Patient Guide - Carilion New River Valley Medical Center

Patient and Visitor Information

Welcome to Carilion New River Valley Medical Center

To Our Patients: We appreciate the confidence you have placed in us for your care. Our team of physicians, nurses and staff are committed to providing you with excellent service throughout your stay at Carilion New River Valley Medical Center (CNRV).

We pride ourselves on our friendly and caring environment. Our customer service promise is: “We promise to respect and care for you and your family as we would our own.” This is displayed in our front lobby, and our staff has signed their names to this commitment.

Our services are award winning. In 2009, CNRV was named by National Research Corporation as the Consumer’s Choice in our area. From our medical care services to our Emergency Department, we have been singled out for customer satisfaction honors year after year.

In order to promote health and wellness, our campus, as well as the other hospitals in the New River Valley, became smoke free in January 2010. We appreciate your support in helping us maintain our fresh-air atmosphere on the campus. If you are at the hospital and have any parking concerns, we hope our free valet parking service and our Carilion shuttle service will help alleviate any inconvenience for you.

To orient you to these and many other services offered at CNRV, we have prepared these materials for use during your stay. Should you have any additional questions or concerns, please feel free to ask any member of our staff.

We thank you for the privilege of serving you. Again, welcome to Carilion New River Valley Medical Center.

Sincerely,

Melina Perdue President, Carilion New River Valley Medical Center Sr. Vice President, Carilion Clinic Regional Hospital Operations 1

We Stand by Our Promise to Care for You Every day, nearly 1,000 people come together to work at Carilion New River Valley Medical Center (CNRV) with one common goal: providing the best possible care for our patients and their families. It is a responsibility we not only take pride in owning, but commit to when we sign our customer service agreements.

Every day, you could meet one of the many dedicated doctors, nurses, therapists or technicians who are here to care for you. You’ll also find our housekeeping staff maintaining your room; dietary personnel preparing and serving your meals; and maintenance personnel keeping the hospital building and systems in top operation.

Working for you behind the scenes are many employees you may never see face-to-face. Our safety officer, security officers, medical record transcriptionists and department secretaries are here to provide necessary services that help make your stay as comfortable as possible.

So remember, no matter what job the staff at CNRV is performing for you today, you are the reason we are here and you can count on us for your care.

If you or someone you know is interested in joining the Carilion staff, you can find our open positions anytime under the employees link on our website at www.CarilionClinic.org by choosing “Careers.”

CNRV - A Commitment to Excellence Our Mission: Improving the health of the communities we serve.

Our Values: We place high regard on integrity and accountability and will act responsibly, ethically and confidentially with all. We will make a difference through individualized treatment of, loyalty to, and compassion for our patients.

Our Vision: CNRV will become a leading community and regional hospital performing at the highest levels nationally in all aspects of the patients’ experience.

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Table of Contents About Carilion New River Valley Medical Center ...............................................

No Tobacco Use Policy..............................................................................................

Patient Services ................................................................................................................

Accommodations .......................................................................................................

Admissions and Planning for Discharge ............................................................

What to Bring, What to Leave Home ...................................................................

HIPAA ..............................................................................................................................

Identification Bracelet...............................................................................................

Passcode ........................................................................................................................

“Tell Us” Program ........................................................................................................

Patient Safety ...............................................................................................................

Electrical Equipment .................................................................................................

Room Safety .................................................................................................................

Smoking.........................................................................................................................

Patient Meals................................................................................................................

Hospitalist Care at CNRV (in-hospital doctors) ................................................

Helpful Information at Your Fingertips...................................................................

Wayfinding....................................................................................................................

Calling FromYour Room or Within the Hospital ..............................................

Outside Telephone Calls .........................................................................................

Cafeteria and Vending Machines..........................................................................

Mail and Flowers.........................................................................................................

Parking ...........................................................................................................................

Valet Parking and Shuttle Service ........................................................................

Security ..........................................................................................................................

Chaplain Services .......................................................................................................

