Guide KEY INFORMATION FOR YOUR STAY

Take This Copy Home With You FREE!

SPEAK UP Ask Questions & Voice Concerns

MEDICINE GUIDE Key Questions to Ask

SUCCESSFUL DISCHARGE How to Plan Ahead

BROOKWOODBAPTISTHEALTH.COM

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ONTENT On Our Cover Speak Up! Ask Questions and Voice Concerns ...... 11 Guide Key Questions to Ask . . . . . 12 Successful Discharge How to Plan Ahead . . . . 28 S

PAGE WELCOME ...... 2 ABOUT US ...... 3 8 PHONE DIRECTORY ...... 5 OUR COMMITMENT TO CARE . . 6 You, the SPECIAL SECTION ...... 8 Patient RIGHTS & RESPONSIBILITIES . . . 13 n Choose a Support Person YOUR PRIVACY MATTERS . . . . 17 n Prevent Falls ADVANCE DIRECTIVES ...... 26 n Infection Control LEAVING THE . . . . . 28 n AFTER-HOSPITAL CARE . . . . . 31 Pay Attention to Your Care n UNDERSTANDING YOUR BILL . . . 32 Speak Up n SPOTLIGHT ON HEALTH . . . . 34 Manage Your Meds Heart Attack & Stroke Warning Signs Stop Smoking MEDICATION SIDE EFFECTS . . . 36 GAMES ...... 39 NOTES ...... 40

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 1 3/13/20 11:29 AM WELCOME About Us

United In Service and Devotion to You A Letter From Citizens Baptist Medical Center In 2015, Baptist and Brookwood Medical Center came together to form a new community of care: Brookwood n behalf of our talented and dedicated team of Baptist Health. Our union was founded on our mutual dedication staff and physicians, we would like to welcome to comprehensive, compassionate, high-quality care for the O you to Citizens Baptist Medical Center, part communities we have served since 1922. of Brookwood Baptist Health. With roots extending for almost a century, Brookwood Baptist Health With five , a freestanding emergency department, represents the largest healthcare network in Central more than 70 other locations including health centers, physician Alabama. practices and imaging centers, and the largest We are part of a community built on care composed network in the state, our system offers convenient care for of five hospitals with more than 1,700 people across central Alabama. licensed beds, including Brookwood Baptist Medical Center, Princeton Baptist Medical Center, Walker Baptist Medical Center and Shelby Baptist Though we are a new community of care with a different name Medical Center. Our network also provides with the largest primary and logo, we are still devoted to the personal, individual, care network in the state, along with physician practices, diagnostic and high-level care our patients know and deserve. We’re still your outpatient surgery centers, and a freestanding emergency department. neighbors and your friends, and now we are Alabama’s newest progressive healthcare network—united in service and devotion Citizens Baptist Medical Center is united in service and devotion to the to you, your family, and all the people of central Alabama. people of Central Alabama and dedicated to putting people back at the center of healthcare. Thank you for choosing Citizens Baptist. We hope you find this patient Our five Brookwood Baptist Health hospitals are: information guide to be a valuable resource during your stay—and beyond. Brookwood Baptist Medical Center Shelby Baptist Medical Center Providing high-quality care and delivering patient satisfaction is our 2010 Brookwood Medical Center Drive 1000 First St. N. priority, and we appreciate the opportunity to be your healthcare provider. Birmingham, AL 35209 Alabaster, AL 35007 Sincerely, (205) 877-1000 (205) 620-8100

Frank Thomas Citizens Baptist Medical Center Walker Baptist Medical Center CEO, Citizens Baptist Medical Center 604 Stone Ave. 3400 Highway 78 Talladega, AL 35160 Jasper, AL 35501 (256) 362- 8111 (205) 387-4000

Princeton Baptist Medical Center 701 Princeton Ave. S.W. Birmingham, AL 35211 (205) 783-3000 2

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 2 3/13/20 11:29 AM About Us

United In Service and Devotion to You In 2015, Baptist Health System and Brookwood Medical Center came together to form a new community of care: Brookwood Baptist Health. Our union was founded on our mutual dedication to comprehensive, compassionate, high-quality care for the communities we have served since 1922.

With five hospitals, a freestanding emergency department, more than 70 other locations including health centers, physician practices and imaging centers, and the largest primary care network in the state, our system offers convenient care for people across central Alabama.

Though we are a new community of care with a different name and logo, we are still devoted to the personal, individual, high-level care our patients know and deserve. We’re still your neighbors and your friends, and now we are Alabama’s newest progressive healthcare network—united in service and devotion to you, your family, and all the people of central Alabama.

Our five Brookwood Baptist Health hospitals are: Brookwood Baptist Medical Center Shelby Baptist Medical Center 2010 Brookwood Medical Center Drive 1000 First St. N. Birmingham, AL 35209 Alabaster, AL 35007 (205) 877-1000 (205) 620-8100

Citizens Baptist Medical Center Walker Baptist Medical Center 604 Stone Ave. 3400 Highway 78 Talladega, AL 35160 Jasper, AL 35501 (256) 362- 8111 (205) 387-4000

Princeton Baptist Medical Center 701 Princeton Ave. S.W. Birmingham, AL 35211 (205) 783-3000 3

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 3 3/13/20 11:29 AM ABOUT US continued

Hospital Map

Carbon Hill

Talladega 280

United in service and devotion to all of central Alabama.

Brookwood Baptist Medical Center

Citizens Baptist Medical Center

Princeton Baptist Medical Center

Shelby Baptist Medical Center

Walker Baptist Medical Center

Brookwood Baptist Health Freestanding Emergency Department

Brookwood Baptist Health Primary and Specialty Care Network

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 4 3/13/20 11:29 AM PHONE DIRECTORY

Main Number Calling from INSIDE Citizens Baptist Medical Center: the hospital? Dial the last four digits only. 256.362.8111

FREQUENTLY CALLED NUMBERS Billing and Insurance 256.761.4518 Financial Assistance 256.761.4518 Care 256.761.4566 Pastoral Care 256.362.8111 Volunteer Services 256.761.4297

For more information on the resources available to you, visit www.CitizensBaptistMedicalCenter.com.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 5 3/13/20 11:29 AM OUR COMMITMENT TO CARE

Patient Satisfaction Matters to Us

How’s your stay? Are you getting the care you need? Are your doctors and nurses listening and responding to your questions or requests? Our goal is to provide the best quality care. To do so, we ask for feedback. During Your Stay Please speak with your nurse or supervisor if you have any questions or concerns about your care. If your issue still is not resolved, then contact an administrative representative or a nursing house supervisor. You also have the right to file your complaint with either: Alabama Department of Public Health KEPRO Complaint Department, Suite 600 KEPRO Rock Run Center RSA Tower 5700 Lombardo Center Drive 201 Monroe Street Suite 100 Montgomery, AL 36104 Seven Hills, OH 44131 1.800.356.9596 1-844-430-9504 keproqio.com The Joint Commission One Renaissance Boulevard Oakbrook, IL 60181 Fax: 630-792-5636 Website: www.jointcommission.org, then click "Report a Safety Event" Photography/Videography Policy Patients and visitors are not allowed to photograph, film or otherwise record medical procedures, Citizens Baptist staff or physicians. Photographing, filming or any recording of other patients or visitors is not allowed unless the person being photographed, filmed or recorded gives specific permission. Citizens Baptist may ask an individual to stop photographing, filming or recording at any time. Failure to comply with Citizens Baptist's request may result in calling security and removing the offending party from the facility. 6

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 6 3/13/20 11:29 AM After Your Stay Once you leave our care, we will continue to seek your feedback through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The HCAHPS survey is a tool to measure and report patient satisfaction. It’s made up of simple questions on key care topics such as:

n doctor and nurse communication

n medication and discharge information

n staff responsiveness

n overall quality of the hospital environment

If you’re selected to receive this brief telephone survey, please take the time to complete it. The results will help us know what we’re doing right and where we can improve.

