AR_North Arkansas Regional Medical Center by Patient Point

in funeral service responding to your personal needs. When you need the assistance of a funeral director,

We’re here to help! Family owned and operated since 1924. Glenna Ragan, President 1904 Capps Road Harrison

870-741-3481

Providing dialysis care to Northwest Arkansas for over 10 years Choosing the right dialysis provider can be the most important decision you make, so we design your dialysis therapy to meet your lifestyle and personal goals – including transplantation. We offer many therapy options, including home dialysis. We are open Monday-Saturday! Dwight Zabel, MD & John R Martinez, MD Kidney Specialists Johnna Manna, PA-C 1409 Gladden Street Harrison, AR 72601

(870) 204-6683

• Bathing, Dressing, Grooming • Toileting & Personal Hygiene • Grocery Shopping & Errands • Meal Planning and Cooking • Light Housekeeping & Laundry • Recuperation Assistance • Appointment Management • Medication Management A Nursing Home Alternative & Assistance ATLIS has been helping seniors live at home since 1985. Whether your need hourly help or 24-hour care, • Compassionate Care for Your we can help. Calls are accepted 24 hours a day. Loved One

320 W. Bower • Harrison, AR 72602

(870) 741-7512 • atlisinhomecare.com

In This Guide Welcome.....................................2 NARMC Mission Statement.......2 Room Numbering System..........2 Patient Rights.............................4 Patient Responsibilities..............6 Your Admission to NARMC....7-8 Admissions.....................................7 Insurance.......................................7 Valuables........................................8 Medication.....................................8 Call Button....................................8

General Information.............8-16 Telephones.....................................8 Smoking.........................................8 Firearms.........................................8 Television.......................................9 Television Channel Listing...........9 Food and Nutrition Services........10 Cafeteria.......................................10 Snacks..........................................10 Guest Trays..................................10 Safety and Security......................10 Inquiries about You.....................11 Nightingaleâ&#x20AC;&#x2122;s Gift Shop...............11 Thrift Shop...................................11 Chapel/Clergy..............................12 Overnight Stay with Patients......12 Visiting Hours..............................12 Surgical Patients...........................13 Mail, Newspapers and Flowers....13 Safety Drills..................................14 Infection Control.........................14 Handwashing...............................14 Your Length of Stay.....................15 Cellphones Allowed.....................15 No Cameras Allowed...................15

Gifts/Gratuities............................15 Private Duty Sitters List...............16 Discharge.....................................16

Of Special Interest to Our Patients and Families.......17-21 Patient Resources.........................17 Advance Directives......................18 Organ Donation..........................18 Ethical/Care Dilemma?...............19 Interpreters..................................20 Services for Visual, Hearing & Speech-Impaired Patients......20 Community Resources & Support Groups......................20 NARMC Gold Club......................21 Volunteer Services.......................21

Rural Health Clinics.................22 Hospital Services.................23-24 Medical Staff........................25-27 Frequently Called Numbers.....28 An Important Message from Medicare..................28-30 Services Provided.....................31 What About My Bill?................32 Adults Need Shots, Too!...........33 Medication Safety.....................34 Pain Management...............35-36 Helpful Websites......................37 Notes....................................38-40

Welcome to North Arkansas Regional Medical Center North Arkansas Regional Medical Center was established December 17, 1950, as Boone County Hospital with 50 beds and 51 employees. Today, North Arkansas Regional Medical Center is licensed for 174 beds, employs over 800 people and serves five counties in a service area that has over 85,000 people. North Arkansas Regional Medical Center is a county-owned, not-forprofit healthcare system with seven rural health clinics and three ambulance substations. Services are located in Lead Hill, Jasper and Marshall, Arkansas. The hospital is totally self-sufficient and receives no county funding through taxes or other methods. The board of directors of the medical center corporation leases the hospital from the county through its board of governors. North Arkansas Regional Medical Center is a dedicated, diverse and growing industry that serves all in need of healthcare.

NARMC Mission Statement Our mission is to improve the health of our community by providing safe, quality healthcare and resources with compassion and integrity.

Room Numbering System Patient room numbers beginning with “4” are located in the original part of the hospital. Patient room numbers beginning with “5” are located in the Patient Tower. The second digit of the room number indicates the floor. For example: Room #5203 will be on the second floor of the tower. Room #4318 will be on the third floor of the original hospital.

Rooms 4201-4210 Observation Unit, original building Rooms 4301-4327 Medical Unit, original building Rooms 5101-5124 Medical & Surgical Unit, Patient Tower, park on lower parking lot across from Hudson’s Grocery Rooms 5201-5224 Critical Care and Pediatric Unit, park on lower parking lot across from Hudson’s Grocery Rooms 5301-5324 Obstetrics and Women’s Health Unit, park on lower parking lot across from Hudson’s Grocery To directly phone a patient’s room, dial (870) 414 plus the room number.

Licensure North Arkansas Regional Medical Center is a fully licensed healthcare facility that meets all the requirements of the state of Arkansas.

Patient Safety and Satisfaction We are committed to doing everything we can to make your stay with us as safe and pleasant as possible. We encourage your feedback regarding your stay. We send patient satisfaction surveys to a random selection of our patients on a weekly basis. Survey results are analyzed and used to support performance improvement initiatives. If you have any concerns at all about our facility or services, please give our nursing staff the first opportunity to assist you. If further assistance is necessary, please contact our Vice President, Quality Services/Chief Nursing Officer Sammie Cribbs, at 870-414-5130. If you have an urgent concern, a member of administration is on call 24 hours a day, seven days week—just ask any staff member to notify the administrator on call. We appreciate this opportunity to serve you!

Safety Precautions

Most patient accidents within the hospital are caused by falls. Unless you have been told it is permissible to do so, it would be best not to get in or out of bed by yourself. Please ask your nurse to help you. If the rails on your bed are in the up position, they are there for your protection and to assist you in turning. Also please do not try to get in and out of a wheelchair by yourself. If you bring personal electrical devices into the hospital to be used by a patient, you must first give them to your nurse to be checked out by our Engineering Department. These items include, but are not limited to: hairdryers, curling irons, razors, radios, heating pads or fans.

Patient Rights and Responsibilities All patients receiving care in a North Arkansas Regional Medical Center facility shall be afforded The RIGHT to: • R eceive needed medical care no matter what your race, disability, color, religion, national origin or ability to pay. This is in accordance with Title VI and VII of the Civil Rights Act of 1964 and its implementing regulations. • Know your rights and be involved in making decisions about your medical care. • Kind and courteous care. • Respect, dignity, comfort and privacy when receiving care, and when giving or receiving information about your care. • Receive care in a safe place. • Refuse medical care to the limit allowed by law and to be told what could happen to you medically if you refuse. • Know the names of the people taking care of you and what their job is. You also have the right to know the name of the doctor who is responsible for taking care of you. • Your medical information being kept confidential. • Get information that is in your record within a reasonable time. • Give and receive information about your medical problem and its possible and/or unexpected outcome in terms that you can understand. • Be told all you need to know about the care or procedure the doctor wants you to have so that you can decide whether or not you want this to be done. You will be given this information before you receive the care or the procedure. If you need an interpreter, we will get one for you.