Television and Newspapers ...................................................................................

Internet Access (WiFi) ...............................................................................................

Visiting Hours...............................................................................................................

Gift Corner.....................................................................................................................

Volunteers .....................................................................................................................

Community Pharmacy..............................................................................................

Patient Care Partnership ...............................................................................................

Understanding Your Rights and Responsibilities............................................

Patient Rights...............................................................................................................

Patient Responsibilities ............................................................................................

Advance Directives ....................................................................................................

Infection Control.........................................................................................................

Voicing your Concerns..............................................................................................

Health Information - Call Carilion Clinic.............................................................

Website ..........................................................................................................................

Insurance and Payment Information...................................................................

Help With Your Bill and How to File Insurance Claims...................................

Frequently Asked Questions About Billing...........................................................

Payment Policy and Contacts .....................................................................................

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About Carilion New River Valley Medical Center Building a Reputation for Quality Care and Service Carilion New River Valley Medical Center (CNRV) is the New River Valley’s Consumer Choice Award winner for 2009/2010 as surveyed by the National Research Corporation. Our staff is also proud to have been twice chosen as Thomson Reuters Top 100 Performance Improvement Leader for 2005 and 2007. The Birthplace, our family-centered maternity care unit, is also a 5-star consumer preference award winner.

CNRV offers a modern hospital facility that includes diagnostic and medical care, a Level III Trauma Emergency Department, The Birthplace and Carilion Clinic Saint Albans Hospital. CNRV’s Heart and Vascular Center brings together our cardiology and vascular teams, advancing our treatment services and enhancing the patient experience.

Surrounded by pastoral views of rolling hills and mountain vistas, CNRV is conveniently located off I-81, Radford Exit 109. The Medical Center serves the counties of Montgomery, Pulaski, Floyd, Giles, Wythe, Bland and Carroll, as well as the city of Radford. These communities also support two universities, a medical school and two community colleges. Virginia Tech, Edward Via School of Osteopathic Medicine, Radford University, New River Community College and Wytheville Community College are all within driving distance of the Medical Center.

Unique in design and philosophy, the restful atmosphere and roomy layout of our facility makes any length of stay comfortable for patients and their families. Since its move to the medical park in 1999, CNRV has continued to grow and is now a regional referral facility for various medical specialties and treatments in our area, such as surgical specialties, like orthopaedic spine care, and vascular and bariatric surgery. Also on site is Carilion Clinic Saint Albans Hospitals for inpatient and outpatient psychiatry and behavioral medicine services.

Located on campus are physician practices featuring more than 25 specialties.

Services include a full array of women’s obstetrics and gynecological care; cardiac care and rehabilitation for adults and pediatrics; vascular diagnostics and surgical services; advanced imaging and radiology; orthopaedic surgery; level III trauma emergency services; diagnostic sleep center; respiratory therapy; cardiopulmonary rehab; and a full complement of physical rehabilitation therapies and wound care.

As part of Carilion Clinic, CNRV also offers patients seamless access to even higher levels of care if needed, such as robotic heart surgery, neonatal care at Carilion Clinic Children’s Hospital and cancer treatments and Cyberknife surgery at Carilion Clinic’s Cancer Center in Roanoke, Va. 4

No Tobacco Use Policy at CNRV CNRV and Carilion Clinic facilities in the New River Valley are tobacco free as of January 2010. We appreciate you not smoking or using any tobacco products in or near our facilities. Our staff will ask you to stop using tobacco products on our property, which includes our parking lots. This policy is for the health and well-being of our patients, visitors and employees.

Patient Services Accommodations It is our pleasure to provide you with a hospital room that is as comfortable as possible. Your room assignment at CNRV is based upon your condition and the bed availability at the time of your arrival.

If you should need to speak with your nurse at any time, the “call bell” in your room is equipped with a two-way intercom for your bedside convenience.