Want to Know How We Score? You can review and compare the quality, care and safety ratings for different hospitals at: n Medicare Hospital Compare uses HCAHPS results and other data: www.medicare.gov/hospitalcompare/ search.html You also can find information on hospitals at: n Healthcare Facilities Accreditation Program (HFAP): www.hfap.org n DNV GL Healthcare www.dnvglhealthcare.com n The Joint Commission: www.qualitycheck.org

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 7 3/13/20 11:29 AM You, the Patient As the patient, you play a key role n Ask healthcare workers to wash as a member of your healthcare their hands before providing your team. We encourage your questions treatment if they fail to do so. and active participation in your n Ask a relative or friend to be care and treatment. Here are some with you if this will help you ask of the ways you can be involved as a questions and better understand member of the healthcare team: answers. n Many patients have shorter n After surgery, follow instructions, hospital stays due to advances in like if you are asked to cough, take modern medicine, care available in deep breaths or get out of bed. post-hospital settings, outpatient n When you are discharged, make services and home health options. sure your physician or nurse talks When you no longer need with you about your prescribed inpatient hospital care, your doctor medications—the dosage and or the hospital staff will inform purpose of the drug. you of your proposed discharge. n Tell us all of the medications you It is important that you share are taking, including any herbs, information with the staff that vitamins, dietary supplements or may relate to your care or future over-the-counter medication. Carry care needs. It also is important a written list of your medications that you let your family know of at all times. Tell us if you have pain, the anticipated discharge date so and if your pain doesn’t get better, arrangements can be made for please let us know. discharge early in the day. n Tell us about any allergies or bad n If the medicine you receive looks reactions you have to medication, different from what you expect, food or dyes. ask about it. n Cover your mouth and nose with a n Make sure you are informed of the tissue when you cough. Promptly results of any test or procedure. dispose of used tissues. If you will n If you are having surgery, make be in contact with other patients, sure that you and your physicians you may be requested to wear a all agree and are clear on exactly mask. Please wash your hands what will be done. after contact with bodily fluids. n Inform the nursing staff if you have n Research has clearly shown that any problems standing or walking, smoking increases the risk of heart so they can assist as needed. disease, including heart attack, n If the healthcare provider does not certain types of cancer and many check your armband before care or other potentially fatal diseases. If treatment, please ask that they do so. you smoke and are interested in n Do your part to minimize the risk quitting, speak with your physician. of infection. 8

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 8 3/13/20 11:29 AM CHOOSE A SUPPORT PERSON A trusted friend or family member can be a big help during your hospital stay. Select one key person to be your healthcare advocate. If you become stressed or your ability to communicate changes, Don’t forget to tell the staff who you’ve this person can stand picked to be your support person. in for you—and stand up for your care. A support person can: n ask questions you might not think of and write down information

n double-check your medications and treatments

n watch for signs your condition is getting worse and ask for help

PREVENT FALLS While you are here, you may feel dizzy or weak. Illness, procedures, medications or even just lying down for too long can make you less steady on your feet. To keep yourself safe:

n Use the nurse call button for help getting out of bed.

n Ask for help going to the bathroom or walking around. (And use hospital handrails when they're available.)

n Wear nonslip socks or footwear.

n Keep often-used items within easy reach (glasses, remote, tissues, etc.).

n Make sure your wheelchair is locked when you get in or out of it. Never step on the footrest.

n Have a family member or support person stay with you if possible. Patients of all ages are at risk for falls. It’s better to be extra careful than risk another medical problem.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 9 3/13/20 11:29 AM YOU, THE PATIENT continued INFECTION CONTROL Preventing or stopping the spread For visitors: of germs is always important, n Clean your hands upon entering and but it’s even more important in exiting the patient’s room. a healthcare setting. Various n Avoid contact with patient precautions may be used by dressings, tubes and other items visitors, staff and patients to stop that the patient may have touched. the spread of germs. n Put on protective equipment (gloves, gowns, masks) as indicated Contact precautions stop the before entering the room and spread of harmful germs spread by remove when exiting the room. touching another person or their n Go to the nurses station if you have surroundings. any questions. Droplet/airborne precautions When cleaning hands with soap stop harmful germs that can spread and water: by coughing or sneezing. n Wet hands with warm water. n Dispense soap into palm. When either of these precautions is n Lather by rubbing hands together for in place, the hospital staff will: 15 seconds, covering all surfaces of n Clean their hands upon entering and hands and fingers. exiting the room. n Rinse hands thoroughly. n Put a sign on the patient’s door to let n Dry hands with paper towel. others know that special infection n Use a paper towel to turn off faucet. control precautions are in place. n Discard paper towel in the trash n Wear gloves and mask when container. entering the room. When cleaning hands with alcohol For patients: hand sanitizer: n Clean your hands frequently. n Dispense one measure of gel into n Be sure visitors read the sign on your the palm of one dry hand. door. n Rub hands together, covering all n Limit visitors to a few family and surfaces of hands and fingers until friends. dry—about 15 to 20 seconds. If you had surgery: n Clean your hands before and after touching the wound, dressing or any tubes connected to the wound. n Report any redness, swelling or drainage from the surgical wound to your nurse or doctor.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 10 3/13/20 11:29 AM PAY ATTENTION TO YOUR CARE n Tell your nurse if something doesn’t seem right. n Know what time you normally get medication, and tell your nurse if you don’t get it. n Request drawings or illustrations to help you learn about your condition. You Are Key n Read and understand all medical forms You are the most before signing. Ask if you need information important member of explained. your healthcare team. n If your treatment involves medical Make sure you: equipment, practice using it with your nurse n Understand your before you leave the hospital. treatment

n Don’t be afraid to ask for a second opinion. n Ask questions The more information you have, the better n Speak up about pain you will feel about making decisions. n Know your medications

n Talk to your doctor and family about whether n Plan early for a you want life-saving actions taken. successful discharge

SPEAK UP If you have questions or concerns, you have the right to ask and get a response from your doctor or nurse that makes sense to you. To help, share your answers to these questions with hospital staff.

n What language would you prefer to speak? n Do you need glasses, hearing aids or other devices to help with talking to hospital staff? n Do you prefer to hear, see or read health information? n Do you have any cultural, ethnic or religious-based special needs? n Who will be your support person who talks with hospital staff about your healthcare wishes? And Remember, Take Charge of Your Communication: Ask About Jargon: If you hear a medical term you don’t understand, ask what it means. Teach Back: After you get instructions or an explanation, repeat back what you thought you heard so you can double-check that you understood. Take Notes: Write down any key facts your doctor tells you so you won’t forget. 11

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 11 3/13/20 11:29 AM YOU, THE PATIENT continued MANAGE YOUR MEDS Whether you take one or five PREVENT MEDICATION ERRORS medications, it’s important to know what you are taking and Be sure your why. Ask your doctor these doctors and questions about any new and nurses know: current medications you take: n That your name

n What is the name of my matches the name on the medication? Generic name? medication (use your ID bracelet to double-check). n Why am I taking it? How will it help? When will it start n All the prescription drugs, over- working? the-counter medications and herbal or vitamin supplements you take. n What dose? How often?

