Lahey Clinic is committed to providing its patients with the highest quality care. Patient rights as outlined in the Massachusetts Patients' Rights Statute, Chapter 111, Section 70E are summarized below and apply to all patients at Lahey Clinic. To obtain a complete copy of the General Laws of Massachusetts, G.L.c. 111 § 70E Patients' and Residents' Rights please contact Customer Relationship Management at 781-744-8556.

Summary of Massachusetts Patients' Rights Statute

All patients have the right to freedom of choice in their selection of Lahey Clinic, or a Lahey Clinic physician, or health service at Lahey Clinic, except in the case of emergency medical treatment or as otherwise provided for by contract as long as that the physician, Lahey Clinic, or health service is able to accommodate the patient's choice.

Each patient shall have the right to receive an itemized bill of laboratory charges, pharmaceutical charges, and third party credits and shall be provided an explanation of his bill regardless of the source of payment. This information shall also be made available to his attending physician.

In Addition, Every Lahey Clinic Patient Shall Have The Right:

1. to obtain from Lahey Clinic the name and specialty, if any, of the physician or any other person responsible for his care or the coordination of his care;
2. to confidentiality of all records and communications to the extent provided by law;
3. to have all reasonable requests responded to promptly and adequately within the capacity of Lahey Clinic;
4. to ask for and obtain an explanation as to the relationship, if any, of Lahey Clinic to any other health care facility or educational institution where the relationship relates to his care or treatment;
5. to obtain from Lahey Clinic a copy of any rules or regulations of Lahey Clinic which apply to his conduct as a patient;
6. to ask for and receive from Lahey Clinic information relative to financial assistance and free health care;
7. to ask to look at his medical records and to receive a copy of those records and the fee for the copies shall be in accordance with Lahey Clinic's fees charged for copying medical records, except that no fee shall be charged to where the records are requested for the purpose of filing or appealing a claim under the Social Security Act or any federal or state financial needs-based benefit program, and Lahey Clinic shall provide copies of the medical record within thirty days of the request as long as the requestor shall present reasonable documentation at the time of making the records request that the purpose of the request is to support a claim or appeal under any provision of the Social Security Act or any federal or state financial needs-based benefit program;
8. to refuse to be examined, observed, or treated by students or any other Lahey Clinic staff without jeopardizing access to psychiatric, psychological, or other medical care and attention;
9. to refuse to serve as a research subject and to refuse any care or examination when the primary purpose is educational or informational rather than therapeutic;
10. to privacy during medical treatment or care within the capacity of Lahey Clinic;
11. to prompt life saving treatment in an emergency without discrimination on account of economic status or source of payment and without delaying treatment to discuss the source of payment unless the delay can be imposed without material risk to his health, and this right shall also extend to those persons not already patients of Lahey Clinic if Lahey Clinic has a certified emergency care unit;
12. to informed consent to the extent provided by law;
13. to ask for and receive a copy of an itemized bill or other statement of charges submitted to any third party by Lahey Clinic for care of the patient and to have a copy of the itemized bill or statement sent to the attending physician of the patient;
14. if refused treatment because of economic status or the lack of a source of payment to prompt and safe transfer to a facility which agrees to receive and treat such patient. Said facility refusing to treat such patient shall be responsible for: ascertaining that the patient may be safely transferred; contacting a facility willing to treat such patient; arranging the transportation; accompanying the patient with necessary and appropriate professional staff to assist in the safety and comfort of the transfer, assure that the receiving facility assumes the necessary care promptly, and provide pertinent medical information about the patient's condition; and maintaining records of the foregoing; and
15. if the patient is a female rape victim of childbearing age, to receive medically and factually accurate written information prepared by the commissioner of the Massachusetts Department of Public Health about emergency contraception; to be promptly offered emergency contraception; and to be provided with emergency contraception upon request.
16. in the case of a patient suffering from any form of breast cancer, to complete information on all alternative treatments which are medically viable.