Admissions and Planning for Discharge We appreciate your help in completing your admission form. Not only is this form a vital part of our medical records, but it is required by Virginia law. All information on your admission form will always be kept confidential.

The admitting offices may also ask you to sign other necessary forms and will discuss financial arrangements for any balance that is not covered by insurance. Deductibles that are not covered by insurance are expected at time of admission, and you can see more about insurance and payment information on page 17.

We do request an admission deposit on all admissions that have no insurance.

In some cases, the admitting office may refer you to our Social Services team for possible financial assistance.

Effective discharge planning is as important as the admission process. Your continued recuperation and continuity of healthcare services depend on it.

As you prepare to leave our facility, your hospitalist or primary care physician will help to coordinate and approve your discharge. The nursing staff will help explain your discharge orders. Your social worker/case manager will assist you and your family in making plans and arrangements for your continued care once you leave the hospital, if necessary. These services can include assistance 5

with nursing home or adult home placement, home health and hospice care, transportation, any necessary home equipment needs or services, and referrals to community resources.

For your safety, please remember not to leave the hospital without someone from our staff to assist you.

What to Bring, What to Leave at Home For your comfort, please bring only the essential personal items such as pajamas or a nightgown, bathrobe, slippers, personal toiletries and reading material. Please leave jewelry and other expensive or sentimentally valuable items at home. If you wear contact lenses, dentures, removable bridges or a prosthetic device, tell your nurse during your admission. If you do have a valuable with you when you are admitted, it can be secured and recorded by the nursing staff at your request.

Please bring your Living Will or Advance Directive and your power of attorney, if applicable. We will also need a list of all the medications you are currently taking. This includes over-the-counter medicines and dietary supplements, too. Also bring the names and telephone numbers of family members and friends who are your emergency contact, in case we need to get in touch with them.

HIPAA The Health Insurance Portability and Accountability Act (HIPAA) of 1996 established national standards to protect patients' personal and medical records. The regulations outlined by HIPAA protect the medical records and other personal health information maintained by healthcare providers, health plans and health insurers and healthcare clearinghouses. If you have any questions about your privacy rights as a patient, please ask your social worker or nurse.

Identification Bracelet When you are admitted, you will be given a wristband with your name on it.

This band helps ensure proper identification for medications and procedures during your stay, and must be worn at all times.

Passcode At CNRV, a passcode is assigned to each patient during admission for informational purposes. This means that any information regarding the patient will only be shared with persons who can provide the passcode. It is up to the patient or their immediate family to share this code.

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“Tell Us” Program At CNRV we take patient care very seriously. Our physicians, nurses and technicians play an important role in providing you with care that is free of error, but we need help from you and your family and friends. Please don’t hesitate to ask questions or raise concerns. We want you to feel completely comfortable telling us what you need. For more information, please see the “Tell Us” Program handout in your admission packet.

Patient Safety We are committed to doing everything possible to make you feel safe and secure during your stay. Following these regulations helps us make this happen.

• Electrical Equipment: - Electronic devices can often interfere with medical equipment, so personal radios, televisions, computer games, mobile phones and non-essential grooming items may not be allowed in patient rooms.

However, personal cell phones may be used in the main lobby, all waiting areas and all exteriors.

• Room Safety: - Side rails are there to assist you with mobility and positioning. If you need them adjusted, please let your nurse know so they can assist you.

- A nurse call system is located on your bedrail for easy access. Please use the call system for assistance, especially when asked to do so.

- Tell our staff right away if any equipment in your room isn’t working properly.

- Don’t try to get in or out of a wheelchair by yourself.

- The bathroom contains an emergency cord if you need assistance.

Don’t try to get up without help if you feel weak or unsteady, and always ask for help if you need any assistance.

• Smoking: - CNRV is a smoke-free/tobacco-free facility. Smoking is not allowed in the building or on Carilion Clinic property.

There may be a fire or disaster drill while you are in the hospital. They are required by law and are designed to prepare staff in the event of a real disaster. You are not required to participate in these periodic drills. Instead, we ask that you and your visitors remain in your room.