How long? n Any allergies you have to medications, anesthesia, foods, n What is the best time latex, etc. (morning, night, etc.) or way to take it (with food, with water)?

n What are possible side effects? What do I do if they happen?

n Are there any foods, drinks or activities to avoid?

n What do I do if I miss a dose?

Remember, take charge of your medication. Think you’re due for your next dose? Wondering if this new medication can replace one you already take? Want to make sure all your medications and supplements are safe to take together? Don’t be afraid to ask.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 12 3/13/20 11:29 AM RIGHTS & RESPONSIBILITIES

You Have the Right to the Best Care

As a natural outgrowth of our Make choices about your own organizational values and Mission, care, treatment and services, the Board of Trustees, the medical including the right to request staff and the employees of Citizens or refuse care, treatment and Baptist Medical Center jointly services in accordance with respect, protect and promote the law and regulation and without following rights and responsibilities coercion, discrimination or of patients. The staff and physicians retaliation. of Citizens Baptist Medical Center Be informed about the outcomes want to enhance your health, of care, treatment and services dignity and wholeness. Because of that have been provided, our Mission, we hereby adopt this including unanticipated Bill of Rights & Responsibilities. outcomes. Have your cultural, psychosocial, You Have the Right to: religious, spiritual and personal Be treated with respect, kindness, values, beliefs and preferences personal privacy and dignity. respected.

Nondiscrimination. The Expect we will assess and address effectiveness and safety of care, your pain concern. treatment and services for your Have your family or your health condition does not depend caregiver notified of your on your race, religion, sex, gender admission to the hospital at your identity or expression, sexual request.

orientation, language, ethnicity, Have your personal physician country of origin, culture, age, notified of your admission to the socioeconomic status, physical hospital.

or mental disability, or source of Make an advance directive, payment. including a living will and/or Communication and education power of attorney for healthcare. during your medical care, Have a designee (parent, legal treatment and services in a guardian, person with medical manner that meets your oral and power of attorney) exercise your written communication needs. rights when you are incapable

CONCERNS? If you have concerns about the care you or your loved one is receiving, please speak with your doctor or nursing supervisor. If you feel that your issue isn’t resolved, contact a hospital administrative representative.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 13 3/13/20 11:30 AM RIGHTS & RESPONSIBILITIES continued of doing so without coercion, Be informed of the source of discrimination or retaliation. the hospital’s reimbursement Privacy, confidentiality and for your services, and of any security of your medical records limitations which may be placed and details about your care. upon your care. Be free from mental, physical, Effective communication, sexual and verbal abuse and including qualified interpreter or neglect. If restraints are translation services and auxiliary necessary, you have the right to aids for vision, speech, hearing or have them applied safely. cognitive impairment provided Be informed of protective and by your healthcare facility, at community services. no cost to you, in a manner that Be told of business ties between meets your needs in accordance the hospital and your other with law and regulation and as caregivers. reasonably available. Know that the hospital will give Informed consent. you the best care it can. You may Specify language preference be asked to move to another for discussing your healthcare hospital or place of treatment. If information. so, you will be told your choices Access, request amendment and what could happen with to and obtain information those choices. on disclosures of your health Say yes or no to being a part of information, in accordance with research. law and regulation. Participate in the development Have a “Patient Representative” of your plan of care while in the and a “Support Person” who hospital and be told about how may be a family member, friend to continue your care upon your or other individual with you discharge from the hospital. for emotional support during Be told of the hospital rules, the course of the hospital which include no smoking. stay unless this individual’s Receive a copy of your bill. presence infringes on other’s Know the name and professional rights, safety, or is medically or status of any person providing therapeutically contraindicated. your care and/or services. Your “Support Person” may or Know the reasons for any may not be the same individual proposed change in the as your “Patient Representative.” professional staff responsible for These individuals can assist you your care. with medical decisions and your Know the reasons for your visitor rights if you choose to transfer either within or outside have them do so. the hospital. Make a complaint or grievance freely without being subject

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 14 3/13/20 11:30 AM to coercion, discrimination or problems while you are in the unreasonable interruption in hospital. This includes telling care. Dial the hospital operator your doctors or nurses if you are who will contact your hospital in pain. Patient Advocate or Nursing Asking questions and letting House Supervisor, or contact your physician or hospital staff one of the following agencies: know when you or your family Alabama Department of Public do not understand what you have Health been told about your medical Complaint Department condition, your treatment or Suite 600 RSA Tower what you should do to care for 201 Monroe Street yourself. Montgomery, AL 36104 Following instructions, including 1-800-356-9596 your plan of care as developed www.adph.org by your healthcare team. Your KEPRO plan of care includes the effect KEPRO Rock Run Center of lifestyle on your health. You 5700 Lombardo Center Drive also are responsible for accepting Suite 100 the consequences of not getting Seven Hills, OH 44131 treatment or not following the 1-844-430-9504 instructions of your caregivers. keproqio.com Knowing and following hospital rules, policies and regulations The Joint Commission in place to support quality One Renaissance Boulevard care for all patients and a safe Oakbrook, IL 60181 environment for all individuals Fax: 630-792-5636 in the hospital, as outlined Website: www.jointcommission. in the hospital Patient and org, then click "Report a Safety Visitor Information Guide. This Event" includes, but is not limited to, the You Are Responsible for: hospital’s no smoking guidelines. Giving the hospital a copy of your advance directive, if you have one. Letting the hospital know about any you are taking at home, your present medical problems, and any medical information that could help make it easier for the doctors and hospital staff to provide care, treatment and services for you. You should tell your doctors or nurses about any changes to your medical 15

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 15 3/13/20 11:30 AM RIGHTS & RESPONSIBILITIES continued

Showing respect for other information private. If you have patients, visitors and the problems or questions about safety hospital staff by using polite and or any issue regarding your care or courteous language and conduct. the care of your loved ones while This includes treating hospital in our hospital, please talk to your belongings and property with nurse, a member of your patient respect. care team or the nurse manager. Paying your hospital bill. This If you are not comfortable includes giving the hospital talking with one of these people, correct information about your you may call an administrative insurance or your way for paying representative, a nursing house your bill. supervisor, hospital administration These rights and responsibilities or nursing administration. All can and should be exercised on concerns will be treated with the patient’s behalf by a parent, respect and in a timely manner. guardian, designee or proxy If, after sharing your concerns, decision-maker if the patient lacks you still are not satisfied, then you decision-making capacity, is legally may choose to file a grievance. A incompetent, or is a minor in grievance is a verbal or written accordance with the law. notice regarding dissatisfaction with patient care. It can be Patient Concerns submitted to any hospital Citizens Baptist Medical Center department manager or to hospital is committed to providing quality administration. healthcare and medical services in a caring, safe and supportive environment. We try to make your hospital visit pleasant; however, if you have concerns or issues, there are steps in place to help you. Our goal is to handle a complaint promptly. A family member, guardian, patient representative, support person or significant other may register a concern, file a complaint or grievance, ask questions or make recommendations. We will respect your comments and keep this

