Your rights in care

Hospitals and other providers that take federal funds must take reasonable steps to give people with limited English real access to care (45 CFR 92.201). That includes a qualified interpreter, for free, and translated papers when needed.

They may not rely on a minor child to interpret, except in an emergency with an immediate threat and no qualified interpreter available. An adult who came with the patient may interpret only in such an emergency, or when the patient asks and the adult agrees.

Send it to the language services office or patient relations, with a copy to the nurse manager.

Providers must make reasonable changes so a person with a disability can get care (45 CFR 84). Aids such as sign language interpreters and large print are free (45 CFR 92.202). Treatment may not be denied or limited because of a disability, and the facility's Section 504 coordinator takes requests.

Send it to the Section 504 coordinator or patient relations, with a copy to the nurse manager.

Federal law bars discrimination in health care on these grounds (Section 1557 of the Affordable Care Act, 45 CFR 92). A provider with 15 or more staff must name a civil rights coordinator (45 CFR 92.7). Complaints can also go to the HHS Office for Civil Rights within 180 days of the act.

Send it to the civil rights coordinator or patient relations.

Hospitals must have a written visitation policy, with the reasons for any limits, and must tell patients about it (42 CFR 482.13(h)). The patient chooses the visitors, such as a spouse, a companion, family or a friend, and limits may not discriminate. When the patient cannot choose, a support person can use the patient's visitation rights.

Nursing home residents may have visitors of their choice at any time, within reasonable clinical and safety limits (483.10(f)(4)). Some states add essential caregiver laws, such as Florida (s. 408.823), Georgia (31-7-430) and, for long-term care, Texas (Health and Safety Code ch. 260B).

Send it to the nurse manager and patient relations.

Patients have the right to make informed decisions about their care, and to accept or refuse treatment (42 CFR 482.13(b)(2)). Hospitals, nursing homes, home health agencies and hospices must ask about advance directives and put them in the chart (42 CFR 489.102). They follow them as state law allows, and a health care agent named under state law can speak for a patient who cannot.

Send it to the attending doctor, with a copy to patient relations. Attach the document.

In a hospital, a restraint or a locked room is allowed only to keep the patient or others safe (42 CFR 482.13(e)). It is never allowed for discipline or staff convenience, and the order may never be written as needed.

When it is used for violent or self-destructive behavior, a trained clinician must see the patient within one hour. Each order then lasts at most 4 hours for adults, 2 hours for ages 9 to 17 and 1 hour under 9. A stricter state law takes priority. Rules for nursing homes are on the page Nursing homes and care at home.

Send it to the nurse manager and the attending doctor, with a copy to patient relations.

Each state's law sets how long a person can be held for a psychiatric evaluation and when a court hearing takes place. For example, Florida allows 72 hours for the exam (s. 394.463), Texas 48 hours (Health and Safety Code 573.021) and Pennsylvania up to 120 hours (50 P.S. 7302).

The state Protection and Advocacy agency helps people in psychiatric care for free, and the National Disability Rights Network lists each one.

Send it to the unit's patient rights advocate or patient relations.

The privacy officer takes privacy complaints (45 CFR 164.530(d)). On request, the provider must also give a list of certain disclosures of the patient's information (45 CFR 164.528). After a breach, it must tell you in writing without unreasonable delay, and no later than 60 days after finding it (45 CFR 164.404).

You can also complain to the HHS Office for Civil Rights within 180 days of when you knew or should have known (45 CFR 160.306).

Send it to the privacy officer.

Privacy rules let staff share information with family and friends involved in the patient's care, unless the patient objects (45 CFR 164.510(b)). The rules allow this but do not require it. A signed note from the patient records who the patient wants told.

A health care agent or other legal representative named under state law has the patient's rights to information for that role (164.502(g)).

The patient signs this one. Give it to the nurse manager and ask that it go in the chart.

A provider may not retaliate against a patient for using privacy rights or filing a privacy complaint (45 CFR 164.530(g)). Nursing homes (42 CFR 483.10(j)) and home health agencies (484.50(c)) may not retaliate for any complaint. The hospice (418.52(b)) and dialysis (494.70(a)) rules say the same.

The HHS Office for Civil Rights takes complaints about retaliation under the privacy and civil rights rules, within 180 days.

Send it to the administrator, with a copy to patient relations.