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Welcome to Saint John’s Health Center
Thank you for entrusting your care to Saint John’s. The information included in this
pamphlet will answer many of the questions frequently asked by patients and their
families. We encourage you to review the contents carefully. If you have additional
questions, please contact any member of Saint John’s staff and we will be happy to assist
you.

You are the center of the health care team! Your health care safety is our priority. You
and your family can play a vital role by becoming active, involved, and informed. Speak
up!

Speak up if you have questions or concerns. If you don’t understand, ask again.
Pay attention to the care you receive. Make sure you are getting the right treatments and
medications by the right health care professionals.
Educate yourself about your diagnosis, the medical tests you are undergoing, and your
treatment plan.
Ask a trusted family member or friend to be your advocate.
Know what medications you take and why you take them.
Use a hospital that has undergone a rigorous on-site evaluation against established,
state-of-the-art quality and safety standards, such as those approved by the Joint Commission.
Participate in all decisions about your treatment. You are the center of the health care team!

For Your Safety and Security:
We offer the following suggestions to ensure your safety as a patient at Saint John’s:

• Be sure to obtain assistance before getting out of bed for the first time after surgery, and whenever assistance is needed.
• Always obtain assistance when getting in or out of a wheelchair.
• Always wear non-skid slippers when walking around the unit where you are staying.
If you did not bring yours from home, we have disposable slippers.
• National Electric Code safety regulations require that all electrical appliances used in patient care areas must pass a safety inspection by the Health Center’s biomedical electronics personnel. If you have brought an electric-powered appliance from home, please ask your nurse to arrange an inspection. Battery-powered laptop computers or radios may be used, except in a room where oxygen is in use.

Our Security Department is available 24 hours a day to address any security concerns,
and can assist you in securing any valuables you may have brought to the hospital. Saint
John’s Health Center cannot be responsible for valuables brought to our hospital unless
the item is stored in our safe. Staff will help you and provide you with a receipt so that
you may claim your item upon discharge.

Saint John’s Catholic Traditions:
Saint John’s was founded as, and remains today, a ministry of the Sisters of Charity of
Leavenworth and is a Catholic healthcare provider.

As a Catholic provider, Saint John’s observes the Ethical and Religious Directives for
Catholic Health Services, as developed by the National Conference of Catholic Bishops
and promulgated in the Archdiocese of Los Angeles [4th Edition, 2001].

Questions regarding the Ethical and Religious Directives may be directed to the
Vice President, Mission and Ethics at (310) 829-8060.

Patients’ Rights:
You have the right to:

1. Considerate and respectful care, and to be made comfortable. You have the right to respect for your cultural, psychosocial, spiritual, and personal values, beliefs, and preferences.
2. Have a family member (or other representative of your choosing) and your own physician notified promptly of your admission to the hospital.
3. Know the name of the physician who has primary responsibility for coordinating your care and the names and professional relationships of other physicians and non-physicians who will see you.
4. Receive information about your health status, diagnosis, prognosis, course of treatment, prospects for recovery and outcomes of care (including unanticipated outcomes) in terms you can understand. You have the right to effective communication and to participate in the development and implementation of your plan of care. You have the right to participate in ethical questions that arise in the course of your care, including issues of conflict resolution, withholding resuscitative services, and forgoing or withdrawing life-sustaining treatment.
5. Make decisions regarding medical care, and receive as much information about any proposed treatment or procedure as you may need in order to give informed consent or to refuse a course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or nontreatment and the risks involved in each, and the name of the person who will carry out the procedure or treatment.
6. Request or refuse treatment, to the extent permitted by law. However, you do not have the right to demand inappropriate or medically unnecessary treatment or services. You have the right to leave the hospital even against the advice of physicians, to the extent permitted by law.
7. Be advised if the hospital/personal physician proposes to engage in or perform human experimentation affecting your care or treatment. You have the right to refuse to participate in such research projects.
8. Reasonable responses to any reasonable requests made for service.
9. Appropriate assessment and management of your pain, information about pain, pain relief measures and to participate in pain management decisions. You may request or reject the use of any or all modalities to relieve the pain, including opiate medication, if you suffer from severe chronic intractable pain. The doctor may refuse to prescribe opiate medication, but if so, must inform you that there are physicians who specialize in the treatment of severe chronic pain with methods that include the use of opiates.
10. Formulate advance directives. This includes designating a decision maker if you become incapable of understanding a proposed treatment or become unable to communicate your wishes regarding care. Hospital staff and practitioners who provide care in the hospital shall comply with these directives. All patient rights apply to the person who has legal responsibility to make decisions regarding medical care on your behalf.
11. Have personal privacy respected. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. You have the right to be told the reason for the presence of any individual. You have the right to have visitors leave prior to an examination and when treatment issues are being discussed. Privacy curtains will be used in semi-private rooms.
12. Confidential treatment of all communications and records pertaining to your care and stay in the hospital. You will receive a separate “Notice of Privacy Practices” that explains your privacy rights in detail and how we may use and disclose your protected health information. For a copy of the Notice of Privacy Practices please ask our registration personnel or find it in the registration kiosk. This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
13. Receive care in a safe setting, free from mental, physical, sexual or verbal abuse and neglect, exploitation or harassment. You have the right to access protective and advocacy services including notifying government agencies of neglect or abuse.
14. Be free from restraints and seclusion of any form used as a means of coercion, discipline, convenience or retaliation by staff.
15. Reasonable continuity of care and to know in advance the time and location of appointments as well as the identity of the persons providing the care.
16. Be informed by the physician, or a delegate of the physician, of continuing health care requirements and options following discharge from the hospital. You have the right to be involved in the development and implementation of your discharge plan. Upon your request, a friend or family member may be provided with this information also.
17. Know which hospital rules and policies apply to your conduct while a patient.
18. Designate visitors of your choosing, if you have decision-making capacity, whether or not the visitor is related by blood or marriage, unless:
    
