Patient Guide - Carilion Tazewell Community Hospital by Carilion Clinic

Patient and Visitor Information

Carilion Tazewell Community Hospital 141 Ben Bolt Ave. Tazewell, VA 24651 276-988-8700 CarilionClinic.org/ctch

ÂŠ2012 Carilion Clinic Strategic Development J799 2/12/GG

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Welcome to Carilion Tazewell Community Hospital Carilion Clinic Mission: Improving the health of the communities we serve. Carilion Tazewell Community Hospital (CTCH) Vision: We envision CTCH will provide the primary medical care services needed by our citizens through a coordinated system and network of services that are delivered by CTCH and Carilion Clinic.

To Our Patients:

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We appreciate the confidence you have placed in us for your care. Our team of physicians, nurses, and staff is committed to providing you with excellent service throughout your stay at Carilion Tazewell Community Hospital (CTCH). We are proud of our clinical and nursing care. We are committed to creating an environment that is compassionate and caring to help you in meeting your healthcare goals. CTCH is also committed to involving you and your family in your care. We welcome questions and want to hear from you on how we are doing. To promote health and wellness, our campus, as well as the other hospitals throughout Carilion Clinic, became tobacco-free in January 2010. We appreciate your support in helping us maintain our fresh air atmosphere on campus. To orient you to the services offered at CTCH, we have prepared these materials for use during your stay. Should you have any additional questions or concerns, please feel free to ask any member of our staff. We thank you for the privilege of serving you. Welcome to Carilion Tazewell Community Hospital. Sincerely,

John S. Piatkowski, M.D., M.B.A., President, CEO

Kathren R. Dowdy, R.N., M.S.N., N.E.-B.C., C.P.H.Q., COO, CNO 1

We’re Here to Serve

HEALTH INFORMATION

Providing you—our patient—with the best possible care takes the cooperative efforts of many different people doing many different jobs. Not only are there doctors, nurses, therapists and technicians to help you, there are many employees working behind the scenes to make your stay as comfortable as possible. No matter what job the staff at Carilion Tazewell Community Hospital is doing, they’re doing it for you.

If you or a loved one have a medical condition and would like more information regarding a particular disease, please contact Carilion Clinic. The help-line is staffed with nurses, available to assist you in finding appropriate support groups, printed material about your condition and educational classes that may be helpful to you.

CARILION TAZEWELL COMMUNITY HOSPITAL MISSION, VALUES AND VISION

Call Carilion Clinic with your health-related questions at 540-2666000 or 800-422-8482, Monday – Friday, 8 a.m. - 5 p.m.

OUR MISSION: Carilion Tazewell Community Hospital, a nonprofit organization, will provide, or provide access to, quality cost-effective, patient-focused, primary medical services, illness prevention programs and services for the promotion of healthy lifestyles to the residents of Tazewell County and the surrounding areas.

You may also find a wealth of healthcare information and service overviews on our website at www.CarilionClinic.org/ctch.

OUR VISION: We envision CTCH will provide the primary medical care services needed by our citizens through a coordinated system and network of services that are delivered by CTCH and Carilion Clinic. We will: • Be committed to delivering superior quality and value. • Reflect the values of the community and serve the needs of its residents. • Be committed to developing and participating as a partner of an integrated system of comprehensive health services. • Strive to meet quality standards in all aspects of operation and will expect each of our board members, employees, contractors, medical staff, and volunteers to maintain the highest standard of personal and professional conduct. • Respect the individual patient’s rights and needs to the extent consistent with the hospital’s policies. • Form effective partnerships with the medical staff, and other health-related providers in order to deliver comprehensive healthcare services. • Operate as a corporate entity that strives to provide quality services, to contain the associated costs and to maintain fiscal viability necessary to meet the needs of the citizens.