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 16 3/13/20 11:30 AM YOUR PRIVACY MATTERS Privacy and Health Information

Who Presents This Notice. This Hospital and Health Professionals use Notice describes the privacy practices computerized systems that may subject of Citizens Baptist Medical Center your Protected Health Information to (the “Hospital”) and members of its electronic disclosure for purposes of workforce, as well as the physician treatment, payment and/or healthcare members of the medical staff and allied operations as described below. When health professionals who practice the Hospital and Health Professionals at the Hospital. The Hospital and use or disclose your Protected Health the individual healthcare providers Information, the Hospital and Health together are sometimes called "the Professionals are required to abide Hospital and Health Professionals" in by the terms of this Notice (or other this Notice. While the Hospital and notice in effect at the time of the use or Health Professionals engage in many disclosure). joint activities and provide services in a clinically integrated care setting, Notifications. The Hospital is the Hospital and Health Professionals required by law to protect the privacy each are separate legal entities. This of your medical information, distribute Notice applies to services furnished this Notice of Privacy Practices to you, to you at Citizens Baptist Medical and follow the terms of this Notice. The Center, as a Hospital and all off-campus Hospital also is required to notify you outpatient departments as an inpatient if there is a breach or impermissible or outpatient in a Hospital-affiliated access, use or disclosure of your program involving the use or disclosure medical information. of your health information. Permissible Uses and Disclosures Without Your Privacy Obligations. The Hospital Written Authorization. In certain and Health Professionals each are situations, your written authorization required by law to maintain the must be obtained in order to use and/ privacy of your health information or disclose your PHI. However, the ("Protected Health Information" or Hospital and Health Professionals do "PHI") and to provide you with this not need any type of authorization Notice of legal duties and privacy from you for the following uses and practices with respect to your disclosures: Protected Health Information. The

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 17 3/13/20 11:30 AM YOUR PRIVACY MATTERS continued

USES AND DISCLOSURES FOR Healthcare Operations. Your TREATMENT, PAYMENT AND PHI may be used and disclosed HEALTHCARE OPERATIONS. for healthcare operations, which Your PHI may be used and disclosed include internal administration to treat you, obtain payment for and planning and various activities services provided to you and conduct that improve the quality and cost “healthcare operations” as detailed effectiveness of the care delivered below: to you. For example, PHI may be used to evaluate the quality and Your PHI may be Treatment. competence of physicians, nurses used and disclosed to provide and other healthcare workers. PHI treatment and other services to may be disclosed to the Hospital you –– for example, to diagnose Compliance & Privacy Office in order and treat your injury or illness. In to resolve any complaints you may addition, you may be contacted to have and ensure that you have a provide you appointment reminders comfortable visit. Your PHI may be or information about treatment provided to various governmental alternatives or other health-related or accreditation entities such as the benefits and services that may be of Joint Commission on Accreditation interest to you. Your PHI may also be of Healthcare Organizations disclosed to other providers involved to maintain our license and in your treatment. For example, accreditation. In addition, PHI may a doctor treating you for a broken be shared with business associates leg may need to know if you have who perform treatment, payment diabetes because if you do, this may and healthcare operations services impact your recovery. on behalf of the Hospital and Health Payment. Your PHI may be used Professionals. and disclosed to obtain payment Additionally, your PHI may be for services provided to you--for used or disclosed for the purpose of example, disclosures to claim and allowing students, residents, nurses, obtain payment from your health physicians and others who are insurer, HMO, or other company that interested in healthcare, pursuing arranges or pays the cost of some or careers in the medical field or desire all of your healthcare (“Your Payor”) an opportunity for an educational to verify that Your Payor will pay for experience to tour, shadow healthcare. The physician who reads employees and/or physician faculty your X-ray may need to bill you or members or engage in a clinical your Payor for reading of your X-ray Practicum. therefore your billing information may be shared with the physician Disclosure to Relatives, Close who read your X-ray. Friends and Other Caregivers. Your PHI may be disclosed to a family member, other relative, a close personal friend or any other person

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 18 3/13/20 11:30 AM identified by you who is involved Public Health Activities. in your healthcare or helps pay for Your PHI may be disclosed for the your care. If you are not present, following public health activities: or the opportunity to agree or (1) to report health information to object to a use or disclosure cannot public health authorities for the practicably be provided because of purpose of preventing or controlling your incapacity or an emergency disease, injury or disability; (2) to circumstance, the Hospital and/or report child abuse and neglect to Health Professionals may exercise public health authorities or other professional judgment to determine government authorities authorized whether a disclosure is in your best by law to receive such reports; interest. If information is disclosed (3) to report information about to a family member, other relative or products and services under the a close personal friend, the Hospital jurisdiction of the U.S. Food and and/or Health Professionals would Drug Administration; (4) to alert a disclose only information believed to person who may have been exposed be directly relevant to the person’s to a communicable disease or may involvement with your healthcare or otherwise be at risk of contracting payment related to your healthcare. or spreading a disease or condition; Your PHI also may be disclosed in and (5) to report information to your order to notify (or assist in notifying) employer as required under laws such persons of your location or addressing work-related illnesses general condition. and injuries or workplace medical surveillance.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 19 3/13/20 11:30 AM YOUR PRIVACY MATTERS continued

Victims of Abuse, Neglect or or law enforcement authority makes Domestic Violence. Your PHI certain requests to us.

may be disclosed to a governmental Organ and Tissue authority, including a social service Procurement. Your PHI may or protective services agency, be disclosed to organizations authorized by law to receive reports that facilitate organ, eye or of such abuse, neglect, or domestic tissue procurement, banking or violence if there is a reasonable transplantation. belief that you are a victim of abuse, neglect or domestic violence. Research. Your PHI may be used or disclosed without your consent Health Oversight Activities. or authorization if an Institutional Your PHI may be disclosed to Review Board approves a waiver of a health oversight agency that authorization for disclosure. oversees the healthcare system and is charged with responsibility for Health or Safety. Your PHI may ensuring compliance with the rules be used or disclosed to prevent or of government health programs such lessen a serious and imminent threat as Medicare or Medicaid. to a person’s or the public’s health or Judicial and Administrative safety. Proceedings. Your PHI may be U.S. Military. Your PHI may be disclosed in the course of a judicial uses or disclosed to U. S. Military or administrative proceeding in Commanders for assuring proper response to a legal order or other execution of the military mission. lawful process. Military command authorities Law Enforcement Officials. Your receiving protected health PHI may be disclosed to the police information are not covered entities or other law enforcement officials subject to the HIPAA Privacy Rule, as required or permitted by law or but they are subject to the Privacy in compliance with a court order Act of 1974 and DoD 5400.11-R , or a grand jury or administrative "DoD Privacy Program," May 14, subpoena. For example, your PHI 2007. may be disclosed to identify or locate Other Specialized Government a suspect, fugitive, material witness Functions. Your PHI may be or missing person, or to report a disclosed to units of the government crime or criminal conduct at the with special functions, such as the facility. U.S. Department of State under Correctional Institution. certain circumstances, for example You PHI may be disclosed to a the Secret Service or NSA to protect correctional institution if you are an the country or the President. inmate in a correctional institution and if the correctional institution

