OAR 333-700-0115: Patients’ Rights, Responsibilities and Family Education

(1) The governing body of the facility shall adopt written policies regarding the rights and responsibilities of patients and, through the chief executive officer, shall be responsible for development of, and adherence to, procedures implementing such policies. (2) These policies and procedures shall be made available to patients and any guardians, next of kin, the Division, and to the public. The staff of the facility must be trained in and involved in the execution of such policies and procedures. The patients' rights policies and procedures must ensure all patients in the facility: (a) Are informed of these rights and responsibilities, and of all rules and regulations governing patient conduct and responsibilities; (b) Are informed of services available in the facility and of related charges; (c) Are informed by a physician of their medical conditions unless medically contraindicated (as documented in their medical records); (d) Are provided health care interpreter services in accordance with ORS 413.559 and OAR 950-050-0160 if the patient prefers to communicate in a language other than English; (e) Are afforded the opportunity to participate in the planning of their medical care (either through direct involvement or if the patient chooses, through family or a representative); (f) Are afforded the opportunity to refuse to participate in experimental research; (g) Are transferred or discharged only for medical reasons, for their own welfare or that of other patients or for nonpayment of fees. Patients discharged for these reasons shall be given a written notice prior to transfer or discharge. A patient exhibiting violent, abusive, or threatening behavior may be discharged immediately if necessary to protect themselves, other patients, or employees. A written notice shall be given to these patients within ten days of transfer or discharge; (h) Are informed about the effects and potential hazards of receiving dialysis and related treatments; (i) Are treated with consideration, respect and full recognition of their individual and their personal needs, including maintenance of confidentiality; (j) Are informed regarding the facility's reuse of dialysis supplies, including hemodialyzers. If printed materials such as brochures are utilized to describe a facility and its services, they must contain a statement with respect to reuse. Patients have the right to refuse the use of reprocessed dialyzers; and (k) Are informed of all choices of dialysis treatment including peritoneal, self-care, home dialysis, in-center dialysis, no treatment, hospice, and transplantation. If the patient is not considered to be a candidate for transplantation, this information shall be made available to the patient or the patient's family member in writing and include the reason(s). (3) The facility shall have written documentation from the patient that they have had their rights and responsibilities explained. (4) The facility shall provide the patient and the patient's family with the opportunity for education including, but not limited to the following topics: (a) Physical orientation of the dialysis center; (b) Policy for scheduling patient treatment times; (c) Policies on violent or disruptive behavior; (d) Duties of members of the dialysis team; (e) Team member qualifications and duties; (f) Boundary issues between staff and patient; (g) Importance of dialysis adequacy and lab values; (h) Dietary needs and fluid balance; (i) Medications; (j) Benefits of exercise; (k) Disaster planning for situations in which the facility is unable to operate; (l) Infection control procedures; (m) Water purification; (n) Handling of hazardous substances; (o) Quality control process; (p) Medical records including contents and confidentiality issues; and (q) The right of patients and families to request private conversations with a member(s) of the multidisciplinary team at a time of their convenience. (5) Grievance mechanism: The facility must inform patients (or their representatives) of the facility's grievance process and the procedures for appeal. All patients are encouraged and assisted to understand and exercise their rights. Grievances and recommended changes in policies and services may be addressed to facility staff, administration, the Network, and agencies or regulatory bodies with jurisdiction over the facility, through any representative of the patient's choice, without restraint or interference, and without fear of discrimination or reprisal. (6) The facility's grievance process must: (a) Include a record of each grievance made by a patient, a patient's representative or family member; (b) Include documentation of the facility's investigation of each grievance, including the resolution; (c) Include the method and phone number for submitting grievances that cannot be resolved at the facility level, such as the facility's corporate office, the Network, and the Division; (d) Include evidence that the person expressing the grievance is notified in writing of the outcome of the grievance investigation; and (e) Include evidence the facility has responded to the grievance within 30 days.