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Patient Meals Your doctor, in consultation with a registered dietician, will determine the diet that is best suited to your personal and specific nutritional needs. A food representative will bring you a menu so you can make your meal selections. The menu will reflect the diet that has been specially ordered for you.

Hospitalist Care at CNRV During your hospital stay in the medical units, you may be seen by a physician called a hospitalist. The hospitalist is a doctor who specializes in caring for acute care patients in the hospital. These doctors do not have outpatient medical practices, which gives them the opportunity to care throughout the day and night for patients needing hospitalization. Our hospitalists work with every specialist and clinical department in the hospital, which enables them to consult with the other professionals who may participate in your care.

Consultations with outside specialists are necessary in some cases, and you can take comfort in knowing our hospitalists will arrange for these, too. Please be sure to notify your hospitalist if you have been under the care of doctors other than your primary care physician (PCP), so they can be informed of your hospital stay as well.

Our nursing staff provides 24-hour care during your stay and includes professional registered nurses, licensed practical nurses and nursing assistants.

A unit director or manager is responsible for coordinating care on each unit.

Please feel welcome to talk with any of our staff if you have questions or concerns.

Also note that once you are discharged, you will return to the care of your PCP.

Helpful Information at Your Fingertips Wayfinding At each entrance you will find a large, color-coded layout of the hospital. In attached boxes to the side are layout sheets you may take with you to help you navigate the hospital corridors. On the back of this sheet is a parking map and an area map of the New River Valley.

You may also notice wall and overhead signage that corresponds to the color coding on your map.

At the main entrance to the medical center is an information desk. If you need 8

assistance, please don’t hesitate to ask the person at this desk, or any of our volunteers or a staff member you may meet in the hallways. We would be happy to help you find your destination.

Patient room information is located at the round desk in the main lobby. Our volunteers are here to assist you in any way they can.

Calling From Your Room or Within the Hospital If you need to make a local call, dial “9” for an outside line, then the number you wish to call. For long-distance calls, you will need to have a calling card or call collect. For assistance in making these types of calls, dial “0” to reach the hospital operator. Phone lines for outgoing calls are available from patient rooms at all times.

Outside Telephone Calls We offer a direct phone number to your room for your friends and family to use. If it is not noted on your telephone, please ask your nurse for your direct number. The main telephone number to CNRV is 540-731-2000. Please remember, patient calls will not go through after 10 p.m., even when dialing the patient directly. A patient can phone out at any time of the day or night.

Cafeteria and Vending Machines Our Atrium cafeteria is located on the ground floor of the Medical Center.

The main lobby staircase and elevators all lead to the open-air dining room.

The 50-foot glass atrium looks out onto a patio, gazebo, reflecting pond and views of the surrounding pastures. The cafeteria is open to visitors and staff alike.

Hours of operation: Monday - Friday: • Breakfast, 6:30 - 10 a.m. (self-serve breakfast bar, eggs, bacon, biscuits, gravy) • Lunch, 11 a.m. - 3:30 p.m. (hot entrees and vegetables, salad bar, deli sandwich fixings) • Dinner, 4:30 - 6 p.m. (self-serve entrees, deli sandwich fixings) Saturday and Sunday: • Breakfast, 7 - 9 a.m. (self-serve breakfast bar, eggs, bacon, biscuits, gravy) • Lunch, 11 a.m. - 2 p.m. (self-serve entrees, deli sandwich fixings) • Dinner, 4:30 - 6 p.m. (self-serve entrees, deli sandwich fixings) 9

We offer hot food, deli and salad bars, specialty salads, hamburgers, hot dogs, fries, desserts and beverages. Guests can eat in or carry out. Seating is also available outside around the pond.

We gladly accept cash and credit cards for food purchases. In addition, vending machines with microwavable choices, ice cream, soft drinks and candy are available 24 hours a day and are located near the cafeteria elevators on the lower level. Vending machines are also available in the emergency department. An ATM machine is conveniently located in the main lobby near the volunteer desk as well.