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 20 3/13/20 11:30 AM Workers’ Compensation. Your send you any marketing materials. PHI may be disclosed as authorized (However, marketing materials by and to the extent necessary to can be provided to you in a face-to- comply with state law relating to face encounter without obtaining workers' compensation or other Your Marketing Authorization. The similar programs. Hospital and/or Health Professionals also are permitted to give you a As Required by Law. Your PHI promotional gift of nominal value, may be used and disclosed when if they so choose, without obtaining required to do so by any other law not Your Marketing Authorization). The already referred to in the preceding Hospital and/or Health Professionals categories; such as required by the may communicate with you in FDA, to monitor the safety of a a face-to-face encounter about medical device. products or services relating to your treatment, case management Appointment Reminders. Your or care coordination, or alternative PHI may be used to tell or remind treatments, therapies, providers you about appointments. or care settings without Your Fundraising. Your PHI may be Marketing Authorization. used to contact you as a part of In addition, the Hospital and/or fundraising efforts, unless you Health Professionals may send you elect not to receive this type of treatment communications, unless information. you elect not to receive this type USES AND DISCLOSURES of communication, for which the REQUIRING YOUR WRITTEN Hospital and/or Health Professionals AUTHORIZATION may receive financial remuneration. Use or Disclosure With Your Sale of PHI. The Hospital and Authorization. For any purpose Health Professionals will not other than the ones described above, disclose your PHI without your your PHI may be used or disclosed authorization in exchange for direct only when you provide your written or indirect payment except in authorization on an authorization limited circumstances permitted by form (“Your Authorization”). For law. These circumstances include instance, you will need to execute an public health activities; research; authorization form before your PHI treatment of the individual; sale, can be sent to your life insurance transfer, merger or consolidation company or to the attorney of the Hospital; services provided representing the other party in by a business associate, pursuant litigation in which you are involved. to a business associate agreement; providing an individual with a copy Marketing. Your written of their PHI; and other purposes authorization (“Your Marketing deemed necessary and appropriate Authorization”) also must be by the U.S. Department of Health obtained prior to using your PHI to and Human Services (HHS). 21

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 21 3/13/20 11:30 AM YOUR PRIVACY MATTERS continued

Uses and Disclosures of those permitted by law, your written Your Highly Confidential authorization is required. Information. In addition, federal YOUR RIGHTS REGARDING and state law require special YOUR PROTECTED HEALTH

privacy protections for certain INFORMATION highly confidential information about you (“Highly Confidential Right to Request Additional Information”), including the subset Restrictions. You may request of your PHI that: (1) is maintained restrictions on the use and in psychotherapy notes; (2) is about disclosure of your PHI (1) for mental illness, mental retardation treatment, payment and healthcare and developmental disabilities; (3) operations, (2) to individuals (such as is about alcohol or drug abuse or a family member, other relative, close addiction; (4) is about HIV/AIDS personal friend or any other person testing, diagnosis or treatment; (5) identified by you) involved with is about communicable disease(s), your care or with payment related to including venereal disease(s); (6) is your care, or (3) to notify or assist in about genetic testing; (7) is about the notification of such individuals child abuse and neglect; (8) is about regarding your location and general domestic abuse of an adult; or (9) is condition. While all requests for about sexual assault. In order for your additional restrictions will be Highly Confidential Information to carefully considered, the Hospital be disclosed for a purpose other than and Health Professionals are not

22

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 22 3/13/20 11:30 AM required to agree to these requested Right to Inspect and Copy Your restrictions. Health Information. You may You also may request to restrict request access to your medical record disclosures of your PHI to your file and billing records maintained by health plan for payment and the Hospital and Health Professionals healthcare operations purposes (and in order to inspect and request not for treatment) if the disclosure copies of the records. Under limited pertains to a healthcare item or circumstances, you may be denied service for which you paid out-of- access to a portion of your records. pocket in full. The Hospital and If you desire access to your records, Health Professionals must agree please obtain a record request form to abide by the restriction to your from the Hospital Health Information health plan EXCEPT when the Management Office and submit disclosure is required by law. the completed form to the Hospital Health Information Management If you wish to request additional Office. If you request copies of paper restrictions, please obtain a request records, you will be charged in form from the Health Information accordance with federal and state law. Management Office and submit To the extent the request for records the completed form to the Health includes portions of records which are Information Management Office. A not in paper form (e.g., X-ray films), written response will be sent to you. you will be charged the reasonable Right to Receive Confidential cost of the copies. You also will be Communications. You may charged for the postage costs, if you request, and the Hospital and Health request that the copies be mailed to Professionals will accommodate, any you. However, you will not be charged reasonable written request for you for copies that are requested in order to receive your PHI by alternative to make or complete an application means of communication or at for a federal or state disability benefits alternative locations. program. Right to Revoke Your Right to Amend Your Records. Authorization. You may You have the right to request that PHI revoke Your Authorization, Your maintained in your medical record Marketing Authorization or any file or billing records be amended. written authorization obtained in If you desire to amend your records, connection with your PHI, except please obtain an amendment request to the extent that the Hospital form from the Hospital Health and/or Health Professionals have Information Management Office taken action in reliance upon it, and submit the completed form to by delivering a written revocation the Hospital Health Information statement to the Hospital Health Management Office. Your request will Information Management Office be accommodated unless the Hospital identified below. and/or Health Professionals believe