• B e free from all forms of abuse or harassment. • An advance directive (such as a living will, healthcare proxy, or durable power of attorney for healthcare) and to have those directives followed. • Take part in solving and answering questions and/or conflicts about your care, and to have those questions/conflicts looked at and, if possible, worked out. For help, contact a hospital social worker at 870-414-4019, 870-414-4229 or 870-414-4278. • Receive pastoral counseling and other spiritual services. • Receive appropriate assessment and help to manage pain. • Have a family member or person of your choice, and your physician, contacted promptly of your admission to the hospital. • Have visits from people outside the hospital (certain areas of the hospital do have visitor restrictions), and writing to or talking to visitors of your choice. • An interpreter if you do not speak or understand English. We will get one for you as soon as possible at no cost to you. • Special assistance and/or equipment for those with hearing, vision or speech problems, at no cost to you. • Leave the hospital even when your doctor doesn’t think you should. If you decide to leave against your doctor’s advice, the hospital will not be responsible for any harm your leaving may cause you. You will be asked to sign a “Release for Responsibility for Discharge” form. • Be told how to take care of yourself following discharge from the hospital. • Not be restrained or secluded just because the staff cannot control your behavior, doesn’t have the time to stay with you, or is upset with your behavior. If seclusion or restraints are used (including medications used as restraints), they will be used as instructed in North Arkansas Regional Medical Center’s Restraint Policy. • Look at and be given an explanation of your hospital bill even if you don’t have the ability to pay. • Tell the staff if you are unhappy with your care. This can be done verbally or in writing without fear of the staff taking it out on you. If you have any concerns you need to talk about, you should talk to your doctor or nurse, or call 870-414-5020 to talk to a patient representative.

24-Hour Patient Hotline

NARMC believes that all patients have the right to voice concerns or complaints about their care, and the right to have those concerns or complaints reviewed and resolved if possible.

NARMC provides several avenues to accomplish this: 1. D iscuss your need or concern with your nurse, and he or she will follow our Patient Complaint Resolution Process. 2. C all the NARMC 24-Hour Patient Hotline at 870-414-5020. A designated representative will return your call within one working day. 3. Ask to speak to the nursing supervisor on duty. If your complaint is not resolved to your satisfaction, you have the right to file a formal grievance. If you wish to file a formal grievance, contact a hospital social worker at 414-4019 or by calling our hotline at 414-5020. You also have the right to file a grievance directly with the Health Facility Services. You may contact the service at: Arkansas Department of Health Health Facility Services 5800 W. 10th St., Suite 400 Little Rock, AR 72204 Phone: 501-661-2201 Email: adh-hfs-complaints@arkansas.gov or by calling the patient representative at 870-414-5050 If you are a Medicare patient, you can contact: KEPRO Medicare Beneficiary Helpline KEPRO Rock Run Center, Suite 100 5700 Lombardo Center Dr. Seven Hills, OH 44131 Phone:â&#x20AC;&#x2C6;1-800-589-7337 Email: webmaster@ohiokepro.com If you are a Medicaid or ARKids First patient, you can contact: The Department of Human Services Appeals and Hearings Section P.O. Box 1437, Slot N401 Little Rock, AR 72203 Phone: 1-888-987-1200

All patients receiving care in a North Arkansas Regional Medical Center facility shall have the following RESPONSIBILITIES: â&#x20AC;˘ T o give to the medical staff, to the best of your ability, correct and complete information about what is wrong with you right now, past illnesses, hospitalizations, medications, and other things relating to your health.

• T o report unexpected changes in your condition to the medical staff who are responsible for caring for you. • For telling the medical staff whether or not you clearly understand what the medical staff is planning to do to you and what is expected of you. • To follow the plan of care advised by the medical staff. This may include following the instructions of nurses and other healthcare staff as they carry out their duties and enforce the necessary hospital rules and regulations. • To accept what may happen to you if you refuse recommended treatment or do not follow the medical staff’s instructions. • To follow hospital rules and regulations involving patient care and conduct. • To show kind and courteous behavior toward other patients, visitors, and hospital staff, and show respect of their rights and property. • To tell your physician and the hospital of any advance directives (such as a living will) or religious beliefs that you wish to have followed in the event that you are no longer able to speak on your own behalf.

Your Admission to NARMC Admissions

You are being admitted to our facility at the request of your physician who is on our medical staff. We are proud to offer private rooms for NARMC patients.

Insurance

Questions concerning insurance coverage, cost or financial issues should be directed to the Insurance Department where a financial counselor will answer any inquiries. Patients who have insurance or are eligible for Medicare, Medicaid, or any other federal or state program, should present the proper membership card (papers) or proof of eligibility upon admission. Patients who do not have insurance and anticipate difficulty with payment of their bill are urged to talk with a financial counselor. Phone 870-414-4007 from 8:00 a.m. to 4:30 p.m. Monday through Friday.

Valuables

We strongly recommend that valuables be left at home or sent home with a family member. THE HOSPITAL WILL NOT ASSUME ANY RESPONSIBILITY FOR LOST ITEMS. If you have valuables or a large amount of cash, nursing personnel will explain our procedure for their safekeeping. Please remember to claim valuables when discharged.

Medication

In order to ensure that prescribed care is not compromised, the pharmacy department will dispense all patient medications for inpatients. Observation patients should bring their medications from home. You should bring your current medication bottles or current list of medications for review. After your nurse has seen them, please send them home with your family.

Call Button

Your call button to “beep” your nurse is located on the television control. Once the button is activated, the staff will answer you over the intercom. All you need to do at that point is respond to the staff’s questions.

General Information Telephones

Local calls can be made from your room by dialing 9 + the number. Long-distance calls can be made from your room by dialing 9 + 0 and asking for an outside operator’s assistance. You should specify the service you wish to use (ie, AT&T, MCI, Verizon, etc.). For the consideration of our patients, the phones in patient rooms will not ring after 9:00 p.m. or before 7:00 a.m. However, the patient can make outgoing calls at any time.

Smoking

NARMC is a smoke-free facility. Smoking is never permitted inside the hospital. Visitors and employees are not permitted to smoke on the grounds or in the buildings of NARMC facilities.

Firearms

Firearms are not allowed in the hospital.

Television

The television in your room offers basic cable service and is provided free of charge.

NARMC Patient Room TV Guide 2 WGN 3 NBC (KYTV-DT-1) 4 FOX KRBK 5 ABC KATV 6 ABC KSPR 7 My Network TV KOZL 8 CBS KOLR 9 CBS KTHV 10 QVC 11 PBS AETN 12 CW KSPR 13 The Weather Channel 14 TBS 15 MeTV KTKO Essential 16 USA Network 17 ESPN 18 ESPN2 19 Discovery Channel 20 FOX Sports Southwest 21 FX 22 TNT 23 Lifetime 24 VH1 25 TLC 26 History 27 AMC 28 A&E 29 Disney Channel 30 Spike 31 HLN 32 CNBC 33 ABC Family 34 Nickelodeon 35 CNN 36 E!

37 Travel Channel 38 HGTV 39 TV Land 40 Univision 41 Food Network 42 Comedy Central 43 MTV 44 BET 45 Animal Planet 46 NBC Sports Network 47 truTV 48 msnbc 49 Syfy 50 FOX News Channel 51 CMT 52 TCM 53 FOX Sports 1 54 Cartoon Network 55 Bravo 56 GSN 57 National Geographic 58 SEC Network 59 Cox Channel 60 Golf Channel 61 Cox Sports Television 62 Fox Sports SW Plus 63 Fox Business 64 POP 65 Hallmark Channel 66 FXX 67 Ion Television 68 Investigation Discovery 69 Fox Sports 2 70 EWTN 73 Velocity HD

Food and Nutrition Services

The primary goal of the Food Services Department at NARMC is to provide optimal nutritional care for patients through wholesome, balanced meals according to their individual needs and medical conditions to improve health and healing. We strive to provide nutritious, attractive, palatable and appealing meals for regular and modified diets. Nutritional care is an integral component of the comprehensive approach for achievement of good health. Maintaining and improving the nutritional status of the individuals served by the Food Services Department is essential to ensuring a high quality of life. Your diet is prescribed by your physician. Outside food may be brought in by family in accordance with your diet.

Cafeteria

Our cafeteria is located on the first floor in the original building and is available to family members and guests for breakfast from 7:00 a.m. to 9:30 a.m., lunch from 10:30 p.m. to 1:30 p.m. and dinner from 4:00 p.m. to 6:30 p.m. You may call the DineLine for daily menu choices at 870-414-4380.

Snacks

Snacks and refreshments for visitors may be obtained 24 hours a day through vending machines located in the Emergency Room lobby, the original buildingâ&#x20AC;&#x2122;s first floor main hallway, and second floor tower waiting room.