OUR VALUES: • Respect: We acknowledge the dignity, diversity, and worth of the people we serve, each other, and our institution. • Integrity: We act responsibly, honestly, and confidentially and within ethical and professional principles. • Excellence: We strive to improve continually in everything we do as individuals, teams and as an organization. • People: The people of CTCH are the source of its success, knowledge, skill and compassion. 2

WHAT YOU MAY NEED DURING YOUR STAY, WHAT TO LEAVE HOME For your comfort, please only bring essential personal items, such as pajamas or a nightgown, bathrobe, slippers, personal toiletry items and reading material. Also, bring the names and telephone numbers of family members and friends who are your next-of-kin contact should we need to get in touch with them. Please leave jewelry and other expensive or sentimentally valuable items at home. If you wear contact lenses, dentures, removable bridges or a prosthetic device, please tell your nurse when you are admitted. YOUR CARE WHILE YOU ARE WITH US During your hospital stay, you may be seen by a hospitalist. When you are discharged, you will return to the care of your primary care physician. Hospitalists are physicians who specialize in caring for patients in the hospital. They do not have an outpatient medical practice. Our hospitalists are also familiar with every specialist and department in the hospital, which enables them to consult with other professionals who participate in your care. Consultations with others are necessary in some cases, and our hospitalists will arrange for these, too. Please be sure to notify your hospitalist if you are under the care of other doctors so they can be informed of your hospital stay as well. Our nursing staff provides 24-hour care during your stay and includes professional registered nurses, licensed practical nurses and nursing assistants. A unit director or manager is responsible for coordinating care on each unit. Please feel free to talk with our staff if you have questions or concerns.

Table of Contents About Carilion Tazewell Community Hospital . . . . . . . . . . . . . . . . . . . . . . . . 4 Patient Care Partnership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Understanding Your Rights and Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . Patient Rights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Patient Responsibilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Advance Directives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Infection Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Voicing Your Compliments or Concerns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Helpful Information at Your Fingertips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Calling From Your Room or Within the Hospital . . . . . . . . . . . . . . . . . . . . . . . . Outside Telephone Calls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Vending Machines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mail and Flowers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Parking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Spiritual Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Newspapers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Visitation Hours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Volunteers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sitters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Patient Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Accommodations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Admission and Planning for Discharge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HIPAA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Identification Bracelet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pass Code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Patient Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Meals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Regarding Your Bill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . What You May Need During Your Stay, What to Leave Home . . . . . . . . . . . Your Care While You Are With Us . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Health Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

About Carilion Tazewell Community Hospital Located in the beautiful mountains of southwest Virginia, Carilion Tazewell Community Hospital (CTCH) is a 56-bed acute care facility. We primarily serve Tazewell County and the southern W.V. counties of Mercer and McDowell. CTCH officially became part of the Carilion Clinic family in 2008, but has been under Carilion’s management since 1981. CTCH offers a wide variety of services, including, but not limited to: • Cardiopulmonary service • Emergency Department • Home Care • Inpatient medical care/hospitalists • Lab services • Physical rehabilitative services • Radiology/imaging diagnostics • Surgical services CTCH is dedicated to community, history and family, as exemplified through memorials and tributes throughout the hospital. Local artists’ works decorate the halls and the “Tree of Love,” located in the west wing, shares the legacy of those who have contributed to the hospital’s expansion fund over the years. At CTCH, you can trust our family to take care of yours.

Patient Care Partnership UNDERSTANDING YOUR RIGHTS AND RESPONSIBILITIES Carilion Tazewell Community Hospital and all other Carilion Clinic facilities are committed to providing an environment which fosters quality healthcare for its patients as described below. Employees are expected to assist patients in understanding and exercising their rights. Likewise, patients are expected to understand their responsibilities to their caregivers and other individuals attempting to provide services to them.

MEALS Your doctor, in consultation with a registered dietitian, will determine the diet best suited to your personal and specific nutritional needs. REGARDING YOUR BILL The hospital's basic daily charge includes your room and a portion of your nursing care, medical records, bedside meals, housekeeping, laundry, building maintenance and admissions. Depending on your doctor's orders, additional charges will be made for items such as medications, anesthesia, operating room, recovery room, laboratory tests, X-rays, respiratory therapy, and other diagnostic and therapeutic services. If you have insurance, you can help us in expediting your claim by furnishing the following information: • Copy of insurance card • Name of the company that carries your group insurance • Policy number • Whether your insurance requires pre-admission review Our staff will file claims for you with healthcare insurers or other programs, such as Medicare and Medicaid. All co-insurances are due and payable within 30 days after your insurance pays. If you do not have insurance, you are requested to make a cash deposit at the time of admission. The difference between the cash deposit and the full amount of the bill is expected to be paid within 30 days. If other arrangements are necessary, please contact our business office or Carilion Patient Payment Services. Carilion Clinic also offers assistance to patients with limited ability to meet their financial obligations. A patient financial specialist from Eligibility Assistance Service may contact you while in the hospital to assist you in making financial arrangements. If you have questions, please contact Patient Payment Services or our business office at 540-224-5500 or at 888-822-1872.