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 23 3/13/20 11:30 AM YOUR PRIVACY MATTERS continued that the information that would be Effective Date and Duration of Viruses or Bacteria amended is accurate and complete or This Notice other special circumstances apply. This Notice is effective on June 1, 2017. What's got you sick? Right to Receive an Accounting Right to Change Terms of of Disclosures. Upon request, This Notice. The terms of this you may obtain an accounting of Notice may be changed at any time. Antibiotics only treat bacterial infections. Viral illnesses cannot be treated with certain disclosures of your PHI made If this Notice is changed, the new antibiotics. When an antibiotic is not prescribed, ask your healthcare professional during any period of time prior to the notice terms may be made effective for tips on how to relieve symptoms and feel better. date of your request provided such for all PHI that the Hospital and period does not exceed six years and Health Professionals maintain, Illness Usual Cause Antibiotic does not apply to disclosures that including any information created Viruses Bacteria Needed occurred prior to April 14, 2003. or received prior to issuing the new If you request an accounting more notice. If this Notice is changed, Cold/Runny Nose NO than once during a twelve (12) month the new notice will be posted in Bronchitis/Chest Cold (in otherwise healthy children and adults) NO period, you will be charged for the waiting areas around the Hospital accounting statement. and on our internet site at www. Whooping Cough Yes CitizensBaptistMedicalCenter. Right to Receive Paper Copy Flu NO com . You also may obtain any new of This Notice. Upon request, notice by contacting the Hospital Strep Throat Yes you may obtain a paper copy of this Compliance & Privacy Officer. Notice, even if you have agreed to Sore Throat (except strep) NO receive such notice electronically. HOSPITAL CONTACTS Fluid in the Middle Ear (otitis media with effusion) NO For Further Information or Corporate Compliance & Complaints. If you desire further Privacy Office Urinary Tract Infection Yes information about your privacy rights, Tenet Healthcare are concerned that your privacy rights 14201 Dallas Parkway have been violated or disagree with Dallas, TX 75254 a decision made about access to your Email: PrivacySecurityOffice@ Antibiotics Aren’t Always the Answer PHI, you may contact the Hospital tenethealth.com Compliance & Privacy Office. You Ethics Action Line (EAL): also may file written complaints with 1-800-8-ETHICS the Director, Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Hospital Compliance & Privacy Office will provide you with the correct address for the Director. The Hospital and Health Professionals will not retaliate against you if you file a complaint with the Hospital Privacy www.cdc.gov/getsmart Office or the Director.

U.S. Department of Health and Human Services Centers for Disease Control and Prevention

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 24 3/13/20 11:30 AM Viruses or Bacteria What's got you sick?

Antibiotics only treat bacterial infections. Viral illnesses cannot be treated with antibiotics. When an antibiotic is not prescribed, ask your healthcare professional for tips on how to relieve symptoms and feel better.

Illness Usual Cause Antibiotic Viruses Bacteria Needed Cold/Runny Nose NO Bronchitis/Chest Cold (in otherwise healthy children and adults) NO Whooping Cough Yes Flu NO Strep Throat Yes Sore Throat (except strep) NO Fluid in the Middle Ear (otitis media with effusion) NO Urinary Tract Infection Yes

Antibiotics Aren’t Always the Answer

www.cdc.gov/getsmart

U.S. Department of Health and Human Services Centers for Disease Control and Prevention

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 25 3/13/20 11:30 AM ADVANCE DIRECTIVES A Simple and Smart Way to Take Charge of Your Care

Citizens Baptist Medical Center the same right to get the care you wants you to know that you need. In Alabama, you can set up an have a right to make an advance advance directive for healthcare. directive for healthcare. In fact, we The choices you have include: encourage you to do so. Your nurse A living will is used to write down will ask you if you have an advance ahead of time what kind of care you directive. If you brought your do or do not want if you are too sick advance directive with you to the to speak for yourself. hospital, the nurse can place a copy in your medical record. If you do A proxy can be part of a living not have an advance directive with will. You can pick a proxy to speak you, we will ask you to have a family for you and make the choices you member bring it to the hospital. would make if you could. If you pick a proxy, you should talk to that What is an advance directive? person ahead of time. Be sure that An advance directive is used to tell your proxy knows how you feel your doctor and family what kind about different kinds of medical of medical care you want if you treatments. Another way to pick a are too sick or hurt to talk or make proxy is to sign a durable power decisions. If you do not have an of attorney for healthcare. The advance directive, certain members person you pick does not need to be of your family will have to decide on a lawyer. your care. You can choose to have any or all You must be at least 19 years of of these three advance directives: age to set up an advance directive. living will, proxy and/or durable You must be able to think clearly power of attorney for healthcare. and make decisions for yourself Hospitals, home health agencies, when you set it up. You do not and nursing homes usually need a lawyer to set up an advance have forms you can fill out if you directive, but you may want to talk want to set up a living will, pick a with a lawyer before you take this proxy or set up a durable power of important step. Whether or not you attorney for healthcare. If you have have an advance directive, you have questions, you should ask your own 26

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 26 3/13/20 11:30 AM lawyer or call your local Council on law or the level of service provided Aging for help. in some areas. Citizens Baptist Medical Center hospitals will honor When you set up an advance advance directives for all patients directive, be sure to sign your 19 years and older in all inpatient name and write the date on any areas. form or paper you fill out. Talk to your family and doctor now so Advance directives may or may they will know and understand not be honored in outpatient your choices. Give them a copy of areas. Please discuss your advance what you have signed. If you go to directive with your physician prior the hospital, give a copy of your to having outpatient procedures. advance directive to the person Once you decide on the care you who admits you to the hospital. want or do not want, talk to your family. Explain why you want the What do I need to decide? You care you have decided on. Find out will need to decide if you want if they are willing to let your wishes treatments or machines that will be carried out. make you live longer even if you will never get better. An example Family members do not always of this is a machine that breathes want to go along with an advance for you. Some people do not want directive. This often happens when machines or treatments if they family members do not know about cannot get better. They may want a patient’s wishes ahead of time or food and water through a tube or if they are not sure about what has pain medicine. With an advance been decided. Talking with your directive, you decide what medical family ahead of time can prevent care you want. this problem.

Talk to your doctor and family You can change your mind at any now. The law says doctors, time. As long as you can speak for hospitals and nursing homes must yourself, you can change your mind follow advance directives, living at any time about what you have wills and proxies. Before you set written down. If you make changes, up an advance directive, talk to tear up your old papers and give your doctor. Find out if your doctor copies of any new forms or changes is willing to go along with your to everyone who needs to know. wishes. If your doctor does not If you have questions, please tell feel he or she can carry out your your nurse or dial 0 for the operator wishes, you can ask to go to another and ask for advance directive doctor, hospital or nursing home. assistance. Due to the types of visits, advance directives for end of life are not applicable either due to Alabama

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 27 3/13/20 11:30 AM Before You Leave the Hospital A successful recovery after your stay starts with a solid plan before you go.

CHECKLIST FOR DISCHARGE Make sure you have the following information before you leave the hospital.

p Discharge instructions. This n Home care: cooking, cleaning, includes why you were in the laundry, shopping

hospital, who cared for you, your n Healthcare: taking your procedures and medications. medications, doctor’s p Medication list. This includes all your appointments, physical new and former prescriptions, over- therapy, wound care, injections, the-counter medications, vitamins medical equipment and supplements. Ask if there are p Follow-up care instructions. any medications you can stop taking Beyond medication, this can include: or that are not good to take together. n foods or activities to avoid Also make sure you know why, how n tests or appointments and when to take each one. n how to care for incisions or use p Prescriptions. Check that equipment your has your new n warning signs to watch for prescriptions and that you have a plan to get them filled. n who to call with questions p Local resources. Ask your discharge planner for help finding local after-care services or other support groups. Try the teach-back method. Repeat back p After-hospital services. Know what you hear the how much support you’ll need in discharge planner say these areas: to make sure you understand the n Personal care: bathing, eating, details correctly. dressing, toileting 28

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 28 3/13/20 11:30 AM PLAN EARLY A Reason to Plan Early If you need a rehabilitation facility, Reduce your chances of being nursing home, skilled care or readmitted and increase your other service after your stay, chances for a healthy recovery by you’ll need time to find and weigh planning early. Take steps as soon your options. For help comparing as possible during your stay to plan services in your local area, go to: for a successful transition from the hospital. n www.medicare.gov/ nursinghomecompare/ To begin, ask to speak with your search.html discharge planner, and review the following: n www.medicare.gov/ homehealthcompare/ n your discharge summary and search.html discharge plan n www.qualitycheck.org n your complete medication list and instructions Not Ready to Leave? n your upcoming appointments You have the right to appeal n what to do if you don’t feel well your discharge if you don’t agree with the decision that you are ready to leave the hospital. Speak with your discharge planner or physician and share your concerns. You also may need to reach out to Medicare, Medicaid or your insurance company.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 29 3/13/20 11:30 AM BEFORE YOU LEAVE THE HOSPITAL continued TOP 10 QUESTIONS TO ASK BEFORE DISCHARGE 1. What number can I call 24 hours a day if I have questions or concerns? Who is my contact?