Guest Trays

If a family member would like to eat in the patientâ&#x20AC;&#x2122;s room, guest trays are available for a charge. A hostess is assigned to your floor and will work with you daily on your menu choices. Payment is required to be made prior to receiving a guest tray. You may pay by the meal, day or week. Payment is made to the hostess on your floor. Complimentary guest trays are provided to one parent who is staying with a patient age 12 or under.

Safety & Security

All exterior exits are locked each evening at 9:00 p.m. and unlocked each morning at 6:00 a.m. Between these hours, visitors may enter the hospital through the Emergency Department. Parking is available. Please be sure to lock your vehicle. NARMC is not responsible for loss or damage.

Inquiries about You

We believe your health is a personal matter. Therefore, diagnostic and other confidential information about you will not be released to others without your permission. We urge you to tell your friends and relatives that they should contact a member of your immediate family to inquire about your progress. If relatives or friends call the hospital, only a general condition report can be given.

Nightingaleâ&#x20AC;&#x2122;s Gift Shop

Nightingaleâ&#x20AC;&#x2122;s Auxiliary Gift Shop is always ready with the perfect gift to brighten the day of your favorite patient. The gift shop is located near the atrium of the first floor Patient Tower and is open Monday through Friday from 9:00 a.m. to 4:00 p.m. Stop in to pick up a bouquet of fresh flowers, a new baby gift or a quick snack. You also can shop online by visiting www.narmc.com, or call 870-414-5131. All profits from the gift shop are used by the Auxiliary to purchase equipment for NARMC.

Thrift Shop

The Thrift Shop is located at 225 North Main Street. It is operated by the NARMC Auxiliary and is open Monday through Saturday from 9:00 a.m. to 4:00 p.m. All profits of the Thrift Shop are used by the Auxiliary to purchase equipment for NARMC. You may reach the Thrift Shop by calling 870-365-2483. Volunteers and donations are welcome.

Chapel/Clergy

NARMCâ&#x20AC;&#x2122;s chapel is located on the second floor of the Patient Tower. It is the policy of NARMC to respect and provide for each patientâ&#x20AC;&#x2122;s right to pastoral counseling and other spiritual needs. Local ministers are encouraged to visit their members who are in the hospital. If you need us to contact your minister, please let one of our staff know. If your minister is not available or you do not have a minister and would like to be visited by one of our volunteer chaplains, let one of our staff know and we will contact one for you. We maintain a list of ministers in the area who are available to our patients. This list contains ministers of many different denominations and beliefs. You may choose which one you want us to contact. You also may leave a message for a chaplain by calling 870-414-5414. If you have special religious or cultural beliefs, please advise our staff so we can do everything possible to meet those needs.

Overnight Stay with Patients

Occasionally, it is necessary for a relative to remain overnight with a patient. Only one guest may stay in a private room. We require a parent to stay with any child who is age 12 or under and will provide a recliner or chair bed.

Visiting Hours

NARMC has established visiting hours for the benefit of patients and to facilitate the administration of quality care. Visitors in limited numbers are welcome and usually provide good therapy. However, our primary objective is to maintain an environment conducive to your speedy recovery, which requires adequate rest. Therefore, we regulate the time of day you may receive visitors, their number and length of stay. Please help us enforce all visitor regulations that your physician has approved for your benefit. Visiting hours are as listed: General Nursing Noon - 8:30 p.m. OB Noon - 8:30 p.m. Nursery Noon - 8:30 p.m. Siblings of the newborn are the only children allowed to visit while the baby is in the room.

Critical Care Unit Visiting hours are as follows: 6:00 a.m. - 6:30 a.m. 8:30 a.m. - 6:30 p.m. 8:30 p.m. - 9:00 p.m. This allows uninterrupted times for shift changes, physician rounds and patient rest. The unit will be closed during the following hours: 6:30 a.m. - 8:30 a.m. for shift change and morning rounds, 6:30 p.m. - 8:30 p.m. for shift change and evening rounds, and 9:00 p.m. - 6:00 a.m. to encourage patient rest. Families of Hospice Patients are allowed unrestricted visiting. If a patient is in isolation, only adults are permitted to visit, and in some cases, family only. Visitors must follow isolation precautions posted on the outside of the patientâ&#x20AC;&#x2122;s door. Children 12 years of age and under must only visit during visiting hours and must be strictly supervised by an adult. There are restrictions regarding children visiting during RSV and flu season. Restrictions will be posted on all entrance doors.

Surgical Patients

If you are scheduled for surgery, please remember surgery cases are performed as close to their scheduled time as possible. However, when emergencies arise, some surgical cases may be delayed.

Mail, Newspapers and Flowers

A U.S. Postal Service mail bin is located at the North entrance by Cardiac Rehabilitation. Visit our website at www.narmc.com to send a patient an email. Emails will be delivered Monday through Friday, 8:00 a.m. to 4:30 p.m. Patient mail is delivered Monday through Friday by volunteers. Please instruct persons sending correspondence to put the room number and name under which the patient was admitted (your name, not your familyâ&#x20AC;&#x2122;s name for you, ie, Granny, Pa, Sis, Mom), as well as the hospitalâ&#x20AC;&#x2122;s address of 620 N. Main, Harrison, AR 72601 on the envelope.

Newspaper vending machines are located at Admissions by the ER and first floor of the original building by the cashier. Flowers or gifts will be delivered to your room when they arrive. However, plants and flowers are not permitted in the Critical Care Unit or in isolation rooms.

Safety Drills

Periodic fire drills, conducted as a precaution, involve hospital personnel, not patients. They ensure our readiness to deal with such a situation should it ever arise. Should a drill occur, the door to your room will be closed. Please do not be alarmed. At least twice a year, the hospital conducts disaster drills to ensure that the hospital staff and other community health agencies are prepared to handle large disasters. We make every attempt not to disturb our patients, but your cooperation will be needed.

Infection Control

Handwashing is the best way to prevent infection. Please wash your hands before and after visiting patients and after using the bathroom. We request that visitors use the public restrooms instead of the bathrooms in patient rooms. Our hospital staff uses standard precautions when caring for all patients, regardless of diagnosis. Barriers such as gowns, gloves and masks are used in the care of all patients when there is a potential for body substance exposure. Some diseases require that additional precautions be used. This further protects patients and visitors. If this is necessary, a sign will be placed on the patient’s door. The nurse will instruct visitors to wear appropriate attire such as a gown, gloves or mask while visiting the patient. Handwashing is necessary after removing the special protective devices.

Make sure everyone washes hands

To help prevent hospital infections, the Centers for Disease Control (CDC) and Prevention says that doctors or nurses should wash their hands (or use alcohol gel) in front of you when they enter your room, and if they don’t, you should remind them. We encourage our patients to speak up in that way, so don’t be shy— your safety is at stake. Since reminding your caregivers to use hand hygiene may make you uncomfortable, Consumer Reports has a list of ways to ask a doctor or nurse to wash up:

“I’m a little concerned about the high rates of hospital infections these days. Would you mind washing your hands one more time before we proceed with care?” “I didn’t see you clean your hands, so would you please do it in front of me?” “Did you wash your hands before you came? You know I need to make sure.” “I’ve heard a lot about how handwashing is important to reduce infections, and so in taking care of myself, I need to ask whether you washed your hands before you came into my room. If you haven’t, I do appreciate you doing so now.” “Doctor, I didn’t see you wash your hands. Did you do that outside?”

Your Length of Stay

While you are a patient, a member of the Utilization Management Department will review your medical record. These healthcare professionals evaluate the medical necessity of your admission and hospital stay. Medicare and other insurance providers reimburse the hospital for services only when it is medically necessary to be hospitalized since less costly alternatives such as outpatient care, extended care facilities or home healthcare are available. Members of your healthcare team will help you plan for your care when you are ready for discharge.

Cellphones Allowed

For your convenience, cellphones are allowed to be used at NARMC. Please power off your wireless equipment within 3 feet of medical equipment. Thank you for your cooperation.

