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Privacy Statement

As a health care facility, we are committed to delivering quality medical care to you, our patient, and to making your stay as pleasant as possible. The following Rights and Responsibilities, are endorsed by the administration and staff of this hospital, and apply to all patients. In the event that you are unable to exercise these rights on your own behalf, then these rights are applicable to your designated/legal representative. As it is our goal to provide medical care that is effective and considerate, we submit these to you as statement of our policy.

You have the right to:

l      Have a family member, another person that you choose, or your doctor notified when you are admitted to the hospital.

l      Receive information in a way that you understand. This includes interpretation and translation, free of charge, in the language you prefer for talking about your health care. This also includes providing you with needed help if you have vision, speech, hearing, or cognitive impairments.

l      Designate a support person, if needed, to act on your behalf to assert and protect your patient rights.

l      Receive information about your current health, care, outcomes, recovery, ongoing health care needs, and future health status in terms that you understand.

l      Be informed about proposed care options including the risks and benefits, other care options, what could happen without care, and the outcome(s) of any medical care provided, including any outcomes that were not expected. You may need to sign your name before the start of any procedure and/or care. “Informed consent” is not required in the case of an emergency.

l      Be involved in all aspects of your care and to take part in decisions about your care.

l      Make choices about your care based on your own spiritual and personal values.

l      Request care. This right does not mean you can demand care or services that are not medically needed.

l      Refuse any care, therapy, drug, or procedure against the medical advice of a doctor. There may be times that care must be provided based on the law.

l      Expect the hospital to get your permission before taking photos, recording, or filming you, if the purpose is for something other than patient identification, care, diagnosis, or therapy.

l      Decide to take part or not take part in research or clinical trials for your condition, or donor programs that may be suggested by your doctor. Your participation in such care is voluntary, and written permission must be obtained from you or your legal representative before you participate. A decision to not take part in research or clinical trials will not affect your right to receive care.

l      Decide if you want visitors or not while you are here. The hospital may need to limit visitors to better care for you or other patients.

l      Receive visitors designated by you, the patient, including, but not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member, or a friend.

l      Designate a support person who may determine who can visit you if you become incapacitated.

l      Create advance directives, which are legal papers that allow you to decide now what you want to happen if you are no longer healthy enough to make decisions about your care. You have the right to have hospital staff comply with these directives.

l      Ask about and discuss the ethics of your care, including resolving any conflicts that might arise such as, deciding against, withholding, or withdrawing life-sustaining care.

l      Receive a medical screening exam to determine treatment.

l      Participate in the care that you receive in the hospital.

l      Receive instructions on follow-up care and participate in decisions about your plan of care after you are out of the hospital.

l      Request a discharge planning evaluation at any time regardless of outcome.

l      Receive a prompt and safe transfer to the care of others when this hospital is not able to meet your request or need for care or service. You have the right to know why a transfer to another health care facility might be required, as well as learning about other options for care. The hospital cannot transfer you to another hospital unless that hospital has agreed to accept you.

l      Expect emergency procedures to be implemented without unnecessary delay.

l      Receive care in a safe setting free from any form of abuse, harassment, and neglect.

l      Receive kind, respectful, safe, quality care delivered by skilled staff.

l      Know the names of doctors and nurses providing care to you and the names and roles of other health care workers and staff that are caring for you.

l      Request a consultation by another health care provider.

l      Receive proper assessment and management of pain, including the right to request or reject any or all options to relieve pain.

l      Receive care free from restraints or seclusion unless necessary to provide medical, surgical, or behavioral health care.

l      Receive efficient and quality care with high professional standards that are continually maintained and reviewed.

l      Limit who knows about your being in the hospital.

l      Be interviewed, examined, and discuss your care in places designed to protect your privacy.

l      Be advised why certain people are present and to ask others to leave during sensitive talks or procedures.

l      Expect all communications and records related to care, including who is paying for your care, to be treated as private.

l      Receive written notice that explains how your personal health information will be used and shared with other health care professionals involved in your care.

l      Review and request copies of your medical record unless restricted for medical or legal reasons.

l      Review, obtain, request, and receive a detailed explanation of your hospital charges and bills.

l      Receive information and counseling on ways to help pay for the hospital bill.

l      Request information about any business or financial arrangements that may impact your care.

