covers the cost of your room, meals, 24-hour nursing care, laboratory work, tests, medication, therapy and the services of hospital employees. You will receive a separate bill from your physicians for their professional services. If you have questions about these separate bills, please call the number printed on each statement.

The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your

PREPARING TO LEAVE THE HOSPITAL AdventistHealth.org/NW

MAIN NUMBER: 503-257-2500 20 Adventist Medical Center

Uninsured?Oregon Health Plan If you are unable to pay your bill, we can screen you for the Oregon Health Plan and may be able to assist you with an Oregon Health Plan application.

Uninsured DiscountIf you have no coverage, a 25 percent discount will be applied to your account.

Financial AssistanceIf you feel that you are unable to pay some or your entire bill, you may request a review to see if you qualify for assistance.

policy is a contract between you and your insurance company, and you have the final responsibility for payment of your hospital bill.

COORDINATION OF BENEFITS (COB)Coordination of Benefits, referred to as COB, is a term used by insurance companies when you are covered under two or more insurance policies. This usually happens when spouses or partners are listed on each other’s insurance policies, both parents carry their children on their individual policies or there is eligibility under two federal programs. This also can occur when you are involved in a motor vehicle accident and have medical insurance and automobile insurance.

Most insurance companies have COB provisions that determine who is the primary payer when medical expenses are incurred. This prevents duplicate payments. COB priority must be identified at admission in order to comply with insurance guidelines. Your insurance may request a completed COB form before paying a claim, and every attempt will be made to notify you if this occurs. The hospital cannot provide this information to your insurance company. You must resolve this issue with your insurance carrier in order for the claim to be paid.

MEDICAREThis hospital is an approved Medicare provider. All services billed to Medicare follow federal guidelines and procedures. Medicare has a COB clause. At the time of service, you will be asked to answer questions to help determine the primary insurance carrier paying for your visit. This is referred to as an MSP Questionnaire and is required by federal law. Your assistance in providing accurate information will allow us to bill the correct insurance company.

Medicare deductibles and coinsurance are covered by your secondary insurance. If you do not have secondary insurance, you will be asked to pay these amounts or establish a payment plan. If you are unable to pay these amounts, we will help you determine if you qualify for a state-funded program.

COMMERCIAL INSURANCEAs a service to our customers, we will forward a claim to your commercial insurance carrier based on the information you provide at the time of registration. It is very important for you to provide all related information such as policy number, group number and the correct mailing address for your insurance company.

FOR SELF-PAY PATIENTSPatient Financial Services Department will send statements for payment of self-pay accounts. You will receive two to three billing statements and two to three telephone calls over a 90-day period to obtain a payment or to make payment arrangements. If payment arrangements are not established and no payment is made during the 90-day period, the account will be placed with a collection agency. If you need an itemized statement, you can obtain one by calling our Customer Service Department at the number listed below. If you have any questions regarding your billing statement, you can contact the Patient Financial Services Department at 503-257-2500.

PREPARING TO LEAVE THE HOSPITAL continued AdventistHealth.org/NW

21 MAIN NUMBER: 503-257-2500

CAREGIVER RESOURCES

While your loved one is in the hospital, who will speak up for him or her? You can, by being the patient’s advocate—the person who will help the patient work with doctors, nurses and hospital staff. To help your loved one make the best decisions about his or her care and treatment, follow the advice in the caregiver list at left.

While you are making sure that your loved one’s needs are being met, don’t neglect your own. Caregiving is a stressful and time-consuming job. You may neglect your diet, your normal exercise routine and your sleep needs. You may find that you have little or no time to spend with friends, relax or just be by yourself for a while. But downtime is important. Don’t be reluctant to ask for help in caring for your loved one. Find out more about how you can ease the stress of caregiving at www.caregiver.org.

Your role as a patient advocate.

For the CAREGIVER

www.aoa.govCaregiver resources from the Administration on Aging

www.caregiving.comOnline support groups and articles on caregiving

Eldercare Locator800-677-1116 www.eldercare.govHelp with locating aging services throughout the U.S.