Mail and Flowers Any mail or flowers addressed to you during your stay will be delivered to your room. Your address at the hospital is: Your Name, Carilion New River Valley Medical Center, P.O. Box 205, Radford, VA 24143. Our volunteers deliver mail and flowers twice a day. Deliveries may be sent at your attention to the hospital at 2900 Lamb Circle, Christiansburg, VA 24073. Mail or flowers that are received after you have been discharged will be sent to your home address.

Our volunteers will also mail stamped letters or cards for you.

Parking Patients and visitors should park in designated areas and enter through doors closest to the service they are using. After 9 p.m., the Emergency Department entrance is the only door open. The circle driveways near entrance areas are only for patient drop-offs. Please do not leave a vehicle there unattended.

Expectant moms who will be having their babies at CNRV have special decals and designated parking near The Birthplace entrance.

Valet Parking and Shuttle Service CNRV is happy to offer free valet parking Monday – Friday from 8 a.m. – 3 p.m. except on major holidays. The valet attendants are located in the driveway office at the Medical Center’s main entrance. This staff will carefully park your car and retrieve it for you during these times at no charge. If you stay past 3 p.m., our security office will be glad to assist you in retrieving your vehicle.

Please, no tipping.

Our free shuttle service operates Monday – Friday from 9 a.m. – 3 p.m. This valuable service helps patients and visitors get to their desired hospital entrances when parking in remote lots. Shuttle call stations are numbered and are located in parking lots around the CNRV campus. The shuttle will pick up passengers at these stations and deliver them to any entrance requested.

Passengers can also press the call buttons at the CNRV exits, where the shuttle will pick them up and take them back to their vehicle. The shuttle is heated/air conditioned and runs year-round except on major holidays. Please, no tipping.

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Security Security personnel are on duty at CNRV 24 hours a day, seven days a week.

All hospital entrances, except the Emergency Department, are locked at night from 9 p.m. until 6 a.m. The Emergency entrance is open 24 hours a day, every day. The Birthplace entrance is opened at night for new moms when they have called ahead. For your protection, interior and exterior areas alike are monitored by camera.

Chaplain Services The chaplain services program is here to offer spiritual support to patients and families at CNRV while facilitating their individual religious needs.

Chaplains are available 24 hours a day. The chaplain program is led by the Rev. Jonathan Webster, a board-certified chaplain who has been with the hospital since 1994. Thirty volunteer chaplains work with the Rev. Webster to provide support to our patients and their families anytime they need it. To contact this service, call 540-731-2556. For urgent situations, you may contact the hospital operator at 540-731-2000 and they will page the chaplain on call.

Guests and visitors may also find solace and comfort in the hospital chapel, which is located near the atrium stairway behind the stained glass window and door. It is always open for prayer and meditation. The chapel holds eight to ten people comfortably.

Television and Newspapers Each patient room is equipped with a color, flat-screen television with local and cable stations. Below are network television stations available and the channels where they can be located. A complete listing should also be available at your bedside as well.

Channel 3 4 8 13

Station WDBJ WSLS FOX 21/27 WSET

Programming CBS ROANOKE NBC ROANOKE FOX ROANOKE ABC LYNCHBURG

Newspaper vending is available at the front entrance to the Medical Center.

Local, regional (Roanoke Times) and national choices are available.

Internet Access (WiFi) Wireless internet service (non-secured) is available on campus. If you are having trouble setting up your personal computer, you may contact your nurse for a tech support contact.

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Visiting Hours Rest is an extremely important part of the recovery process. It’s important to remember this when visiting medical and surgical patients. It is best for visitors to arrive after 9 a.m. or before 8 p.m. and to stay less than 30 minutes at a time. The number of visitors should also be kept to two or three at a time.

Specific guidelines for visiting intensive care patients are posted near the Critical Care Unit. A visitors’ waiting room is provided for family and friends between the Progressive and Critical Care units. If visitors feel the need to stay overnight, check with the nursing staff.