You and your family/guardian have the right to:

l      Tell hospital staff about your concerns or complaints regarding your care. This will not affect your future care.

l      Seek review of quality of care concerns, coverage decisions, and concerns about your discharge.

l      Expect a timely response to your complaint or grievance from the hospital. Complaints or grievances may be made in writing, by phone, or in person. The hospital has a duty to respond to these complaints or grievances in a manner that you can understand.

It is the intent of the hospital to provide quality care and address any concerns that you may have. Please feel free to ask questions about any of these rights that you do not understand, please discuss them with your doctor or nurse.

If you have a question about your rights as a patient or have a quality concern related to your care, dial “0” to contact the Patient Representative.  Please discuss your concerns with them and appropriate follow-up will be done.

In the event that you have a concern that has not been resolved to your satisfaction

or a grievance about your care, please forward these concerns to:

Patient Safety Officer, Nason Hospital

105 Nason Drive  Roaring Spring, PA 16673

(814) 224-6272

Please include details of your concern, your name, address and telephone number and a timely,

personal response will be given.

Should you feel that your concerns are not adequately addressed or would prefer not to discuss these issues with hospital personnel, you have the right to refer concerns directly to the Pennsylvania Department of Health and/or The Joint Commission :

Pennsylvania Department of Health                 

Adult and Ambulatory Care Services               

Room 5432 Health & Welfare Building             

625 Forster Street                                             

Harrisburg, PA 17108-0090                              


The Joint  Commission

Office of Quality Monitoring

One Renaissance Boulevard

Oakbrook Terrace, IL 60681


Medicare beneficiaries may also call Livanta Quality Improvement Organization

at 1-866-815-5440 for concerns regarding the quality of their care.

If you believe your privacy rights have been violated, you may file a complaint in writing with our Privacy Officer or with the Secretary of the U.S. Department of Health and Human Services.


As a patient, family member, or guardian, you have the right to know all hospital rules and what we expect of you during your hospital stay.

Provide Information

As a patient, family member, or guardian, we ask that you:

l      Provide accurate and complete information about current health care problems, past illnesses, hospitalizations, medications, and other matters relating to your health.

l      Report any condition that puts you at risk (for example, allergies or hearing problems).

l      Report unexpected changes in your condition to the health care professionals taking care of you.

l      Provide a copy of your Advance Directive, Living Will, Durable Power of Attorney for health care, and any organ/tissue donation permissions to the health care professionals taking care of you.

l      Tell us who, if any, visitors you want during your stay.

l      Recognize and respect the rights of other patients, families, and staff. Threats, violence, or harassment of other patients and hospital staff will not be tolerated.

l      Comply with the hospital’s no smoking policy.

l      Refrain from conducting any illegal activity on hospital property. If such activity occurs, the hospital will report it to the police.

l      Promote your own safety by becoming an active, involved, and informed member of your health care team.

l      Ask questions if you are concerned about your health or safety.

l      Make sure your doctor knows the site/side of the body that will be operated on before a procedure.

l      Remind staff to check your identification before medications are given, blood/blood products are administered, blood samples are taken, or before any procedure.

l      Remind caregivers to wash their hands before taking care of you.

l      Be informed about which medications you are taking and why you are taking them.

l      Ask all hospital staff to identify themselves.

l      You are responsible for your actions if you refuse care or do not follow care instructions.

l      You are responsible for paying for the health care that you received as promptly as possible.
l      You are expected to follow the care plans suggested by the health care professionals caring for you while in the hospital. You should work with your health care professionals to develop a plan that you will be able to follow while in the hospital and after you leave the hospital.

Adapted From The PA Department of Health

Revised 08/2015 Printed 08/2015