800-MEDICAREwww.medicare.gov—then search for caregiversOfficial U.S. government site for people with Medicare

National Academy of Elder Law Attorneyswww.naela.orgLegal help for seniors and people with special needs

National Alliance for Caregivingwww.caregiving.orgSupport for family caregivers and the professionals who serve them

Caregiver Action Network202-454-3970www.caregiveraction.orgSupport for caregivers of chronically ill, aged, or disabled loved ones

CAREGIVER...

Know what conditionyour loved one is being treated for.

Patient’s rightsKnow your patient’s rights and responsibilities (See page 8).

Advance directivesKnow whether or not your loved one has an advance directive and if so, what it specifies (See page 13).

Ask questionsIf your loved one is too ill or reluctant to ask questions, make note of his or her concerns and any you may have, and don’t be afraid to speak up (See Please Tell Us... on page 7).

Help track medicationsYour loved one may be prescribed medications while in the hospital and may be seen by several doctors. Keep a wallet-sized notebook of all medications you are taking.

What’s next?Will your loved one need home care or care at another facility? Ask to speak with a case manager to find out what your options are.

MAIN NUMBER: 503-257-2500 22 Adventist Medical Center

RESOURCES AdventistHealth.org/NW

STAFF DEFINITIONS Your Team of Physicians

While you are a patient in our hospital, you may be seen by one or more physicians. These physicians are part of our Admission & Management (A&M) service. Because they care for patients in a hospital setting only, they are more readily available to see you each day and to order necessary tests and treatments. Your A&M physicians are in contact with your primary care physician and are familiar with your medical case, the reason for your hospitalization and any diagnostic testing you have had recently. Don’t hesitate to ask them questions or tell them about your concerns.

NursesIn each nursing unit, a registered nurse is responsible for supervising patient care and directing the nursing and support staff of the unit. Registered nurses are assisted by nursing assistants and nurse technicians. The nursing staff is available around the clock.

Dietitians A registered dietitian will review your medical record and work with your healthcare team to develop a nutrition care plan for you. Registered dietitians also are available to educate you about any diets you may need to follow after you are discharged.

Rehabilitation Therapists Physical therapists, occupational therapists, speech pathologists and audiologists will work with you, your family and your medical team to help meet goals of recovery. Therapy may range from brief consultation to long-term intervention, based on the extent of your injuries or illness.

Technicians and Technologists Skilled health professionals perform and assist with laboratory and other procedures, including X-rays, mammograms, ultrasound, CT scans, MRIs, cardiac catheterization, radiation therapy and other procedures that help in diagnosing and treating your illness or injury.

Case Management and Discharge Planners The Case Management Team includes nurses and discharge planners. Team members work together to assess what kinds of needs you may have when you leave the hospital. They can help make arrangements for home services such as home health, hospice, durable medical equipment or home care. They also can assist with admission to a facility for rehabilitative care, respite or extended placement (including coordination with insurance or appropriate government agencies for financial coverage or assistance). They can give information regarding community resources. They also can provide emotional support to assist patients and families in coping with issues related to illness or hospitalization.

Discharge coordinators are available to:n Help you deal with adjustments to your lifestyle

brought on by illness or accident.n Help obtain care after hospitalization through an

extended care facility or home health.n Provide resources for support groups in the

community, financial aid or working with government agencies.

n Offer special help to terminally ill patients.

Pharmacists While you are in the hospital, all of your medications are dispensed by our hospital pharmacists. They can answer any questions you have regarding your medications.

Chaplain Chaplains are available around the clock to offer prayer and support. Call the operator at ext. 0 to request a visit.

VolunteersVolunteers give thousands of hours each year to our hospital to enhance the care of our patients and their families. They provide support throughout the hospital, including staffing the information desk, delivering mail and flowers, operating the gift shop and escorting patients.