Our entire staff serves the community in all their ethnic, religious and economic diversity. Our goal is for you and your family to have the same care 4

IDENTIFICATION BRACELET When you are admitted, you will be given a wristband with your name on it. This band ensures proper identification for medication and procedures. It must be worn at all times during your hospital stay. PASS CODE At CTCH, a pass code will be assigned to each patient upon admission. Information regarding the patient will only be shared with persons who can provide the pass code. PATIENT SAFETY We are sincerely committed to doing everything possible to make you feel safe during your stay. Please help us help you by following these safety regulations: • Electrical Equipment - Electronic devices often interfere with medical equipment, so personal radios, televisions, computer games, mobile phones and non-essential grooming items may not be allowed in patient rooms. Personal cell phones may be used in the main lobby, waiting areas and all exteriors. • Room Safety - Side rails are used for your personal safety and welfare. Only nursing personnel should make any adjustment in side rails. - A nurse call system is within easy reach. Please use the call system for assistance, particularly if you've been asked to do so. - Tell our staff right away if any equipment in your room isn’t working properly. - Don’t try to get in or out of a wheelchair by yourself. Always ask for help if you need assistance. - The bathroom contains an emergency cord if you need assistance. Don’t try to get up without help if you feel weak or unsteady. • Smoking - Carilion Tazewell Community Hospital is a tobacco-free facility. Smoking or use of any of tobacco products is prohibited on the hospital’s campus. There may be a fire or disaster drill while you are in the hospital. These drills are required by law, and are designed to prepare staff in the event of a real disaster. During these drills, we ask you and your visitors to remain in your room. 12

and attention we would want for our families and ourselves. The following sections explain some of the basics about how you can expect to be treated during your hospital stay. They also cover what we will need from you to care for you better. If you have questions at any time, please ask them. Unasked or unanswered questions can add to the stress of being in the hospital. Your comfort and confidence in your care are very important to us. PATIENT RIGHTS We are dedicated to giving you the best healthcare and service possible. As a patient here, you may expect to receive considerate and respectful care. We will honor your rights to be informed and to be involved in making decisions about your care. You have the following rights as a competent adult patient: • You have the right to know about your illness and proposed treatment and to participate in the development of your plan of care. Information will be given to you by your doctors and other members of your healthcare team in a language you can understand. • You have the right to make decisions about your care, including the right to know why you need an operation or treatment and who will perform that operation or treatment. This includes the right to refuse care or treatment and to know what may happen if you do not have this care or treatment. • You have the right to make an advance directive about your healthcare treatment preferences and to have hospital staff comply with that directive. • You have the right to access all information contained in your medical record within a reasonable amount of time (usually 15 days). This includes the right to know the name of the doctor who is in charge of your care and the names of all other health system staff taking care of you. • You have the right to have the presence of a support person, such as a family member, close friend or loved one. The presence of that support person may be limited if it infringes on others’ rights, raises safety concerns or is not medically indicated. You have the right to have your support person and your own physician notified promptly of your admission to the hospital. • You have the right to receive treatment in a safe, abuse-free environment without discrimination as to age, race, ethnicity, religion, 5

culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity or expression, or source of payment. • You have the right to personal privacy while in the hospital and to have all information about your illness and care treated as confidential. • You have the right to be free from restraints or seclusion of any form that are not medically indicated. • You have the right to receive appropriate assessment and management of pain. • You have the right to agree or refuse to take part in any study or experiment related to your care or treatment. • You have the right to take part in resolving ethical issues or conflicts that arise during the course of your care. • You have the right not to be transferred to another facility unless you are given a complete explanation of the transfer, informed of alternatives to the transfer and consent to the transfer. • You have the right to review your bills and have any questions you have about them answered. • You have the right to discuss your concerns or file a complaint with the hospital regarding your experience as a patient here, and to receive a response in a timely manner. You also have the right to an internal appeal to any response that you receive and a right to file a complaint with an external agency. • You have the right to know your rights and responsibilities before treatment, if possible.