    • No visitors are allowed.
    • The facility reasonably determines that the presence of a particular visitor would endanger the health or safety of a patient, a member of the health facility staff or other visitor to the health facility, or would significantly disrupt the operations of the facility.
    • You have told the health facility staff that you no longer want a particular person to visit. However, a health facility may establish reasonable restrictions upon visitation, including restrictions upon the hours of visitation and number of visitors.
19. Have your wishes considered, if you lack decision-making capacity, for the purposes of determining who may visit. The method of that consideration will be disclosed in the hospital policy on visitation. At a minimum, the hospital shall include any persons living in your household.
20. Examine and receive an explanation of the hospital’s bill regardless of the source of payment.
21. Exercise these rights without regard to sex, race, color, religion, ancestry, national origin, age, disability, medical condition, marital status, sexual orientation, educational background, economic status or the source of payment for care.
22. File a grievance. If you want to file a grievance with this hospital, you may do so by calling 310-829-8478 or by writing to the Quality Department at Saint John’s, 1328 22nd Street, Santa Monica, CA 90404. Each grievance will be reviewed and you will be provided with follow-up. The follow-up, with written response, will contain the name of a person to contact at the hospital, the steps taken to investigate the process, the results of the grievance process, and the date of completion of the grievance process. Concerns regarding quality of care or premature discharge will also be referred to the appropriate entity.
23. File a complaint with the California Department of Public Health regardless of whether you use the hospital’s grievance process. The Department of Public Health may be contacted at 800-228-1019 [TDD 800-735-2922] or by writing to the Department of Public Health, Health Facilities Division, 5555 Ferguson Dr., Suite 3201, Commerce, CA 90022.

We are a Joint Commission accredited facility. In our continual pursuit of excellence, if there is a concern regarding patient care or safety, please notify your caregiver or any member of our management team. If you need immediate assistance after business hours, please contact the hospital operator who will connect you to the hospital nursing supervisor. If your concerns cannot be resolved through the hospital, you may contact the Joint Commission’s Office of Quality Monitoring to report any concerns or register complaints, either by calling 1-800-994-6610 or emailing complaint@jointcommission.org.

These Patient Rights combine Title 22 and other California laws, The Joint Commission and Medicare Conditions of Participation requirements. (3/08)

IMPORTANT PHONE NUMBERS:
Main number: (310) 829-5511
Billing Inquiries: (310) 829-8007
Admissions and Financial Counseling: (310) 829-8376
Emergency Room: (310) 829-8212
Physician Referral: (888) ASK-SJHC
Foundation: (310) 829-8424
Employment Information: (310) 829-8017

Pain Management
Our Commitment to Your Pain Relief
Relieving your pain is important to all of us at Saint John’s. Keeping pain under control helps you recover faster with fewer problems. Some pain is unavoidable, but most pain can be prevented or reduced. We will do everything possible to minimize your pain. Please let us know how we can help you.
How We View Your Pain
Pain is whatever you say it is and occurs whenever you say it does.
How to Rate Your Pain
It is easier for us to understand your pain if you can rate it. We use a zero-to-10 Pain Rating Scale to talk about pain. (Ten is the worst pain you can imagine.)