Overnight visitors need to check with the nursing staff when the patient is in a semi-private room.

Gift Corner The Gift Corner offers unique and affordable gifts appropriate for patients and other occasions as well. It is open Monday – Friday from 9 a.m. to 6 p.m. and is located in the main lobby of the Medical Center across from the Community Pharmacy. Cash and major credit cards are accepted.

Volunteers Volunteers help make your stay more comfortable by assisting in many ways, including: • Greeting visitors in the main lobby and surgical waiting room • Providing wayfinding and hospital location information • Delivering mail, flowers, newspapers and packages in the hospital for patients • Providing clerical help and helping organize events • Working in our gift shop If you have special skills or interests, or simply wish to donate your time to volunteering, contact the volunteer coordinator at 540-731-2428.

Community Pharmacy Inside the main lobby of CNRV is a full-service pharmacy that has been serving the public for many years. Community Pharmacy is one of two retail outlets run by Carilion Clinic licensed pharmacists and technicians for patient convenience and safety. The second store, Carilion Medical Center Pharmacy, is located in Roanoke. Both are Good Neighbor Pharmacy members.

Community Pharmacy offers the following for its customers:

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• Prompt and accurate services • Knowledgeable infusion services and home health care • Accepts most third-party insurance plans • Competitive pricing for non-insurance covered prescriptions • State-of-the-art drug interaction monitoring and drug information • 24-hour refill line • Snacks and beverages • Frequent prescriptions purchase card ($6 off purchase with 10 stamps) Store Hours: Monday – Friday: 9 a.m. - 5:30 p.m.

Saturday: 9 a.m. - noon Closed Sundays and holidays Phone: 540-639-1647 Fax: 540-639-0151

Patient Care Partnership Understanding Your Rights and Responsibilities CNRV and Carilion Clinic are absolutely committed to providing an environment that fosters quality healthcare for its patients. This commitment is described in detail below.

Employees are expected to assist patients in both understanding and exercising their rights. Likewise, patients are expected to understand their responsibilities to caregivers and other individuals attempting to provide services to them.

Our entire staff takes pride in serving the community in all its ethnic, religious and economic diversity. Our goal is for you, and your family, to have the same care and attention we would want for our families and ourselves.

The following sections explain some of the basics about how you can expect us to care for you and your family during your hospital stay. They also cover what participation we need from you to ensure you receive the best care from us. If you have questions at any time, we hope you will ask them. Unasked or unanswered questions can add to the stress of being in the hospital. Your comfort and confidence in your care are very important to us.

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Patient Rights We are dedicated to giving you the best healthcare and service possible.

As a patient here, you may expect to receive considerate and respectful care.

We will honor your rights to be informed and to be involved in making decisions about your care. You have the following rights as a competent adult patient: • You have the right to know about your illness and proposed treatment and to participate in the development of your plan of care. Information will be given to you by your doctors and other members of your healthcare team in language you can understand.

• You have the right to make decisions about your care, including the right to know why you need an operation or treatment and who will perform that operation or treatment. This includes the right to refuse care or treatment and to know what may happen if you do not have this care or treatment.

• You have the right to make an advance directive about your healthcare treatment preferences and to have hospital staff comply with that directive.

• You have the right to access all information contained in your medical record within a reasonable amount of time (usually 15 days). This includes the right to know the name of the doctor who is in charge of your care and the names of all other health system staff taking care of you.

• You have the right to have the presence of a support person, such as a family member, close friend or loved one. The presence of that support person may be limited if it infringes on others’ rights, raises safety concerns or is not medically indicated. You have the right to have your support person and your own physician notified promptly of your admission to the hospital.

• You have the right to receive treatment in a safe, abuse-free environment without discrimination as to age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity or expression, or source of payment.

• You have the right to personal privacy while in the hospital and to have all information about your illness and care treated as confidential.