PATIENT RESPONSIBILITIES In order to receive optimal care, you and your family are responsible for: • Providing accurate information about your present illness and past medical history and wishes for your medical care. • Seeking clarification when necessary to fully understand your health problems and the proposed plan of care. • Following through on your agreed plan of care. • Considering and respecting the rights of others. • Being courteous. • Providing accurate information for insurance claims and working with Carilion Clinic to make payment arrangements when necessary, so that 6

Patient Services ACCOMMODATIONS We make every effort to provide you with a comfortable hospital room. Your room assignment at Carilion Tazewell Community Hospital is based upon your condition and the bed availability on the day of your arrival. ADMISSION AND PLANNING FOR DISCHARGE We appreciate your cooperation in helping us complete your admission form. This form is not only a vital part of our medical and legal records, but it is required by Virginia law. All information on your admission form is kept confidential. The admitting offices will also ask you to sign necessary forms and make financial arrangements for any balance not covered by insurance. Any deductible not covered by insurance is expected at the time of admission. Your continued recuperation and the continuity of services are dependent upon effective discharge planning. Your hospitalist or primary care physician will help coordinate and authorize your discharge. Your case manager will assist you and your family in coping with your hospitalization and assist you in making plans and arrangements for your continued care once you leave the hospital. These services include assistance with nursing home or adult home placement, home health and hospice care, transportation, any necessary home equipment needs or services, and referrals to community resources. Please make sure to take all personal belongings with you when you are discharged. Any valuables you have when admitted can be secured and recorded by the nursing staff upon your request. For your safety, please do not leave the hospital without someone from our staff to assist you. HIPAA The Health Insurance Portability and Accountability Act (HIPAA) of 1996 established national standards to protect patients' personal and medical records. The regulations outlined by HIPAA protect the medical records and other personal health information maintained by healthcare providers, health plans and health insurers and healthcare clearinghouses. If you have any questions about your privacy rights as a patient, please ask your case manager or nurse. 11

SECURITY Hospital entrances, except for the Emergency Department, are locked daily from 8 p.m. until 6 a.m. The Emergency entrance is open 24 hours a day, every day. Security personnel are on duty 24 hours a day. Video surveillance is used in the hospital and on its campus. SPIRITUAL CARE You may request a visit from the chaplain by dialing “0” for the hospital operator or by notifying your nurse. NEWSPAPERS Complimentary weekly newspapers from the Tazewell County Free Press are available. Newspaper vending for the weekly Clinch Valley News is also available. VISITATION HOURS Rest is extremely important in the recovery process. Normal visiting hours are 1 – 8 p.m. for medical and surgical visits. VOLUNTEERS Volunteers help make your stay more comfortable by assisting in many ways, including: • Greeting visitors and providing hospital information and directions. • Providing hospital information and directions. • Delivering mail, flowers and packages in the hospital for patients. • Working in our Gift Shop. If you have special skills or interests, or simply wish to donate your time to volunteering, contact 276-988-8700. SITTERS If you have been asked to sit with a patient who is confused or at risk for falls, please let the nurse know when you leave so they can monitor the patient in your absence. Overnight sitters must be at least 18 years old. If the patient is in a semi-private room, the sitter must be of the same gender as the patient. 10

others can benefit from the services provided here. • Following visitation policies of the hospital. • Following the rules and regulations of Carilion Clinic and of the Commonwealth of Virginia, which forbid: - Engaging in verbal or physical abuse. - Using alcohol or illegal substances. - Carrying weapons of any kind. ADVANCE DIRECTIVES You have rights under Virginia law to make decisions about your medical care. These rights include the right to accept or refuse care and the right to make advance directives about your care (a durable medical power of attorney and/or a living will). For further information about your advance directive, please consult the case manager or your nurse. INFECTION CONTROL Everyone plays an important role in infection prevention including hospital staff, patients and visitors. Clean hands are your best protection against infection. Clean your hands before you eat, after using the restroom, before and after changing wound dressings, and after contact with body fluids. You can clean your hands with soap and water or by using a hand sanitizer.