2. Has my follow-up appointment been scheduled? With who?

3. What are key warning signs I need to watch out for? Who do I call if they happen?

4. What special equipment do I need? What special instructions do I need (wound care, injections, etc.)?

5. What kinds of activities and foods are limited? For how long?

6. Do the doctors caring for me after my stay have access to my test results and medications? Do I need follow-up tests?

7. Are my new medications safe to take with my other medications, vitamins or supplements?

8. Do I know how and when to take my medications and how I will get prescriptions filled?

9. Who will provide the extra personal, home or healthcare services I may need?

10. Who can help me if I have concerns about medical costs?

Need Medical Equipment or Supplies? If you need durable medical equipment (walker, wheelchair, hospital bed, oxygen, etc.), Medicare will only cover the cost if you use an approved supplier. To find one in your area, visit www.medicare.gov and select “Where can I get covered medical items?” or call 1-800-MEDICARE (800-633-4227).

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 30 3/13/20 11:30 AM AFTER-HOSPITAL CARE

Quick Guide to Recovery Options for After Your Stay

After-hospital care that fits your hospital, but can’t be cared for at needs is important. Make sure you home. Includes: all daily living and understand what your hospital staff personal care services, 24-hour recommends for you. skilled nursing care, plus social Home Healthcare—care provided activities and events. Special units by professionals in your home to often available for people with help maintain or restore health. Can Alzheimer’s disease or memory loss. include: home care services such as Hospice—care program that housekeeping and meal preparation; provides support for terminally ill personal care services such as patients and families in hospitals, bathing, dressing or eating; and facilities or homes. Includes: healthcare services such as physical 24-hour help with pain control, therapy or skilled nursing. symptom management and Independent Living—communities emotional or spiritual support. with individual, private apartments Rehabilitation—comprehensive or homes. Includes: meals, therapy that aims to improve housekeeping, maintenance, functional abilities and quality of social activities and possibly life after a life-changing event. transportation. Healthcare services like skilled nursing usually are not To get started evaluating or standard. finding after-hospital care —individual units resources in your area, visit: or apartments, usually in a long- n Eldercare Locator term care facility. Includes: home eldercare.acl.gov

and personal care services, as well n National Respite Network and as help managing health conditions Resource Center and medication routines—plus www.archrespite.org social activities and transportation. Medical staff is on-site 24 hours. You also can talk to your case manager or social worker for help Nursing Home—long-term care finding the right after-hospital care. facility for those who don’t need a

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 31 3/13/20 11:30 AM UNDERSTANDING YOUR BILL Take Charge of Your Payments

The hospital billing process may Medicare seem complicated, but you can feel If you have Medicare, you’ll have to more in control by knowing exactly fill out an MSP (Medicare Secondary what your bill covers. For example, if Payer) form. This ensures that you stay overnight, you can expect to Medicare only pays for services see charges for your room, meals, 24- not covered by other insurance you hour nursing care and medications. may have. If you have secondary The bill also will show charges for insurance, this usually covers any special services, such as X-rays Medicare deductibles. If you don’t and lab tests. You’ll receive bills for have secondary insurance, you need doctors, surgeons and specialists to pay these amounts yourself. separately from the hospital. Also be sure to read your quarterly MSNs (Medicare Summary Notices) Commonly Confused Terms to review: • Deductible: The amount you n the amount your doctor(s) charged owe each year before your n the amount Medicare approved insurance begins making and paid payments. n the amount you owe • Co-payment: A flat fee you pay n your current deductible status for a specific service, usually If you have questions, call the due at the time of service. customer service number listed on • Coinsurance: The portion of your statement. your medical expenses that you’re personally responsible KEEPING TRACK for paying. For example, your One of the key ways to feel well- insurance may cover 80 percent informed and less overwhelmed of a bill, while you have to pay about the hospital billing process is the remaining 20 percent. to stay organized. Keep all of your statements and bills together and review each one as it arrives.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 32 3/13/20 11:30 AM Commercial Insurance Need Help? Providers If you don’t understand something If you use a commercial insurance on your bill, or if you’re having provider, then the hospital forwards trouble paying your bills, let us your claim based on the information know. A patient representative can you provide at registration. About a work with you and guide you to month after you leave the hospital, services that can help. you’ll get an explanation of benefits (EOB) statement from your Self-Pay Patients and Payment insurance provider. This isn’t a bill. Arrangements EOBs show: If you’re planning to pay your bills n the amount billed by your without help from Medicare or a doctor or hospital commercial insurance provider, n how much of that cost is then you’ll get bills directly from the covered by your insurance hospital. When the first bill arrives, call the hospital’s financial services n how much you owe department to set up a payment plan. Review this and all other bill- Communicate with the financial related documents carefully. If you have questions, contact your services department as soon as doctor or the customer service possible. If you don’t set up a number listed on the statement. payment plan, or if you stop making payments, then your account may be placed with a collection agency. The hospital wants to work with you, so reach out with any questions or concerns you have.

Understanding Coordination of Benefits (COB) COBs happen when you’re covered under two or more insurance companies. This may occur when spouses or partners are listed on each other’s insurance policies, or when both parents carry their children on their individual policies. To prevent duplicate payments, COBs determine the primary payer. You choose who this is when you’re admitted. Insurance companies usually request completed COBs from you before paying a claim, so make sure you address these requests quickly.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 33 3/16/20 9:16 AM SPOTLIGHT ON HEALTH: Heart Attack & Stroke Recognize the Signs and Get Help Quickly

A heart attack or stroke is a medical emergency and every second counts. The faster you or a loved one recognizes the symptoms and gets help, the better your chances of surviving, with the least amount of damage to your heart or brain. Once you’ve had an event, you’re at greater risk of having another in the future. But keep in mind that the symptoms of a second event can be different from what you experienced the first time. Heart Attack Warning Signs The main symptom of a heart attack is chest pain or discomfort. It also can feel like pressure, fullness or squeezing in your chest. These feelings may start gradually and get worse, or they may come and go. The symptoms of a heart attack can be different for women. Women also may have unusual heartburn, shortness of breath, lightheadedness, nausea, or they may feel tired or anxious weeks before a heart attack. Stroke Warning Signs Think F.A.S.T. when it comes to recognizing a stroke: F ACE DROOPING: Does one side of your face droop or is it numb? Try to smile. A RM WEAKNESS: Is one arm weak or numb? Raise both arms. Does one arm drift downward? S PEECH DIFFICULTY: Is your speech slurred? Are you unable to speak? Try to say a simple sentence like “The sky is blue.” T IME TO CALL 911: If you notice any of these symptoms, even if they go away, call 911 right away.