Except in cases of emergency surgery, at least ten days before a physician operates on a patient to insert a breast implant, the physician shall inform the patient of the disadvantages and risks associated with breast implantation. The information shall include, but not be limited to, the standardized written summary provided by the department. The patient shall sign a statement provided by the department acknowledging the receipt of said standardized written summary. Nothing herein shall be construed as causing any liability of the department due to any action or omission by said department relative to the information provided pursuant to this paragraph.

No provision of this section relating to confidentiality of records shall be construed to prevent any third party reimburser from inspecting and copying, in the ordinary course of determining eligibility for or entitlement to benefits, any and all records relating to diagnosis, treatment or other services provided to any person, including a minor or incompetent, for which coverage, benefit or reimbursement is claimed, so long as the policy or certificate under which the claim is made provides that access to the records is permitted. No provision of this section relating to confidentiality of records shall be construed to prevent access to any such records in connection with any peer review or utilization review procedures applied and implemented in good faith.

Lahey Clinic shall require all persons, including students, who examine, observe or treat a patient of such facility to wear an identification badge which readily discloses the first name, licensure status, if any, and staff position of the person so examining, observing or treating a patient.

Nothing stated in this Notice limit any other right or remedies previously existing at law.

Amended and effective December 14, 2005

In addition to the Patient Rights outlined above in the Massachusetts Patients' Rights Statute, Chapter 111, Section 70E:

Every Lahey Clinic Patient or His or Her Legal Representative (as allowed under State Law) Shall Have The Right:

1. to be informed of his or her health status and to participate in the development and implementation of his or her plan of care;
2. to make informed decisions regarding his or her care, to accept or refuse treatment and to be informed of the medical consequences of such refusal;
3. to formulate advance directives and to have the hospital staff and practitioners who provide care in the hospital comply with these directives;
4. to have a family member or representative and his of her own physician notified promptly of the admission;
5. to personal privacy;
6. to receive care in a safe setting;
7. to be free from all forms of abuse or harassment;
8. to be free from seclusion and restraints, of any form, imposed as a means of coercion, discipline, convenience or retaliation by staff;
9. to respectful care, including consideration of the psychosocial, spiritual and cultural variables that influence the perception of illness;
10. to pain assessment and appropriate pain management;
11. to interpreter services and/or the use of alternative communication techniques to ensure effective communication.

YOUR RESPONSIBILITIES AS A PATIENT:

You are responsible for being considerate of the rights of other patients and for observing Clinic regulations affecting patient care and conduct.

You are responsible for providing accurate and complete information regarding your medical history, for asking questions if you do not understand your care or treatment, for following the plan of care or accepting the consequences if you refuse treatment, and for prompt payment of your Lahey Clinic bill.

You are responsible for discussing pain relief options with your physician or nurse, and for reporting pain promptly.

IF YOU HAVE A COMPLAINT:

You may register a complaint in writing or in person with one of our Patient Representatives. They are available by telephone from 8:30 a.m. to 5:00 p.m.

You may also register a complaint with the Massachusetts Department of Public Health or with the Joint Commission. Specific physician complaints may be reported to the Board of Registration in Medicine. The addresses and telephone numbers are listed below.

1. Patient Care Representatives*
   Lahey Clinic - Customer Relationship Management
   41 Mall Road
   Burlington, MA 01805
   781-744-8556
2. Massachusetts Department of Public Health
   Division of Health Care Quality
   99 Chauncy Street, 2nd Floor
   Boston, MA 02111
   617-753-8000
3. Board of Registration in Medicine
   560 Harrison Avenue - Suite G-4
   Boston, MA 02118
   617-654-9800
4. Joint Commission
   Office of Quality Monitoring
   One Renaissance Boulevard
   Oakbrook Terrace, IL 60181
   800-994-6610

* In the event a complaint needs to be registered in the evening or on a weekend, contact the nursing supervisor by telephoning the operator at 781-744-8300.

HIPAA Privacy Notice (effective as of April 14, 2003)

This notice describes how medical information about you may be used and shared and how you can get access to this information. Please review it carefully.