Follow these steps to ensure adequate cleaning of hands: - Wet hands with warm water and then apply soap. Rub your hands together vigorously for 15 seconds or longer. Get in between fingers and scrub wrist areas. Friction is necessary to rid your hands of germs. Rinse your hands and dry them. Use a clean paper towel to turn off the water faucet. Discard the paper towel in a trash can. - Waterless hand sanitizers are very effective for preventing the spread of infection, if you use enough to over your hands and wrists well. After applying the sanitizer, it should take about 15 seconds to rub your hands dry. - Expect our staff to clean their hands before and after patient care. Remind them if they forget. It’s okay to ask someone to clean their hands. Your health may depend on it. Cover your sneeze or cough with a tissue. If you don’t have a tissue, cough or sneeze into your upper arm – not your hands! Before you cough or 7

sneeze you should always turn away from other people. Discard used tissues in the trash and then clean your hands.

Helpful Information at Your Fingertips

Ask family and friends not to visit if they’re sick. If they must visit, ask them to talk to the nurse before entering the room. Protective items, such as a mask, may be required.

CALLING FROM YOUR ROOM OR WITHIN THE HOSPITAL

Make sure to eliminate germs when you go home by using disinfectants, such as sprays and wipes, to clean surfaces often. Some germs can live three days or longer on hard surfaces. That’s why it’s so important to frequently disinfect surfaces like countertops, sinks, phones and TV remotes. VOICING YOUR COMPLIMENTS OR CONCERNS We are always interested in improving. If you have any concerns about patient care and safety in the hospital that have not been addressed, please contact the hospital’s management. Ask your nurse or the hospital operator to call an administrative representative for you. If you have questions, comments, or concerns about your care or safety, please contact our hospital administration at 276-988-8701. If you have questions about patient rights or responsibilities, quality of care, coverage decisions or premature discharges, you may also notify: Virginia Department of Health Office of Licensure and Certification 9960 Mayland Drive, Suite 401 Richmond, VA 23233 800-955-1819

Virginia Health Quality Center 9830 Mayland Drive, Suite J Richmond, VA 23233 866-263-8402 (Expedited appeals helpline) 800-545-3814 (Consumer helpline)

The Joint Commission One Renaissance Blvd. Oakbrook Terrace, IL 60181 630-792-5000 800-994-6610 complaint@jointcommission.org

Department of Health and Human Services Centers for Medicare & Medicaid Services 800-633-4227

Carilion Tazewell Community Hospital is accredited by several agencies including The Joint Commission, whose mission is to continuously foster and improve the safety and quality of care provided to the public through the organizations that seek its accreditation. If issues cannot be resolved by the hospital, you may also contact The Joint Commission’s Office of Quality Monitoring. You may report any concerns or register complaints about a Joint Commission-accredited healthcare organization by calling 800-994-6610 or emailing complaint@jointcommission.org.

Telephones are provided for your use at no charge. For local calls, dial 9 for an outside line. For long distance, you will need to have a calling card or call collect. Dial 0 to reach the hospital operator for assistance. Cellular or mobile phones may also be used in designated areas. OUTSIDE TELEPHONE CALLS Your room phone has a direct number for your family and friends to use. Please ask your nurse for the direct telephone number to your room if it is not noted on your telephone. The main telephone number is 276-988-8700. Calls to patient rooms through the hospital operator are not forwarded after 9 p.m. VENDING MACHINES Vending machines are available 24 hours daily and are located in the snack bar next to the entrance to the Physical Therapy Department. MAIL AND FLOWERS Any mail or flowers addressed to you will be delivered to your room. Your address at the hospital is: Your Name, Carilion Tazewell Community Hospital, 141 Ben Bolt Ave., Tazewell, VA 24651. Mail received after your discharge will be sent to your home address. We will contact you if flowers are received after your discharge to arrange pick up. Our volunteers will gladly mail out stamped letters or cards you wish to send. PARKING Visitors should park in designated spaces in the west parking lot (on the Emergency Department side of the building). The circular drive near the front door is for drop-off only. Please do not leave a vehicle parked there unattended.