- The Joint Commission
- Phone: 1-800-994-6610
- or email concern to firstname.lastname@example.org.
Holy Family Memorial, its affiliates and all employees are grounded in the vision, mission and values of Catholic healthcare. Believing that our mission and our values of stewardship, excellence, respect, compassionate caring and Christian environment are core to all we do, it is your right to expect that the care and services you receive flow from these values.
We consider you a partner in your healthcare. When you are well-informed, participate in treatment decisions, and communicate openly with your doctor and other healthcare professionals, you help make your care as effective as possible. Holy Family Memorial encourages respect for the personal preferences and values of each individual. We will meet your needs for care to the extent they are in accord with our mission and philosophy, are permitted by law, and are in our scope of service.
While you are being treated by Holy Family Memorial or its affiliates, you, and when appropriate, your family have the right to the following:
- Information: You have the right to be well informed about your illness or injury, possible treatments, and likely outcomes, including unanticipated outcomes, and about pain and pain relief measures. You have the right to discuss this information with your doctor. You have the right to know the names of the people treating you.
- To Consent or Refuse: You have the right to consent or refuse a treatment, as permitted by law, throughout your course of care. If you refuse a recommended
treatment, you will receive other needed and available care.
- Privacy and Security: You have the right to privacy and security. Holy Family Memorial and its affiliates, your doctor, and others caring for you will protect your privacy and security as much as possible.
- Confidentiality: You have a right to expect all information pertaining to your care will be kept confidential, including your treatment records, unless you give permission to release information or reporting is permitted by law. When Holy Family Memorial or its affiliates release information to others such as insurers, they emphasize that the information is confidential.
- Medical Records: You have the right to view your medical record and to have the information explained, except when restricted by law.
- Transfer: You have the right to expect that Holy Family Memorial or its affiliates will give you necessary health services to the best of their ability. If treatment referral or transfer is recommended or requested, you will be informed of risks, benefits, and alternatives. You will not be transferred until the other institution agrees to accept you.
- Relationships: You have the right to know if Holy Family Memorial or its affiliates have relationships with outside parties that may influence your treatment and care. These relationships may be with educational institutions, other healthcare providers, or insurers.
- Research: You have the right to consent or decline to take part in research affecting your care. If you choose not to take part, you will receive the most effective care Holy Family Memorial and its affiliates provide.
- Care Alternatives: You have the right to be told of realistic care alternatives when hospital care is no longer appropriate.
- Charges and Policies: You have the right to know about rules that affect you and your treatment, and about charges and payment methods.
- Ethics Committee: You have the right to seek the assistance of the Ethics Committee regarding ethical issues that may arise in the provision of your care.
- Advance Directive: You have the right to have an advance directive, such as a living will or durable power of attorney for healthcare. These documents express your choices about your future care, or name someone to act on your behalf if you cannot speak for yourself
You have the right to voice your questions, concerns, or complaints to your nurse or physician; or you may put it in writing and send it either directly to Holy Family Memorial or to the Bureau of Health Services. Those addresses are listed below.
- Holy Family Memorial President and CEO
- P.O. Box 1450
- Manitowoc, WI 54221-1450
- Phone: (920) 320-2011
- Bureau of Health Services-Division of Quality Assurance
- P.O. Box 2969
- Madison, WI 53701-2969
- Phone: (608) 266-8481
We work to provide care efficiently and fairly to all patients and the community. You have responsibilities too.
You are responsible for providing information about your health, including past illnesses, hospital stays, and use of medicine.
You are responsible for asking questions to clarify information or instructions and to participate in developing a pain management plan.
If you believe you cannot follow through with your treatment, you are responsible for telling your doctor.
You and your visitors are responsible for being considerate of the needs of other clients, staff, and Holy Family Memorial and its affiliates.
You are responsible for providing information for insurance and working with Holy Family Memorial and its affiliates to arrange payment when needed.
Your health depends not just on the care you receive here, but on the decisions you make in your daily life. You are responsible for recognizing the effect of lifestyle on your personal health.
The primary purpose of Holy Family Memorial and its affiliates is to maintain wellness; promote healing of body, mind, and spirit; and care for the dying. We pledge our commitment to respect the dignity of those we serve.
You and the hospital have the right to restrict visitors, mail, telephone calls, or other forms of communication. These restrictions are determined jointly Holy Family Memorial has open visitation hours.
- Visiting hours may be restricted by the patient’s personal preference. Appropriate signage will be placed on the door informing visitors of the restriction.
- Patients may choose with whom they communicate and allow or not allow as visitors. Patients have the right (subject to their consent) to receive the visitors whom they designate, including but not limited to, a spouse, a domestic partner (including same sex domestic partner), another family member, or a friend, and have the right to withdraw or deny such consent at any time.
- The hospital will not restrict, limit, or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability.
- The hospital will ensure that all visitors enjoy full and equal visitation privileges consistent with patient preferences.
Holy Family Memorial has a long history of safe patient care and has been an early adopter of technology and procedures that maximize patient safety.
For information on specific safety initiatives call (920) 320-2886. Learn more about national patient safety initiatives from the Joint Commission “Speak Up” Program.