Adventist Medical Center 23 MAIN NUMBER: 503-257-2500

HOSPITAL RESOURCES Getting Information FirsthandYour first source for all information about your illness should be your admitting physician. A second source of good information is the nursing staff. Ask your nurse what your blood pressure is when it’s taken each morning and what the two numbers mean. Ask the names of the tests you’re scheduled to have. Our staff will be glad to tell you about the equipment being used. We have clinical nurse specialists who can show you certain procedures. We also

have some excellent teaching videos to tell you about your condition. Ask a nurse to arrange a viewing time.

Case Management Department8 a.m. to 5 p.m., seven days a week Call 503-251-6189 during weekdays or dial 0 on weekends.

Conditions of RegistrationA hard copy of the Conditions of Registration form that you signed can be found on the web.

AdventistHealth.org/NW RESOURCES continued

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MAIN NUMBER: 503-257-2500 24 Adventist Medical Center

WE HOPE TO HEAR FROM YOU AdventistHealth.org/NW

You may send a letter or call us directly at 503-261-6633.

Your satisfaction with your hospital experience is very important to us. In order for us to be better informed about how we are doing, we’ve asked an outside organization to administer a satisfaction survey with a random sampling of our patients. The results of these surveys are compiled and presented to us in summary form; your individual responses are kept confidential.

You may receive one of these surveys several weeks after being discharged from the hospital. The survey asks for your feedback on many aspects of your hospital stay, including the admitting process, your daily care and living arrangements. If you receive a survey, we ask that you be honest and complete in your responses. Only by hearing candid comments from you about our care can we continue to improve. If you wish to give immediate feedback during your hospital stay, please don’t hesitate to contact our patient relations representative.

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Adventist Medical Center 25 MAIN NUMBER: 503-257-2500

AdventistHealth.org/NW CONCERNS ABOUT YOUR CARE

FOUNDATION

Health Care Regulations & Quality ImprovementDepartment of Health Service - Public Health Division800 NE Oregon St., Suite 305Portland, OR 97232971-673-0540

Acumentra Health2020 SW Fourth Ave.Suite 520Portland, OR 97201503-279-0100

The Joint CommissionOffice of Quality and Patient SafetyOne Renaissance Blvd.Oakbrook Terrace, IL 60181Fax: 630-792-5663

The Adventist Medical Center Foundation is a group of individuals committed to enhancing the health of our community. Foundation board members lead in actively seeking philanthropic support. These gifts help the hospital provide medical and surgical services, obtain advanced medical equipment and fund community health and wellness programs.

If you have any concerns about your care, we encourage you to notify your caregivers, the unit manager or hospital administration right away. This communication will usually resolve your concern quickly and effectively. If your concerns are not resolved, you may wish to contact the customer service representative either by phone or letter at:

Adventist Medical Center Customer Service10123 SE Market St.Portland, OR 97216503-251-6189

FILING A GRIEVANCE If your concern regarding quality of care issues has not been addressed to your satisfaction by our staff, you may file a grievance with:

Adventist Health Compliance HotlineAdventist Health 2100 Douglas Blvd.Roseville, CA 95661888-366-3833

If you still feel your concern has not been resolved, you may contact any of the agencies listed at the right.

TELL US YOUR STORY

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MAIN NUMBER: 503-257-2500 26 Adventist Medical Center

NOTICE OF PRIVACY PRACTICES AdventistHealth.org/NW

This notice describes how medical/behavioral health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully. If you have any questions about this notice, please contact the privacy official at 503-251-6820. Who Will Follow This Notice This notice describes Adventist Health healthcare systems’ practices and that of: n Any healthcare professional authorized to enter

information into your medical record. n All departments and units of the healthcare

system. n Any volunteer in our organizations. n All employees, staff and other designated

personnel (e.g., students, contracted agency staff ). n Physicians and other healthcare providers on our

staff, while they are practicing in our facilities. n Adventist Health’s Portland entities: Adventist

Medical Center, Adventist Health/Medical Clinics, Adventist Health/Medical Group, Adventist Health/Home Care, Caremark Behavioral Health Services, Adventist Health/Physical Therapy, Adventist Health/Imaging, and Adventist Health/Laboratory. All these entities, sites and locations follow the terms of this notice. In addition, these entities, sites and locations may share medical/behavioral health information with each other for treatment, payment or healthcare operations purposes described in this notice.