No Cameras Allowed

Patient privacy is important to NARMC. Therefore, use of recording devices such as cameras, video cameras, camera phones and similar devices is strictly prohibited (without prior approval) while in NARMC facilities.

Gifts/Gratuities

Individual employees are not allowed to accept gifts or monetary gratuities. However, you may wish to make a donation to the North Arkansas Medical Foundation. This donation can be made by contacting the North Arkansas Medical Foundation at 870-414-4549.

Private Duty Sitters List

NARMC furnishes a private duty sitters list for patients and families in need of assistance at home. If you are interested in obtaining a copy of this list, please ask your nurse or the case manager for your area. They will be happy to provide you with one. Please note—the furnishing of this list is not a certification of training or abilities. NARMC is not a reference for, nor do we make recommendations about, any of the sitters on the list. IT IS THE RESPONSIBILITY OF THE PATIENT OR FAMILY to check the references of the sitter they wish to employ. North Arkansas Regional Medical Center

Home Care Department

Serving the people of Boone, Carroll, Marion, Newton and Searcy counties by providing:

Home Health • Hospice • LifeLine For more information on any of our services:

870-414-4100

1-800-368-7408

P.O. Box 1927 501 E. Sherman Ave. Harrison, AR 72601

Home Care Department TDD Number: 870-414-4929 answered 8:00 a.m. to 5:00 p.m. Monday through Friday NARMC TDD Number: 870-414-4929 answered 24 hours/day

Discharge

While we recognize most patients are eager to return home, it may be helpful to know that a number of steps are required once a patient has been discharged by his or her physician: • Your doctor will write the discharge order after seeing all of his or her patients on your floor. • Your doctor will dictate any notes pertaining to your case. • The unit secretary will receive your chart. • The secretary will process the orders from the charts and advise your nurse of your discharge. • The nurse will prepare discharge instructions and meet with the patient. This process could take several hours depending on each patient’s individual needs. When the patient’s records are complete and his or her transportation has arrived, the patient will be taken to his or her vehicle by wheelchair. Your doctor and your nurse will give you instructions about post-hospital care. If you have questions about your diet, activities or other matters, please be sure to ask at this time. You also may call 870-414-4000 and ask the switchboard operator to connect you with the floor from which you were discharged.

Of Special Interest to Our Patients and Families Patient Resources

Discharge planning begins the day you are admitted to the hospital. Your physician, hospital staff and social worker will work as a team to plan for your discharge, with input from multidisciplinary areas as applicable. Your doctor is the only person who can medically authorize your discharge from the hospital. Once the doctor decides you can be discharged, he or she must write it in your chart so the nursing staff can process your papers. The coordination of your discharge needs will be arranged by the social worker/nursing staff. Consideration will be given to your preferences, needs and concerns based on the availability of resources/services to provide for your needs. The following is a list of some of the discharge issues that your social worker can assist you with: Home Health Services, nursing home placement, home medical equipment, outpatient rehabilitation, inpatient rehabilitation, Recuperative Care Unit, live-in services, transfers to other facilities and more. Social workers also can help you with: advance directives, financial concerns and assistance, community resources, concerns and complaints, ethical/care dilemmas, grief support, counseling services, issues of neglect and abuse, cancer resource information and support, issues of death and dying, questions about organ donation, depression and thoughts of suicide, dialysis information and support, inpatient psychiatric placement, questions about guardianship and power of attorney and more. There is no charge for the services provided by social services, and all information is confidential. If you wish to see a social worker, ask your physician or nurse to make a referral to Social Services, or you can contact a social worker directly by calling 870-414-4019.

Your Right to Decide - Advance Directives/Living Wills

Advance directives (living wills, healthcare proxy and durable power of attorney for healthcare) are legal documents that let you give guidance to your physicians and family about your healthcare treatments should you be unable to communicate your wishes. Living will and healthcare proxy information and documents are available to anyone who requests one. You will be asked upon admission if you have an advance directive. If you do not have one and want more information, please tell your nurse and he or she will contact one of our social workers. If you do have an advance directive, please bring a copy with you so it can be placed with your medical record. If you have questions about advance directives, ask your nurse to contact a hospital social worker.

Organ Donation

Last year, more than 10,000 patients received a â&#x20AC;&#x153;gift of lifeâ&#x20AC;? through donations of organs such as livers, kidneys and hearts. Many other patients have benefited from transplants of tissue such as bone, skin and corneas. However, there is a critical shortage of organs and tissues available. While thousands of children and adults experience a second chance at life through transplantation each year, thousands more die while waiting for their chance. There are hundreds of Arkansans who can benefit from similar transplants today. Choosing to become an organ and tissue donor is a precious gift, an unselfish act that can touch the lives of many people. A recent change in Medicare Guidelines requires that hospitals report every death to the Organ Procurement Agency in their area to determine if the deceased fits criteria for organ donation. If the deceased does fit the criteria, then the family must be asked about organ donation. Another part of the Medicare Guidelines require that if a death is imminent, we must call the Organ Procurement Agency in our area to report this and give information to determine if the patientâ&#x20AC;&#x2122;s organs would be appropriate for donation. If the organs are appropriate for donation, then this issue must be addressed with the family.

We realize that it sounds harsh to approach a grieving family about organ donation, but if the family has discussed donation in advance, it makes this difficult time a little easier. We encourage you to discuss your feelings about organ donation with your family and friends. Make your wishes known. It also is important to discuss your decision about organ donation with your doctor. If you would like more information about organ donation, tell your nurse and he or she will contact one of our social workers to come talk with you. Or you can call Arora (Arkansas Regional Organ Recovery Agency) at 1-800-727-6726. They will be happy to provide you with information and explain how to become an organ donor.

Ethical/Care Dilemma?

The growth of medical knowledge and technology has prolonged our lives and changed them for the better. But new developments bring new decisions. We recognize that making decisions about care sometimes presents questions, conflicts, or other dilemmas for the hospital and the patient, family or other decision-makers. We further recognize that these dilemmas may arise around issues of admission, treatment or discharge. As a patient or family member, you have the right to participate in resolving dilemmas about care decisions that arise, and to have those questions/dilemmas reviewed and, when possible, resolved. If you need assistance with an ethical/care dilemma, you can request to see one of our hospital social workers, talk with your physician, nurses or administration. When a potential Ethical/Care dilemma needs to be clarified, a hospital social worker will conduct a Case Review and will consult with other disciplines or specific professionals, as deemed necessary for the situation, to assist in resolving the dilemma. You may contact a social worker directly by calling 870-414-4019, 870-414-4278 or 870-414-4229. If needed, an ethics consultant with the University of Arkansas for Medical Sciences will be contacted for assistance in resolving the dilemma.

Some situations where a Case Review and Ethics Consulting may be helpful are: * Anytime the healthcare team needs help making an ethical decision. * When the patient, family member and/or healthcare providers disagree about what is in the best interest of the patient. * When the care of a patient involves difficult ethical considerations, such as the termination of life support. * Wherever questions arise regarding a living will (or advance directives); for example, what it means and when it is appropriate to activate.

Interpreters

Interpreters for non-English speaking and hearing-impaired patients are available by contacting your nurse. Our VRI equipment will be arranged for your usage.

Services for Visual, Hearing and Speech-Impaired Patients NARMC takes steps to ensure that no person with a disability is discriminated against because of the absence of auxiliary aids and services. If you need special arrangements, and/or special assistive devices for the hearing impaired, please notify your nurse.

Community Resources and Support Groups

A list of Community Resources and Support Groups is available through the NARMC Social Services Office. You may request to see one of our social workers or contact them directly at 870-414-4019, 870-414-4278 or 870-414-4229.

BIGGER AND BETTER THINGS Behavioral Unit Now Serving All of Northern Arkansas!

620 N. Panther Ave., Yellville, AR 72687 (870) 449-4201 - Call us or drop by to tour. creeksidehealthandrehab.com SMD@creeksidehealthandrehab.com

Body language can tell you all sorts of things. Like someone is having a stroke.

strokeassociation.org

Know the sudden signs.

