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The Health Care Financing Administration (HCFA) has announced new patient protections in standards to protect the health and welfare of hospitalized patients. The new regulations require that a hospital provide a patient or family member with a formal notice of their rights at the time of admission. The six basic patient rights specified in the regulations are:
• notification of the patient’s rights;
• exercise of those rights in regard to care;
• privacy and safety;
• confidentiality of the medical record;
• freedom from restraints used in the provision of medical and surgical care unless clinically necessary;
• freedom from seclusion and restraints used in behavioral management unless clinically necessary.
The patient rights protections are part of Medicare’s revised Conditions of Participation requirements that hospitals must meet to participate in the Medicare and Medicaid programs. The interim final regulations will be published July 2 in the Federal Register and will be effective 60 days from that date.
HCFA carved out the patient rights section from the larger proposed revision of the hospital Conditions of Participation regulation, published as a Notice of Proposed Rulemaking on Dec. 17, 1997, so the patient protections could be expanded as soon as possible.
"By carving out this section, HCFA will be able to move more quickly to hold all hospitals that participate in Medicare and Medicaid accountable for protecting patients’ rights, and for the inappropriate use of restraints and seclusion," HCFA administrator Nancy-Ann DeParle said in a prepared statement.
The new patient rights protections build on HCFA’s improved enforcement of quality of care in hospitals, DeParle said. The proposed protections will apply to all participating hospitals, including acute, psychiatric, rehabilitation, long-term, children’s, and alcohol-drug hospitals.
These rights include the right to be free from restraints and seclusion in any form when used as a means of coercion, discipline, convenience, or retaliation. Other rights include the right to privacy and confidentiality.
Patients and families who have any concerns about the quality of care provided at a hospital may contact the state survey agency or HCFA regional office to find out whether the hospital has been cited for a violation of the patient safety requirements.
The new patient protections also make con sistent the standards used by HCFA and the Joint Com mission on the Accreditation of Healthcare Organizations to ensure only appropriate use of restraints and seclusion. HCFA adopted the same approach and time frames for monitoring the use of restraints and seclusion developed and enforced by the Joint Commission when it accredits hospitals and behavioral health facilities.
HCFA’s regulations also contain new requirements on staff training so health care workers who have direct patient contact will learn the appropriate and safe use of seclusion and restraints.