Our Pledge Regarding Medical/Behavioral Health Information We understand that medical/behavioral health information about you and your health is personal. We are committed to protecting medical/behavioral health information about you. We create a record of the care and services you receive in our facilities. We need this record to provide you with quality care and to comply with certain legal requirements. Physicians (personal, consultants, specialists) involved in your care may have different policies or notices regarding the doctor’s use and disclosure of your medical/behavioral health information created and/or maintained in the doctor’s office or clinic.

This notice will tell you about the ways in which we may use and disclose medical/behavioral health information about you, via any medium (written, oral or electronic). We also describe your rights and certain obligations we have regarding the use and disclosure of medical/behavioral health information. We are required by law to: n Make sure that medical/behavioral health

information that identifies you is kept private and confidential (with certain exceptions);

n Give you this notice of our legal duties and privacy practices with respect to medical/behavioral health information about you; and

n Follow the terms of the notice that is currently in effect.

How We May Use And Disclose Medical And Behavioral Health Information About You The following categories describe different ways that we use and disclose medical/behavioral health information. For each category of uses or disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all the ways we are permitted to use and disclose information will fall within one of the categories. n Treatment. We may use medical/behavioral

health information about you to provide you with medical treatment or services. We may disclose medical/behavioral health information about you to doctors, nurses, technicians, healthcare students (nursing, medical, psychology, etc.), or other personnel who are involved in taking care of you. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell a dietitian if you have diabetes so we can arrange for appropriate meals. Different departments of the hospital also may share medical/behavioral health information about you in order to coordinate the different things you need, such as prescriptions, lab work and X-rays. We also may disclose medical/

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behavioral health information about you to others who may be involved in your medical care, such as caregivers, clergy or others we use to provide services that are part of your care. We also may disclose medical/behavioral health information about you to individuals outside the facility who may be involved in your medical care after you leave our facility.

n Payment. We may use and disclose medical/behavioral health information about you so that the treatment and services you receive may be billed and collected from you, the party responsible for your bill, an insurance company or a third party. For example, we may need to give your health plan information about surgery you received at the hospital so your health plan will pay us or reimburse you for the surgery. We also may tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

n Healthcare Operations. We may use and disclose medical/behavioral health information about you for healthcare operations. These uses and disclosures are necessary to make sure that all of our patients receive quality care. For example, we may use medical/behavioral health information to review our treatment and services, and to evaluate the performance of our staff in caring for you. We also may combine medical/behavioral health information about our patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We also may disclose information to doctors, nurses, technicians, healthcare students (nursing, medical, psychology, etc.), and other personnel for review and learning purposes. We also may disclose information to accreditation agencies, such as The Joint Commission (TJC), for purposes of evaluating this facility for accreditation.

We also may combine the medical/behavioral health information we have with medical/behavioral health information from other healthcare agencies to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of

medical/behavioral health information so others may use it to study healthcare and healthcare delivery without learning who the specific patients are.

n Appointment Reminders. We may use and disclose medical/behavioral health information to contact you as a reminder that you have an appointment for treatment or medical care.

n Treatment Alternatives. We may use and disclose medical/behavioral health information to tell you about or recommend possible treatment options or alternatives that may be important to you.

n Health-Related Benefits and Services. We may use and disclose medical/behavioral health information to tell you about health-related benefits or services that may be of interest to you.

n Fundraising Activities. We may use contact information about you—such as your name, address and phone number, and the dates you received treatment or services at the hospital— in order to appeal for funds for the hospital and its operations. We may disclose the same information about you to a foundation related to the hospital so the foundation may contact you in an effort to raise money for the hospital. Please write to us at Adventist Medical Center, Philanthropy Department, 10123 SE Market St., Portland, OR 97216 if you wish to have your name removed from the list to receive fundraising requests supporting Adventist Medical Center in the future. In the event that you contact us with this request, all reasonable efforts will be taken to ensure you will not receive any fundraising communications from us in the future.