Spot a stroke F.A.S.T.

479-253-7038

235 Huntsville Road Eureka Springs, AR 72632 “Leaders in skiLLed nursing and rehabiLitative therapy”

• 24-Hour Skilled Nursing Care • Private Accommodations • Clinical Professionals Focused on Getting Your Loved One Back Home • Full Team of Physical, Occupational & Speech Therapists • Dedicated Staff to Care for Dementia & Alzheimer’s Disease • Five-Star Rating from Centers of Medicare & Medicaid for 2014, 2015 & 2016

Caring for you and about you. • Compounding Custom Medications • Free Delivery in Harrison City Limits • Yankee Candles

Proudly serving Harrison and the surrounding communities since 1979.

Fast, Friendly Service

127 N. Main St., Harrison, AR 72601

870-741-6511

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.

aarp.org/caregiving or call 1-877-333-5885 ®

Losing weight’s a lot harder than gaining it…

but very much worth the effort.

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

It’s not easy. But it is worth it.

Learn how you can help stop diabetes by losing weight, eating healthy and staying active. Visit checkupamerica.org or call 1-800-DIABETES.

NARMC Gold Club - For those 55 and better

The Gold Club is an organization based on the philosophy of enhancing a healthy and positive lifestyle for those age 55 or better. Its purpose is to promote physical, mental and social well-being through a range of services, programs and resources. There is no cost to join the Gold Club, and each member is eligible for many services and advantages. Some of the benefits of the Gold Club include: * One free meal per day for caregiver when a Gold Club member is hospitalized. * Educational seminars providing information on topics that affect health and lifestyle. * Resource center. See page 31. * Cafeteria discounts. * Insurance and claims filing assistance, scheduled by appointment. * Gold Club Newsletter containing news and features about Gold Club members, as well as information of interest to seniors. * 55 Alive Mature Driving program. * Special discounts and services provided by participating area merchants. * Free notary service. Contact the Gold Club coordinator at 870-414-4622 for more information or to join the Gold Club.

Volunteer Services

During your stay at our hospital, you may meet some people wearing pink smocks or bright red jackets. These special people are our volunteers, and they donate their time and talents to make a difference here at NARMC. You might see them delivering mail, greeting and giving directions in our front lobby, escorting families or selling items in our gift shop. They also do many jobs behind the scenes in offices and in our thrift shop. We are proud of our volunteers and thankful for their willingness to serve the community. If you are interested in learning more about becoming a volunteer at NARMC, please call 870-414-4622.

Rural Health Clinics Newton County Family Practice

870-446-2203

Marshall Family Practice

870-448-3327

The people of Newton County have a powerful medical resource— Newton County Family Practice. The advanced medical technology and treatment options that were previously hours away are as close as West Court Street in Jasper. As part of the North Arkansas Regional Medical Center’s family of clinics, they are open Monday through Friday 8:00 a.m. to 4:30 p.m. Searcy County residents can rest easy and know that excellent medical care is as close as Marshall Family Practice. The families of this community have the added strength and assurance of North Arkansas Regional Medical Center’s advanced diagnostic and treatment resources close to home. Marshall Family Practice is located on Industrial Park Road in Marshall and is open Monday through Friday 8:00 a.m. to 5:00 p.m.

Claude Parrish Community Health Clinic 870-436-5271 The residents of Lead Hill/Diamond City and the surrounding Boone County area are benefiting from a spirit of cooperation and partnership that comes together in Claude Parrish Community Health Clinic. North Arkansas Regional Medical Center and the clinic are teamed up to provide you and your family with the most advanced diagnostic and treatment capabilities the region has to offer. The clinic is open 8:00 a.m. to noon and 1:00 p.m. to 4:00 p.m. Monday through Friday.

All of the above mentioned Ambulatory Care Clinics are regional outreach clinics of NARMC. Each of these communities also is provided with an NARMC Emergency Services ambulance substation to better serve their citizens.

Hospital Services - Your Health is Important to Us We proudly offer these services, constantly increasing healthcare choices for you. Ambulance Service Anesthesiology * Epidural Behavioral Health Cafeteria Services Cancer Services * Chemotherapies * Inpatient * Outpatient * Nutritional Support * Radiation Oncology C laude Parrish Radiation Therapy Institute * Brachytherapy * External Beam Radiation Therapy *M etastron Injections for bone pain * Prostate Seed Implants *3 D Treatment Planning *W igs, Prosthesis, Turbans * Screenings * Blood Pressure * Body Composition * Breast * Cervical * Cholesterol * Colon * Glucose * Grip Strength * Health Risk Assessments * Prostate * Skin * Social Services * Support Groups * Dialogue

* Reach-to-Recovery * Sleep Apnea Cardiac Services * Echo Cardiogram * Echo Stress Test * EKG - Electrocardiogram * Holter Monitoring * Phase I, IIâ&#x20AC;&#x2C6;& IIIâ&#x20AC;&#x2C6;Rehabilitation * Treadmill Stress Test Case Management Services Community Education CPR & First Aid Classes Critical Care Unit * Coronary Care * Intensive Care Diabetes Education Services * Inpatient & Outpatient Education Services Emergency Medical Services Environmental Services Gold Club Home Health Services * CareLink * Grief Support Group * Hospice of the Hills * Hospice House * In-Home Nursing Services Imaging Services (Radiology) * Bone Mineral Densitometry * CT Scanning - Computed Tomography (3-D) * General/Surgical X-Rays * Invasive Therapeutic Procedures * Mammography * MRI - Magnetic Resonance Imaging

* Nuclear Medicine * Special Radiographic Procedures * Ultrasound Laboratory Services * Inpatient & Outpatient Medical Records Nursing Services Nutrition Services * Evaluation & Counseling * Inpatient & Outpatient Obstetrical & Nursery Services * Birthing Rooms * Childbirth Classes * Refresher Classes * Sibling Classes * Infant CPR Classes * Infant Hearing Tests Ostomy Support Services Pathology Services Pharmacy Services Post-Operative Care Rehabilitation Services * Artificial Limbs & Braces * Inpatient and Outpatient Services * Occupational Therapy * Hand Therapy * Physical Therapy * Speech Therapy Respiratory Therapy Services * Breathing Treatments * EEG - Electroencephalograms * Sleep Studies * Vascular Studies

Surgical Services * Endoscopy * General * Gynecological * Laparoscopic Procedures * Lithotripsy * Ophthalmology (Cataracts) * Orthopedic * Outpatient * Thoracic * Urology * Vascular Volunteer Services Wellness Programs Womenâ&#x20AC;&#x2122;s Health Services Wound Care

Medical Staff

Active Medical Staff Ali Abdelaal, M.D. Oncology/Hematology Ozark Cancer Clinic 715 W. Sherman, Ste J 870-365-0223

Kristoffer Bylow, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Bradford Allen, M.D. Family Practice Marshall Family Practice 211 Airport Rd. Marshall, AR 870-448-3327

Marcus Causey, M.D. Family Practice Crossroads Medical Clinic 1420 Hwy 62/65 870-741-3600

Stacy Armstrong, D.O. Family Practice Ozark Family Practice 602 N. Pine 870-743-4242

Richard Blake Chitsey, M.D. Internal Medicine Clinic 724 N. Spring, Ste. C 870-743-2448

Justin L. Cutler, D.O. Orthopedic Surgery Arkansas Orthopedics & Sports Medicine 224 W. Erie 870-741-8289 Eli Denny, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 Amanda Detar, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Victor Armstrong, D.O. Family Practice Ozark Family Practice 602 N. Pine 870-743-4242

Victor Chu, M.D. Family Practice Crossroads Medical Clinic 1420 Hwy 62/65 870-741-3600

Melissa Dirst-Roberts, M.D. Hospitalist 620 N. Main St. Harrison, AR 72601 870-414-5278

Todd Baker, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Cathy Clary, M.D. Family Practice Family Doctors Clinic 520 N. Spring 870-741-8286