• You have the right to be free from restraints or seclusion of any form that is not medically indicated.

• You have the right to receive appropriate assessment and management of pain.

• You have the right to agree or refuse to take part in any study or experiment related to your care or treatment.

• You have the right to take part in resolving ethical issues or conflicts that arise during the course of your care.

• You have the right not to be transferred to another facility unless you 14

are given a complete explanation of the transfer, informed of alternatives to the transfer and consent to the transfer.

• You have the right to review your bills and have any questions you have about them answered.

• You have the right to discuss your concerns or file a complaint with the hospital regarding your experience as a patient here, and to receive a response in a timely manner. You also have the right to an internal appeal to any response that you receive and a right to file a complaint with an external agency.

• You have the right to know your rights and responsibilities before treatment, if possible.

Patient Responsibilities: In order to receive optimal care, you and your family are responsible for: • Providing accurate information about your present illness and past medical history and wishes for your medical care.

• Seeking clarification when necessary to fully understand your health problems and the proposed plan of care.

• Following through on your agreed plan of care.

• Considering and respecting the rights of others.

• Being courteous.

• Providing accurate information for insurance claims and working with Carilion Clinic to make payment arrangements when necessary, so that others can benefit from the services provided here.

• Following visitation policies of the hospital.

• Following the rules and regulations of Carilion Clinic and of the Commonwealth of Virginia, which forbid: - Engaging in verbal or physical abuse.

- Using alcohol or illegal substances.

- Carrying weapons of any kind.

Advance Directives You have rights under Virginia law to make decisions about your medical care.

These rights include the right to accept or refuse care and the right to make advance directives about your care (a durable medical power of attorney and/or a living will). For further information about your advance directive, please consult the case manager or your nurse.

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Infection Control Everyone plays a role in infection prevention, including hospital staff, patients and visitors.

Help us prevent the spread of infection by following these guidelines: Clean hands are your best protection against infection. Clean your hands before you eat, after using the restroom, before and after changing wound dressings, and after contact with body fluids. You can clean your hands with soap and water or by using a hand sanitizer.

Follow these steps to ensure adequate cleaning of hands: • Wet hands with warm water and then apply soap. Rub your hands together vigorously for 15 seconds or longer. Get in between fingers and scrub wrist areas. Friction is necessary to rid your hands of germs. Rinse your hands and dry them. Use a clean paper towel to turn off the water faucet. Discard the paper towel in a trash can.

• Waterless hand sanitizers are very effective for preventing the spread of infection – if you use enough to cover your hands and wrists well. After applying the sanitizer, it should take about 15 seconds to rub your hands dry.

• Expect our staff to clean their hands before and after patient care.

Remind them if they forget. It’s OK to ask someone to clean their hands.

Your health may depend on it.

• Cover your sneeze or cough with a tissue. If you don’t have a tissue, cough or sneeze into your upper arm – not your hands! Before you cough or sneeze, you should always turn away from other people. Discard used tissues in the trash and then clean your hands.

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

Be sure to eliminate germs when you go home by using disinfectants, such as sprays and wipes, to clean surfaces often. Some germs can live three days or longer on hard surfaces, which is why it’s so important to disinfect surfaces like countertops, sinks, phones and TV remotes regularly.

Voicing Your Concerns We are always looking for ways we can improve. When an individual has any concerns about patient care and safety in the hospital that have not been addressed, he or she is encouraged to contact the hospital’s management. Your nurse or the hospital operator can call an administrative representative for you at your request. If you have questions, comments or concerns about your care 16

or safety, please contact our hospital administration at 540-731-2000.

If you have other questions about patient rights or responsibilities, quality of care, coverage decisions or premature discharges, you may also notify: Virginia Department of Health Office of Licensure and Certification 9960 Maryland Drive, Suite 401 Richmond, Virginia 23233 Phone 800-955-1819 CNRV is accredited by several agencies, including the Joint Commission, whose mission it is to continuously foster and improve the safety and quality of care provided to the public through the organizations that seek its accreditation.