n Hospital Directory. We may include certain limited information about you in the hospital directory. This is a daily list of patients in our facility. This information may include your name, location in the hospital, your general condition (e.g., fair, serious, etc.) and your religious affiliation. Unless there is a specific request from you to the contrary, this directory information, except for your religious affiliation, also may be released to people who ask for you by name. Your religious affiliation may be given to

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a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name. This information is released so your family, friends and clergy can visit you in the hospital and generally know how you are doing. Oregon state laws may not allow behavioral health or chemical dependency patient information to be included in the hospital directory.

n Individuals Involved in Your Care. We may release medical/behavioral health information about you to a friend or family member who is involved in your medical care. Unless there is a specific written request from you to the contrary, we also may tell your family or friends your condition and that you are in the hospital. Oregon state laws may require us to get your written authorization before we release behavioral health information to a friend or family member who is involved in your care.

n Disaster Relief. We may disclose medical/behavioral health information about you to an entity assisting in a disaster relief effort (for example, the Red Cross) so that your family can be notified about your condition, status and location.

n Research. Under certain circumstances, we may use and disclose medical/behavioral health information about you for research purposes, when approved by the Institutional Review Board or Privacy Board.

n As Required by Law. We will disclose medical/behavioral health information about you when required to do so by federal, state or local law. [Oregon statutes require facilities to report cases of cancer to the Health Division. In Washington healthcare facilities, independent clinical laboratories, physicians and others providing healthcare who diagnose must report this information to the cancer registry.]

n To Avert a Serious Threat to Health or Safety. We may use and disclose medical/behavioral health information about you when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat. For example, if you were involved in a violent crime, disclosure may be made to law enforcement.

n Notification in the Case of a Breach. We are required by law to notify you in case your protected health information has been, or is reasonably believed to have been, disclosed as a result of a breach.

n Organ and Tissue Donation. If you are an organ or tissue donor, we may release medical/behavioral health information to organizations that handle procurement or transplantation, or to a donation bank.

n Military and Veterans. If you are a member of the armed forces or a veteran, we may release medical/behavioral health information about you as required by military command authorities. We also may release medical/behavioral health information about foreign military personnel to the appropriate foreign military authority.

n Workers’ Compensation. We may release medical/behavioral health information about you to your workers’ compensation program for work-related injuries or illness.

n Public Health Risks. We may disclose medical/behavioral health information about you for public health activities. These activities generally include the following: n To prevent or control disease, injury

or disability; n To report births and deaths; n To report the abuse or neglect of children,

elders and dependent adults; n To report reactions to medications or problems

with products; n To notify people of recalls of products they

may be using; n To notify a person who may have been exposed

to a disease or may be at risk for contracting or spreading a disease or condition;

n To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

n Health Oversight Activities. We may disclose medical/behavioral health information to a health oversight agency for activities authorized by law. These oversight

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activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the healthcare system, government programs and compliance with civil rights laws.

n Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose medical/behavioral health information about you in response to a court or administrative order. We also may disclose medical/behavioral health information about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute.

n Law Enforcement. We may release medical/behavioral health information if asked to do so by a law enforcement official: n In response to a court order, subpoena,

warrant, summons or similar process; n To identify or locate a suspect, fugitive,

material witness or missing person; n About the victim of a crime if, under certain

limited circumstances, we are unable to obtain the person’s agreement;

n About a death we believe may be the result of criminal conduct;

n About criminal conduct at the facility; and n In emergency circumstances to report a crime,

the location of the crime or victims; or the identity, description or location of the person who committed the crime.

n Coroners, Medical Examiners and Funeral Directors. We may release medical/behavioral health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release medical/behavioral health information about patients of the hospital to funeral directors as necessary to carry out their duties.

n National Security and Intelligence Activities. We may release medical/behavioral health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

n Protective Services for the President and Others. We may disclose medical/behavioral health information about you to authorized

federal officials so they may provide protection to the president, other authorized persons or foreign heads of state, or conduct special investigations.

n Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical/behavioral health information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with healthcare; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

Your Rights Regarding Medical/Behavioral Health Information About You. You have the following rights regarding medical/behavioral health information we maintain about you: n Right to Inspect and Copy. You have the

right to inspect and receive a copy (paper or electronic) of the medical/behavioral health information that may be used to make decisions about your care. Usually, this includes medical and billing records, but may not include psychotherapy notes.