Other sudden stroke symptoms can include: n numbness or weakness in your leg n trouble walking, dizziness, loss of

balance and coordination n confusion or trouble understanding n severe headache with no known n trouble seeing in one or both eyes cause

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 34 3/13/20 11:30 AM SPOTLIGHT ON HEALTH: Stop Smoking Reduce Your Chances of Returning to the Hospital

No matter how long you’ve been a Be prepared to have nicotine smoker, it’s never too late to quit cravings. They usually pass soon, this unhealthy habit. The benefits so wait it out. The good news is start right away and last a lifetime: that they become weaker and less n 20 MINUTES after quitting, frequent the longer you go without your heart rate and blood smoking. When a craving hits, take pressure drop. a walk, call a friend or do something else you enjoy. n 2 WEEKS TO 3 MONTHS after quitting, your circulation improves and your lungs work better. 3 Tips to Help You Quit n 1 YEAR after quitting, your 1. Fight the Urge risk of heart disease is half that Don’t let yourself think that you of a smoker. can have just one cigarette, but n 5 YEARS after quitting, your risk if you do slip, start again and of mouth, throat, esophagus and make tomorrow your new first bladder cancers is cut in half. day to quit. n 10 YEARS after quitting, your 2. Get Moving risk of lung cancer is half that Exercise is a good way to keep of a smoker. your mind off cigarettes. The longer you go without smoking, n 15 YEARS after quitting, your risk of heart disease is the same as a the better you can breathe and nonsmoker’s. the easier it will be to exercise. 3. Keep Your Ready, Set, Quit! Mouth Busy Now that you’ve decided to quit, Try toothpicks, take it one day at a time. Remind celery, sugarless yourself that you are in control—you gum or sugar-free can choose to smoke or not. Make lollipops. a commitment to yourself. Write down why you want to quit and read it every day.

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 35 3/13/20 11:30 AM MEDICATION SIDE EFFECTS

Learn More About the Medications You Take

This chart provides information about some of the most common side effects associated with medications you may receive during your stay. If you have any questions or concerns, please ask your nurse, doctor or pharmacist.

MEDICATION: GENERIC INDICATION MOST COMMON SIDE EFFECTS (BRAND) n Fentanyl Pain Constipation, nausea/vomiting, n Hydrocodone/ rash/itching Acetaminophen May cause drowsiness or dizziness (Vicodin, Lortab, Norco) n Hydromorphone (Dilaudid) n Morphine (MS Contin) n Oxycodone/ Acetaminophen (Percocet) n Tramadol (Ultram) n Butorphanol (Stadol)

n Ondansetron (Zofran) Nausea/vomiting Constipation and fatigue n Prochlorperazine May cause headache (Compazine) n Promethazine (Phenergan) n Scopolamine patch

n Famotidine (Pepcid) Heartburn/ Diarrhea n reflux stomach ulcer Pantoprazole (Protonix) May cause headache n Sucralfate (Carafate) n Lansoprazole (Prevacid)

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 36 3/13/20 11:30 AM MEDICATION: GENERIC INDICATION MOST COMMON SIDE EFFECTS (BRAND) n Celebrex Anti-inflammatory Insomnia n Dexamethasone May cause upset stomach (Decadron) n Hydrocortisone (Cortef) n Ibuprofen (Motrin) n Ketorolac (Toradol) n Methylprednisolone (Medrol) n Celecoxib (Celebrex) n Prednisone (Deltazone)

n Beta Blockers Decrease blood Cough (ACE inhibitors) o Atenolol (Tenormin) pressure and heart o Carvedilol (Coreg) rate/heart attack/ May cause drowsiness or dizziness o Labetalol (Trandate) heart failure o Metoprolol (Lopressor) o Bisoprolol (Ziac) n ACE Inhibitors o Benazepril (Lotensin) o Captopril (Capoten) o Enalapril (Vasotec) o Lisinopril (Zestril) o Quinapril (Accupril) o Ramipril (Altace) n ARBs o Irbesartan (Avapro)

n Apixaban (Eliquis) Prevention/ Risk of bleeding n Aspirin treatment for blood clot formation May cause upset stomach n Clopidogrel (Plavix) n Dabigatran (Pradaxa) n Enoxaparin (Lovenox) n Heparin n Prasugrel (Effient) n Rivaroxaban (Xarelto) n Ticagrelor (Brilinta) n Warfarin (Coumadin) n Edoxaban (Savaysa) n Fondaparinux (Arixtra)

n Alprazolam (Xanax) Anti-anxiety, May cause drowsiness or dizziness n sedation or insomnia Clonazepam (Klonopin) May cause headache n Diazepam (Valium) n Lorazepam (Ativan) n Temazepam (Restoril) n Zolpidem (Ambien) 37

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 37 3/13/20 11:30 AM MEDICATION SIDE EFFECTS continued

MEDICATION: GENERIC INDICATION MOST COMMON SIDE EFFECTS (BRAND) n Bumetanide (Bumex) Diuretic (to reduce Electrolyte depletion (may cause n Furosemide (Lasix) fluid retention) sodium or potassium levels in your blood to change) n Hydrochlorothiazide (Microzide) Dehydration, dizziness, decreased n Spironolactone blood pressure (Aldactone) n Torsemide (Demadex)

n Atorvastatin (Lipitor) Decrease cholestrol Muscle pain n Ezetimbe (Zetia) May cause headache May cause upset stomach

n Amoxicillin/Clavulanate Antibiotic for Rash/flushing (Augmentin) bacterial infection May cause headache n Cephalosporin class (Ceftin, Ancef, Rocephin, May cause upset stomach Mefoxin) n Ciprofloxacin (Cipro) n Clindamycin (Cleocin) n Levofloxacin (Levaquin) n Meropenem (Merrem) n Metronidazole (Flagyl) n Piperacillin/Tazobactam (Zosyn) n Vancomycin n Cefuroxime (Ceftin) n Cefazolin (Ancef) n Ceftriaxone (Rocephin) n Cefepime (Maxipime) n Cephalexin (Keflex) n Aztreonam (Azactam) n Doxycycline (Vibramycin, Monodox) n Daptomycin (Cubicin) n Linezolid (Zyvox) n Penicillin G n Penicillin Benzathine (Bicillin LA and CR) n Ampicillin (Principen) n Ampicillin/Sulbactam (Unasyn)

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AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 38 3/13/20 11:30 AM GAMES

Sudoku Fill in the blank squares so that each row, each column and each 3-by-3 block contain all of the digits 1 through 9.

Answer Key How did you do? Check your answers here:

Source: www.sudoku-puzzles.net 39

AL06225G01_Citizens BaptistMC_ED_Tenet_A1.indd 39 3/13/20 11:30 AM NOTES

Tell friends and family not to visit if they are sick. And make sure ? all your guests wash their hands when they enter your room.

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