Geoffrey Dunaway, M.D. Family Practice Willow St. Health Center 406 N. Willow 870-741-3252

Patricia L. Bell, M.D. Otolaryngology Family ENT & Sinus Center of Harrison 1401 McCoy Dr. 870-741-4368

Andrew L. Coble, M.D. General Surgery Surgery 604 N. Spring 870-741-6418

Max Ann Ferguson, M.D. Urology North Arkansas Urology 715 W. Sherman, Ste. A 870-741-2317

Chris Bennett, M.D. Radiology Associates 620 N. Main St. Harrison, AR 72601 870-414-4075

Kenneth Collins, M.D. Family Practice Family Doctors Clinic 520 N. Spring 870-741-8286

Scott Ferguson, M.D. Urology North Arkansas Urology 715 W. Sherman, Ste. A 870-741-2317

Richard Blubaugh, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Andrea Correll, M.D. Anesthesia 620 N. Main St. Harrison, AR 72601 870-414-4071

Lane Garner, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Shannon Brownfield, M.D. Family Practice Harrison Family Practice 715 W. Sherman, Ste. G 870-741-8247

Timothy Costello, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-425-8865

Asish Ghosh, M.D. Pediatrics Harrison Pediatrics 1418 McCoy Dr. 870-743-2777

Lincoln Godfrey, D.O. Hospitalist NARMC 620 N. Main Harrison, AR 72601 870-425-4402

Kevin Jackson, M.D. Family Practice Crossroads Medical Clinic 1420 Hwy 62/65 870-741-3600

Thomas Leslie, M.D. Family Practice The Leslie Clinic 306 N. Chestnut 870-741-8559

Chad Jensen. D.M.D. Dentistry Super Smiles 500 N. Main St. Harrison, AR 72601 870-741-4746

Gary Linker, M.D. Psychiatry â&#x20AC;&#x201C; Reliant Behavioral Health 620 N. Main St. Harrison, AR 72601 870-414-4106

Christine Gosch, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

James Justice, M.D. Family Practice Newton Co. Family Practice 502 W. Court Jasper, AR 870-446-2203

Brian Linn, M.D. Sports Medicine Arkansas Orthopedics & Sports Medicine 224 W. Erie 870-741-8289

Raymond Griffith, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Charles Klepper, M.D. Internal Medicine Main St. Medical Clinic 707 N. Main St. 870-741-3592

Stephanie Mallett, A.P.N. 520 N. Pine St., Ste. B Harrison, AR 72601 870-741-0249

James Hawk, M.D. Family Practice 303 W. Newman 870-741-4295

William Landrum, M.D. Radiology NARMC 620 N. Main St. Harrison, AR 72601 870-414-4085

Daniel Goodwin, M.D. Hospitalist NARMC 620 N. Main Harrison, AR 72601 870-414-5278

Brandon Hicks, M.D. Radiology Radiology Associates 620 N. Main St. Harrison, AR 72601 870-414-4085 Joanne Holliman, M.D. Pediatrics Family Medicine Clinic 724 N. Spring, Ste A&B 870-365-0850 Dennis Hughes, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 Corey Jackson, M.D. Family Practice Premier Family Care 1417 Gladden St. 870-741-0016

James Langston, M.D. General Surgery Surgical Associates 604 N. Spring 870-741-6418 Thomas Langston, M.D. Family Practice Family Doctors Clinic 520 N. Spring 870-741-8286 Roy Lee, M.D. Family Practice Harrison Mediquick 724 N. Spring, Ste D 870-741-2500 John Leslie, M.D. Family Practice/OB Family Medicine Clinic 724 N. Spring, Ste A&B 870-365-0850

Matthew McAlister, M.D Diagnostic Radiology NARMC 620 N. Main St. Harrison, AR 72601 870-414-4085 Adam McCall, M.D. Family Medicine Clinic 724 N. Spring, Ste A&B 870-365-0850 Bill Mears, M.D. Cardiology Harrison Cardiology 702 N. Spring 870-365-0761

Robert Miller, M.D. Pathology 620 N. Main St. 870-404-4073 Louis Mire, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 Craig Olson, M.D. Radiation/Oncology ParRTI 620 N. Main St. 870-414-4244

Sadip Pant, M.D. Hospitalist 620 N. Main St. Harrison, AR 72601 870-414-5278

Joshua Rutland, M.D. Hospitalist 620 N. Main St. Harrison, AR 72601 870-414-5278

Dawn Phelps, M.D. OB/GYN Cornerstone Medical Clinic 825 N. Main St., Ste A 870-743-4900

Richard Schmidt, M.D. Hospitalist 620 N. Main St. Harrison, AR 72601 870-414-5278

James Waters, M.D. Anesthesia NARMC 620 N. Main St. Harrison, AR 72601 870-414-4071

Charles Sessions, M.D. Radiology NARMC 620 N. Main St. Harrison, AR 72601

Thomas Watts, M.D. Hospitalist 620 N. Main St. Harrison, AR 72601 870-414-5278

Steve Shrum, M.D. Internal Medicine/Peds Cornerstone Medical Clinic 825 N. Main St., Ste A 870-743-4900

Micah Wiegel, M.D. OB/ GYN 520 N. Pine St., Ste B Harrison, AR 72601 870-741-0249

Thomas Pinson, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-425-8865 Heather Powell, M.D. Family Practice Family Medicine Clinic 724 N. Spring, Ste A&B 870-365-0850 Richard Powell II, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 Craig Randall, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 Ronald Reese, M.D. Family Practice Family Medicine Clinic 114 E. Crandall, Ste C 870-741-2299 Jacob Roberts, D.O. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 Sara Rogers, M.D. Anesthesiology 620 N. Main St. 870-414-4071 Ronald Rubio, M.D. Internal Medicine/ Rheumatology North AR Arthritis Clinic 123 Claude Parrish Ave. 870-365-2550

Tarik Sidani, D.O. Orthopedic Surgery Arkansas Orthopedics & Sports Medicine 224 W. Erie 870-741-8289 Rebecca Simon, M.D. Family Practice/OB Dr. Simonâ&#x20AC;&#x2122;s Office 1002 N. Spring 870-741-6373 Erik Snyder, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076 John C. Sorg, M.D. Hospitalist NARMC 620 N. Main St. Harrison, AR 72601 870-414-5278 David Stills, M.D. Family Practice The Leslie Clinic 306 N. Chestnut 870-741-8559

Christopher Taylor, M.D. OB/GYN 1425 Rock Springs Rd. 870-741-1616

Stephen Wilber, D.O. Hospitalist 620 N. Main St. Harrison, AR 72601 870-414-5278 Lowell Williams, DDS Oral Surgery Super Smiles 500 N. Main St. 870-741-4746 Mathew Wilson, M.D. Radiology NARMC 620 N. Main St. Harrison, AR 72601 870-414-4085 Ray Woodmansee, M.D. Emergency 620 N. Main St. Harrison, AR 72601 870-414-4076

Frequently Called Numbers Main Hospital Number 870-414-4000 Administration 870-414-5159 Admissions 870-414-4014 Ambulance 870-414-4074 American Heart Community Training Center 870-414-4548 Business Office 870-414-4010 Cafeteria 870-414-4044 Dine Line (Cafeteria meal selections) 870-414-4380 Emergency Room - General Info 870-414-4074 Food Services 870-414-4046 Gift Shop 870-414-5131 Gold Club 870-414-4622 Home Health & Hospice 870-414-4100 Tower Information Desk 870-414-5140 Marketing 870-414-4454 Medical Records 870-414-4058 Nursing Stations * 1st Floor (Patient Tower) 870-414-5145 * Observation Unit 2nd Floor 870-414-4600 * Critical Care 870-414-5245 * Pediatrics 870-414-5245 * OB/Nursery 870-414-5345 Pre-operative Center Waiting Room 870-414-4284 Patient Accounts Representative 870-414-4016 Patient Hotline 870-414-5020 Rehabilitation Services 870-414-5051 Social Services 870-414-4019 Volunteer Services 870-414-4622 *911* for emergencies

An Important Message from Medicare About Your Rights As a Hospital Inpatient, You Have the Right to:

â&#x20AC;˘ Receive Medicare-covered services. This includes medically necessary hospital services and services you may need after you are discharged, if ordered by your doctor. You have a right to know about these services, who will pay for them and where you can get them.

