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Do seniors have rights when it comes to health care?

by Sue Lanza

We've all been on the receiving end of less than adequate customer service: the burnt steak at a favorite restaurant, the badly made business cards that have your name misspelled or even the car repair that turns your auto into a virtual lemon. What happens when the service that you have issues with concerns your body and the care it has been given from a health care professional? Do you have the same rights to pursue a solution in this case? Is the customer always right in healthcare or do you need to take a back seat and just accept things as they are?

That new blouse you bought seems to pull in the wrong places, making you feel uncomfortable. You go back to the mall and return it for a refund, even if you don't have the receipt. Does the same procedure hold true for health care that you received that you feel is a poor fit or substandard in some way? Yes and no.

Patient Rights: Three Points to Remember

Let's talk about the yes part of this answer first. You definitely do have rights as a patient and as a consumer of any type of product or service. Here are some of the privileges that you do have as someone who is receiving care in the health care industry:

  1. If you enter a hospital or extended care facility, there are mandated patient or resident rights in writing that have been offered to you. Usually you receive a copy of these written rights before you are admitted or at the time of your first procedure. Patient or resident rights are a list of basic expectations about the quality of the services that you can receive--from the right to receive your mail unopened to being properly informed of the risks of any procedure before the course of action begins. The lists of rights are often posted in a number of locations so you can refer to them during your stay. At the time of entering a health care facility, you may be very distracted by your medical condition so you could overlook these important guidelines as they are given to you.
  2. You have the right to privacy of your personal and medical information under the HIPAA guidelines. HIPAA stands for Health Insurance Portability and Accountability Act of 1996. This means that health care providers and health plans must protect any of your medical information that is discussed, written about, billed, or available on a computer.
  3. If something occurs during your stay or visit that is not up to par, you do have the authority to investigate the situation and seek answers. The best place to start is with the supervisor or health care professional who is overseeing your care area. You would clearly explain the expectation you had and what happened instead ("My mother was due to receive a bland diet as prescribed by her doctor and instead she received the regular meal"). If all goes well, the first person you spoke to is able to resolve this and correct the systemic problem that caused it to occur in the first place. If not, you have the option of going to the person above the supervisor, higher and higher in the organization, until you get a satisfactory conclusion to the issue. In this case, you are advocating for yourself or a loved one in getting them the care that has been promised.

Patient Care Rights: Where You're Not Covered

Now let's discuss the rights that you do not have as a patient or a resident:

  1. Nothing that occurs in the course of your care ever gives you the right to be verbally or physically aggressive in the name of advocacy. You've heard that the squeaky wheel gets the oil so you figure that lots of yelling will get you the attention you need. Wrong! You need to remain calm and work your way through the proper persons to get what you need.
  2. You do not have the right to deny payment when a service is rendered but isn't meeting your level of standards. This will get you into trouble with the facility rendering the care as well as potentially damage your credit rating. Air your concerns and seek resolution but pay your bill.

These are general guidelines to let you know that you do have power in the health care delivery system. Make sure you keep copies of any correspondence you make about an issue including names of people you spoke to on the phone or in person. If things get beyond your comfort level, you may need to contact one of the many advocacy groups for patients or even an attorney.

As much as we have focused on negative outcomes here, most people do have positive experiences in many facets of the health care system. The hope is that any roadblocks you face can be as simple for you as returning a blouse.