If issues cannot be resolved by the hospital, you may also contact the Joint Commission’s Office of Quality Monitoring. You may report any concerns or register complaints about a Joint Commission-accredited healthcare organization by calling 800-994-6610 or by emailing complaint@jcaho.org.

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

Call Carilion Clinic at 540-266-6000 or 800-422-8482, Monday – Friday, 8 a.m. – 5 p.m., with any of your health-related questions.

Website You will also find a wealth of healthcare information and service overviews on our website, www.CarilionClinic.org. For CNRV-specific information, choose “Hospitals and Centers” under “Patient Care.” The link is available by clicking “Carilion New River Valley Medical Center” from the list, or you can go to www.CarilionClinic.org/cnrv.

Insurance and Payment Information The hospital’s basic daily charge includes your room and a portion of your nursing care, medical records, bedside meals, housekeeping, laundry, building maintenance and admissions.

Additional charges will be made for some items, such as medications, anes17

thesia, operating room, recovery room, laboratory tests, X-rays, respiratory therapy, and other diagnostic and therapeutic services. You may also receive a bill from your primary care physician.

If you have insurance, you can help us in expediting your claim by providing the following information: • Copy of your insurance card • Name of the company that carries your group insurance • Your policy number • Whether or not your insurance requires pre-admission review All co-insurance payments are due and payable within 30 days after your insurance pays. If you do not have insurance, you are requested to make a cash deposit at the time of admission. The difference between the cash deposit and the full amount of the bill is expected to be paid within 30 days. If other arrangements are necessary, please contact our business office or Carilion Clinic’s Patient Payment Services at 888-822-1872.

Carilion Clinic also offers assistance to patients with limited ability to meet their financial obligations. A patient financial specialist from Eligibility Assistance Service may attempt to contact you while in the hospital to assist you in making financial arrangements.

Help With Your Bill and How to File Insurance Claims Our staff gladly files claims for you with healthcare insurers or other programs such as Medicare and Medicaid. They will also help your doctor with needed documentation. Hospital bills and insurance coverage can often be confusing.

If you have questions, please contact Patient Payment Services or our business office at 540-224-5500 or 888-822-1872.

If you need help understanding your insurance coverage or health plan, start with your insurance company or health benefits manager. If you do not have health coverage, we will try to help you and your family to find financial help or make other arrangements. In order to help, we will need your aid gathering necessary information and other requirements to obtain coverage or assistance.

Frequently Asked Questions about Billing How is my hospital bill determined?

Your hospital bill is determined by the type and quantities of services ordered by your physician, the number of days as an inpatient, the type of bed accom18

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modation and the number and type of supplies ordered.

How do I obtain a copy of my hospital bill?

You will be sent a summary bill for the services provided by Carilion Clinic within 30 days of the actual service date or shortly after your health insurance company has paid its obligation.

Insurance Payment Questions: How long does it take for my commercial insurance plan to pay for my services?

It normally takes between 45 and 70 days for a commercial insurer to pay a claim.

What is my Medicare inpatient deductible?

The Medicare inpatient deductible changes each year on January 1. Please refer to your Medicare explanation of benefits for this year’s deductible or ask one of our financial case managers for the information.

Will Carilion Clinic bill my insurance?

Carilion Patient Accounting will bill your health plan, provided you have given us authorization.

How much will I owe Carilion Clinic for the services I received?

The amount which you will be responsible for will depend on your individual policy.

What is a co-pay?

A co-pay is a set dollar amount determined by the insurance plan you have enrolled in and is payable to the healthcare provider at each visit. The type of service requested normally determines it.

What does “pre-admission” certification mean?

Most of the commercial health insurance plans require the patient to obtain pre-authorization before obtaining non-emergent health services.

Payment Policy and Contacts All patients with the ability to meet their financial obligations are expected to pay for services provided by Carilion Clinic hospitals within 90 days of discharge.

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