To inspect and copy medical/behavioral health information that may be used to make decisions about you, you must submit your request in writing to the Health Information Management (Medical Records) department at Adventist Medical Center. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.

We may deny your request to inspect and receive a copy in certain very limited circumstances. If you are denied access to medical/behavioral health information, you may request that the denial be reviewed. We will comply with state law when choosing a reviewer. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

n Right to Amend. If you feel that the medical/behavioral health information we have about

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you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by the facility.

To request an amendment, your request must be made in writing and submitted to the site where the services were provided. For records within the hospital, contact Health Information Management (Medical Records) department at Adventist Medical Center. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

n Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

n Is not part of the medical/behavioral health information kept by the facility;

n Is not part of the information which you would be permitted to inspect and copy; or

n Is accurate and complete. n Right to an Accounting of Disclosures. You

have the right to request an accounting of disclosures. This is a list of the disclosures we made of medical/behavioral health information about you other than our own uses for treatment, payment and healthcare operations, as those functions are described above.

To request this list or accounting of disclosures, you must submit your request in writing to Privacy Official, Adventist Medical Center, 10123 SE Market St., Portland, OR 97216. Your request must state a time period, which may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.

If the request is prior to Adventist Health using automated tracking of medical information,

you may not request a time period longer than six years. If the request is after Adventist Health started using electronic records, you may not request a time period longer than three years.

n Right to Request Restrictions. You have the right to request a restriction or limitation on the medical/behavioral health information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the medical/behavioral health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.

We are not required to agree to your request except when you pay for the healthcare service in full. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment, or if the disclosure is required by law.

To request restrictions, you must make your request in writing to the privacy official. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

n Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

To request confidential communications, you must make your request in writing to the privacy official. We will not ask you the reason for your request. While we are not required to agree to your request, we will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

n Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you still are entitled to a paper copy of this notice.

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You may obtain a copy of this notice at our website at www.AdventistHealth.org/NW.

To obtain a paper copy of this notice, go to the admitting/registration area within the Adventist facility.

Changes To This Notice We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical/behavioral health information we already have about you, as well as any information we receive in the future. We will post a copy of the current notice in the facility. The notice will contain on the first page, in the top right-hand corner, the effective date. If the notice is changed, we will offer you a copy of the notice upon your request.

Complaints If you believe your privacy rights have been violated, you may file a complaint with the facility or with the Secretary of the Department of Health and Human Services. To file a complaint with the facility, contact the privacy official at

503-251-6820. All complaints must be in writing; therefore, you will be asked to submit your complaint in writing or we will assist you in documenting your complaint.

You will not be penalized for filing a complaint.

Other Uses Of Medical/Behavioral Health Information Other uses and disclosures of medical/behavioral health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical/behavioral health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical/behavioral health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

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NOTES

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Name _________________________________

Dept. __________________________________

Your Name _______________________________________________________

Address _________________________________________________________

City/State/Zip ____________________________________________________

Phone/Email _____________________________________________________

Enclosed is my check forq $25 q $50 q $100 q $500 q $1000 q Other $ ____________________

Please make payable to “Adventist Medical Center Foundation.”Please charge my credit card:q Visa q Mastercard q Other ______________________________________

Card Number _____________________________________________________

Expiration Date ___________________________________________________

Signature ________________________________________________________

Name On Card ____________________________________________________

q I’m interested in including the Adventist Medical Center Foundation in my estate planning.

q I’m interested in learning more about the Adventist Medical Center Foundation and the work they do for my community.

I WOULD LIKE TO RECOGNIZE AdventistHealth.org/NW

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