• Be involved in any decisions about your hospital stay, and know who will pay for it. • Report any concerns you have about the quality of care you receive to the Quality Improvement Organization (QIO) listed here: Arkansas Foundation for Medical Care - 1-888-453-9100 (TTY through Arkansas Relay at: 1-800-285-1131). • If you are a Medicare patient, you can contact: KEPRO Medicare Beneficiary Helpline KEPRO Rock Run Center, Suite 100 5700 Lombardo Center Dr. Seven Hills, OH 44131 Phone: 1-800-589-7337 Email: webmaster@ohiokepro.com

Your Medicare Discharge Rights

Planning For Your Discharge: During your hospital stay, the hospital staff will be working with you to prepare for your safe discharge and arrange for services you may need after you leave the hospital. When you no longer need inpatient hospital care, your doctor or the hospital staff will inform you of your planned discharge date. If you think you are being discharged too soon: • You can talk to the hospital staff, your doctor and your managed care plan (if you belong to one) about your concerns. • You also have the right to an appeal, that is, a review of your case by a Quality Improvement Organization (QIO). The QIO is an outside reviewer hired by Medicare to look at your case to decide whether you are ready to leave the hospital. - If you want to appeal, you must contact the QIO no later than your planned discharge date and before you leave the hospital. - If you do this, you will not have to pay for the services you receive during the appeal (except for charges like co-pays and deductibles). • If you do not appeal, but decide to stay in the hospital past your planned discharge date, you may have to pay for any services you receive after that date. Step-by-step instructions for calling the QIO and filing an appeal are on the next page.

To speak with someone at the hospital about this notice, call 870-414-4014. Please sign and date here to show you received this notice and understand your rights.

____________________________________ ______________________ Signature of Patient or Representative Date

Steps to Appeal Your Discharge • STEP 1: You must contact the QIO no later than your planned discharge date and before you leave the hospital. If you do this, you will not have to pay for the services you receive during the appeal (except for charges like co-pays and deductibles). - Here is the contact information for the QIO: Arkansas Foundation for Medical Care 1-888-354-9100 (TTY: Arkansas Relay - 1-800-285-1131) - You can file a request for an appeal any day of the week. Once you speak to someone or leave a message, your appeal has begun. - Ask the hospital if you need help contacting the QIO. - The name of this hospital is NARMC Provider ID# 040017. • STEP 2: You will receive a detailed notice from the hospital, your Medicare Advantage or other Medicare managed care plan (if you belong to one) that explains the reasons they think you are ready to be discharged. • STEP 3: The QIO will ask for your opinion. You or your representative need to be available to speak with the QIO, if requested. You or your representative may give the QIO a written statement, but you are not required to do so. • STEP 4: The QIO will review your medical records and other important information about your case. • STEP 5: The QIO will notify you of its decision within one day after it receives all necessary information. - If the QIO finds that you are not ready to be discharged, Medicare will continue to cover your hospital services. - If the QIO finds you are ready to be discharged, Medicare will continue to cover your services until noon of the day after the QIO notifies you of its decision. If You Miss the Deadline to Appeal, You Have Other Appeal Rights: • You can still ask the QIO or your plan (if you belong to one) for a review of your case: - If you have Original Medicare: Call the QIO listed above. - If you belong to a Medicare Advantage Plan or other Medicare managed care plan: Call your plan. • If you stay in the hospital, the hospital may charge you for any services you receive after your planned discharge date. For more information, call 1-800-MEDICARE (1-800-633-4227), or TTY: 1-877-486-2048. Additional Information: _________________________________________ ________________________________________________________________ ________________________________________________________________

Services Provided In keeping with our mission, North Arkansas Regional Medical Center offers a variety of health education and patient and family support services: •A merican Heart Community Training Center •R esource referral •C ancer •C ervical •C hildren and family health and safety education •C hronic disease management education and resources •C PR certification • ACLS • BLS • NALS • PALS •D iabetes support group •E ducation and support groups •H ealthy aging resource library • S creenings • Breast • Cervical • Colon • Skin • Prostate • S elf-health assessment and wellness resources • S enior health education • S troke and heart disease •P arenting classes •N icotine Addiction

What About My Bill? Important Facts You will receive a separate bill from each physician who provides care to you. This includes your primary care physician, any consulting physician, the radiologist (Radiology Associates), anesthesiologist (North Arkansas Anesthesia Group) and pathologist. Call 870-414-4016 to talk to a Patient Accounts representative about your hospital bill. • Set up a six-month payment plan on your account; • Request an itemized bill; • Discuss concerns about your bill; • Request information about possible help with your bill through the NARMC subsidy program (see below). Prompt payment in full of an unpaid balance is eligible for a discount. Please inquire at the Business Office by calling 870-414-4007. You can use your Visa, MasterCard or Discover Card to pay your bill. Every time you receive hospital services, both inpatient and outpatient, you need to renegotiate your payment plan. Your bills are not automatically combined. To apply for Medicaid, you can contact your hospital’s Public Benefit Department at 870-414-4291 NARMC Subsidy Program Information Below are the financial guidelines for the subsidy program. The amount of assistance you qualify for is based on your family’s net monthly income. Call 870-414-4626 to request an application.

Family Size

Net yearly income minus $21,840 $29,400 $36,960 $44,520 $52,080 $59,640 $67,200 $74,760 monthly & below & below & below & below & below & below & below & below medical expenses

Adults Need Shots, Too! Kids are not the only ones who need immunization shots. Adults are at risk for diseases that can be prevented by vaccines, so monitoring your own immunization status is vital to good health. According to the Centers for Disease Control and Prevention (CDC), every visit to a healthcare provider should be an opportunity to get a vaccination update. Influenza (Flu vaccination) Influenza is caused by several viruses. The flu shot protects against many of the viruses that cause the illness we call the flu. The flu shot will not give you the flu. But some people do experience soreness or redness at the injection site, and a slight fever or minor muscle aches. Individuals allergic to eggs should not have a flu shot because the vaccineâ&#x20AC;&#x2122;s viruses are grown in eggs. An annual flu shot is especially important for people over age 55 and for people of all ages if they have chronic illnesses like diabetes, heart disease, asthma or other respiratory disease, or if they are on dialysis. Timing is everything when it comes to flu shots. The best time to receive a flu shot is in October or November so that your body has time to build the immunity it needs for the peak flu season. Flu shots are free to Medicare Part B members. Pneumovax (Pneumonia vaccination) Pneumonia can be caused by several different bacteria and viruses. The pneumonia vaccination protects against 23 different types of bacteria that cause pneumonia. People who get this vaccination are much less likely to get the most common types of pneumonia than people who donâ&#x20AC;&#x2122;t get it. As is the case with the flu shot, all people over 65 and all people with chronic illnesses should have this shot at least once. For the majority of patients, one shot provides lasting immunity. However, sickle cell patients, people who do not have a spleen, and people who take immune system suppressing drugs should consider having this vaccination every five years. Pneumonia shots are free to Medicare Part B members.

Medication Safety Follow these general rules whenever taking medication: 1. Know the names of all medications you are taking, including over-the-counter medications and herbal supplements (you may want to write them down and take them with you when you see your doctor). Ask you pharmacist for printed information on your medications for you to refer to later if you should have questions. 2. Be sure to tell the doctor if you have any allergies to medications, if you are on any type of specific diet, if you are pregnant, or planning on getting pregnant, if you are breastfeeding, if you have other medical problems your doctor may not be aware of, or if you have trouble remembering things or reading labels. Make sure each of your prescribers knows all the medications (prescription and nonprescription) you are taking or have taken in the recently. 3. Take your medications exactly as prescribed. Do not increase or decrease your dose without first asking your doctor. Do not stop taking your medication without first asking your doctor. 4. If you notice troubling symptoms that could be related to your medications, contact your physician. 5. Do not store capsules/tablets in the bathroom or other damp places in the house as the heat and moisture can cause the medication to break down and be ineffective. 6. Keep all medicine out of reach of children and in the original containers. Never mix different medications in the same container. 7. Avoid taking medications in the dark and always read the label before taking any medication. 8. Donâ&#x20AC;&#x2122;t crush or chew a tablet, cut a tablet in half or open a capsule without first checking with the pharmacist or physician. Many long-acting and specially coated medications lose effectiveness when crushed or chewed. 9. Never give your medication to anyone else or take another personâ&#x20AC;&#x2122;s medications. 10. Select one pharmacy or pharmacy service and stay with that pharmacy so that all your records are kept in one place to allow the pharmacist to monitor for possible drug interactions and contraindications.

Pain Management This section is about the treatment of medical/surgical pain and how it can be controlled. Pain can affect you in many different ways. It can keep you from sleeping, eating and enjoying your friends and family. With proper treatment, medical/surgical pain can be controlled. When there is less pain, you will feel more active and interested in doing the things that you enjoy. As you heal, the pain will subside and you will no longer require pain medication. Pain can make you feel sad, helpless, vulnerable, angry, depressed and lonely. Often when the pain is successfully treated, these feelings go away.

Concerns and Facts

Below are some common concerns that you may have about medical/ surgical pain treatment procedures and the facts about them. If you have any other concerns, please talk to your doctor or nurse. 1. I can only take medicine or other treatments when I have pain. Fact: You should not wait until the pain becomes severe to take your medicine. Pain is easier to control when it is mild rather than when it is severe. 2. I will become “hooked” or “addicted” to pain medicine. Fact: Studies show that getting “hooked” or “addicted” to pain medicine is very rare. 3. W hat if the medicine does not relieve my pain or stops working? Fact: Medicines work differently on different people. If you are not getting relief, tell your doctor or nurse. 4. If I complain too much, I am not being a “good” patient. Fact: Controlling your pain is an important part of your care. Tell your nurse or doctor if you have pain and/or if your pain is getting worse.

Individualized Pain Management

Medical/surgical pain is treated with many different medicines, and everyone responds to them differently. While you are being treated for pain, tell the doctor or nurse how you feel and if the treatments help. They will want to know how much pain you have, where it is and what if feels like. At NARMC, we use two types of scales to assess your pain. The number scale rates the amount of pain that you are having from 0 to 10. 0 means “no pain” while 10 means the “worst possible pain.”

0-10 Numeric Pain Intensity Scale

0 No Pain

Mild Pain

Moderate Pain

Worst Possible Pain

The Faces Scale also rates your pain from 0 to 10. 0 means “no pain” while 10 means the “worst possible pain.”

It also is important to know what makes the pain feel better or worse and whether the pain has changed in any way.

What You Can Do To Help Us

Take your medication on a regular schedule. Do not wait for the pain to get worse. Ask your doctor or nurse how and when to take extra medicine. If some activities make your pain worse, you may need to take extra doses of pain medicine before these activities. The goal is to PREVENT the pain. Once you feel pain, it is harder to get it under control. Once you are feeling better and healing begins, your pain will subside.

Other Treatment for Pain

Sometimes alternative therapies can be used along with medicine to give even more pain relief. Your doctor or nurse many recommend other treatments such as: biofeedback, imagery, massage, pressure, vibration, breathing and relaxation, distraction, music, hot or cold packs, rest or aroma therapy.

Often when a person returns home from the hospital, he or she will want more information about a new diagnosis or additional healthcare information. The following websites cover a variety of healthcare issues and are recommended by members of our medical staff. American Academy of Family Physicians - www.familydoctor.org American Academy of Pediatrics - www.aap.org/family American Association of Orthopedic Surgeons - www.orthoinfo.aaos.org American Cancer Society - www.cancer.org American College of Obstetrician and Gynecologists - www.acog.org American Diabetes Association - www.diabetes.org American Heart Association - www.americanheart.org Arkansas Medical Society - www.arkmed.org BrainWonders: Info on the Neurological Development of Infants and Childrens - www.zerotothree.org/brainwonders/parents.html My Personal Health Record - www.mvphr.com National Cancer Institute - www.nic.nih.gov National Library of Medicine - www.nlm.nih.gov The Patient Channel - www.thepatientchannel.com WebMD - www.webmd.com

Notes ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

The NAPHE Partnership: Building Healthier Communities Through…

• Healthcare Workforce Training • Health Professions Education • Family & Senior Health Education • Consumer Health Education • Healthy Lifestyle Education • Substance Abuse Prevention Education • Health & Mental Health Support Groups • Community Health Resource Services • Workforce Wellness Initiatives • Nutrition & Environmental Health Services • Teen Pregnancy Education & Support Services • Community Development Services • Volunteers in Service to America (AmeriCorps VISTA)

Help your loved one make a safe return home.

Holly Gillies, CHRC Coordinator hgillies@northark.edu

For more information or referral to a full list of programs and services, please visit our website or contact NAPHE’s Dan J. Hawkins Community Health Resource Center (CHRC) at:

Northark Center Campus 303 N. Main, Ste. 101 Harrison, AR 72601

870-743-CHRC (2472) Fax: 870-391-3530

www.northark.edu/naphe

Returning home can leave your loved one in need of additional assistance. Home Instead CAREGiversSM can provide the care needed to ensure your senior returns home safely. • Transportation to Follow-Up Appointments • Nutrition and Medication Management • Warning Sign Monitoring and Notification • Physical Therapy/Exercise Reminders • Personal Care Services Contact us to put together a personalized care offering for your loved one. HomeInstead.com 870.365.0125 877.425.9071

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

QUIT! III QUIT! QUIT!

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

Sincerely, Sincerely, Sincerely,

Your Heart Your Your Heart Heart 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. Don’t let your heart quit on you. If you are living with high blood pressure, just knowing 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 and thehigh minimum isn’t Uncontrolled blood pressure could lead to stroke, heart attack or death. Get yours to adoing healthy range before it’senough. too late. to a healthy range before it’s too late.

Uncontrolled blood pressure could lead to stroke, heart attack or death. Get yours Find out howhigh at heart.org/BloodPressure out howrange at heart.org/BloodPressure to Find a healthy before it’s too late. Find out how at heart.org/BloodPressure ™ ™ Check. Change. Control. Check. Change. Control.

Check. Change. Control.™

The best in care... close to home 620 North Main • Harrison, AR 72601

(870) 414-4000

Ask Your Doctor.. If JP&O Can Help • Prescription Footwear • Orthopedic Braces • Prosthetic Limbs

Celebrating

25 Years

• Sports Bracing • Mastectomy Bras • Arthritis Bracing

JP&O Prosthetic & Orthotic Laboratory 1014 N. Spring Street, Harrison, AR 72601

www.jpo-online.com

THE AGING EXPERTS

Area Agency on Aging of Northwest Arkansas 1510 Rock Springs Road Harrison, Arkansas

A00000

870-743-4440 • Fax: 870-743-4442

Enhancing the lives of people in Northwest Arkansas through our services. •In-Home Services • Senior Activity Centers •Long-Term Care Ombudsman • Home-Delivered Meals •Family Caregiver Assistance • Case Management •Personal Emergency Response System • Housing •Incontinence Supplies

870-741-1144 or 800-432-9721 • www.aaanwar.org

FREE

Developmental Screening for Children Birth - 5 Years of Age We offer physical, occupational, speech, and developmental therapies. Formal developmental tests are covered by Arkansas Medicaid. Daycare openings available also.

Boone County Special Services Work Center The adult program provides learning and work opportunities for individuals who are mentally and physically challenged. Hours: Monday-Friday, 8:00 AM-3:00 PM • Closed the month of July

707 East Rush • Harrison, AR 72601 • (870) 741-3709