Please rate your pain from zero to 10:

Patient Responsibilities:
Patients are responsible for

• Providing information: Patients and families, as appropriate, must provide, to the best of their knowledge, accurate and complete information about present complaints, past illnesses, hospitalization, medications, and other matters relating to their health. Patients and their families must report perceived risks in their care and unexpected changes in their condition.
• Asking questions. Patients and families, as appropriate, must ask questions when they do not understand their care, treatment, and service or what they are expected to do.
• Following instructions. Patients and their families must follow the care, treatment, and service plan developed. They should express any concerns about their ability to follow the proposed care plan or course of care, treatment, and services. The hospital makes every effort to adapt the plan to the specific needs and limitations of the patients. When such adaptations to the care, treatment, and service plan are not recommended, patients and their families are informed of the consequences of the care, treatment, and service alternatives and not following the proposed course.
• Accepting consequences. Patients and their families are responsible for the outcomes if they do not follow the care, treatment, and service plan.
• Following rules and regulations. Patients and their families must follow the hospital’s rules and regulations.
  Showing respect and consideration. Patients and their families must be considerate of the hospital’s staff and property, as well as other patients and their property.
• Meeting financial commitments. Patients and their families should promptly meet any financial obligation agreed to with the hospital.

Advance Health Care Directives and Your Right to Make Decisions About Medical Treatment:
This section explains your right to make health care decisions and how you can plan now for your medical care if you are unable to speak for yourself in the future. A federal law requires us to give you this information. We hope this information will help increase your control over your medical treatment.

Who decides about my treatment?
Your doctors will give you information and advice about treatment. You have the right to choose. You can say “Yes” to treatments you want. You can say “No” to any treatment that you don’t want—even if the treatment might keep you alive longer.

How do I know what I want?
Your doctor must tell you about your medical condition and about what different treatments and pain management alternatives can do for you. Many treatments have “side effects.” Your doctor must offer you information about problems that medical treatment is likely to cause you. Often, more than one treatment might help you—and people have different ideas about what is best. Your doctor can tell you which treatments are available to you, but your doctor can’t choose for you. That choice is yours to make and depends on what is important to you.

Can other people help with my decisions?
Yes. Patients often turn to their relatives and close friends for help in making medical decisions. These people can help you think about the choices you face. You can ask the doctors and nurses to talk with your relatives and friends. They can ask the doctors and nurses questions for you.

Can I choose a relative or friend to make health care decisions for me?
Yes. You may tell your doctor that you want someone else to make health care decisions for you. Ask the doctor to list that person as your health care “surrogate” in your medical record. The surrogate’s control over your medical decisions is effective only during treatment for your current illness or injury, or, if you are in a medical facility, until you leave the facility.

What if I become too sick to make my own health care decisions?
If you haven’t named a surrogate, your doctor will ask your closest available relative or friend to help decide what is best for you. Most of the time that works. But sometimes everyone doesn’t agree about what to do. That’s why it is helpful if you can say in advance what you want to happen if you can’t speak for yourself.

Do I have to wait until I am sick to express my wishes about health care?
No. In fact, it is better to choose before you get very sick or have to go into a hospital, nursing home, or other health care facility. You can use an Advance Health Care Directive to say who you want to speak for you and what kind of treatments you want. These documents are called “advance” because you prepare one before health care decisions need to be made. They are called “directives” because they state who will speak on your behalf and what should be done. In California, the part of an advance directive you can use to appoint an agent to make healthcare decisions is called a Power of Attorney for Health Care. The part where you can express what you want done is called an Individual Health Care Instruction.

Who can make an advance directive?
You can if you are 18 years or older and are capable of making your own medical decisions. You do not need a lawyer.

Who can I name as my agent?
You can choose an adult relative or any other person you trust to speak for you when medical decisions must be made.

When does my agent begin making my medical decisions?
Usually, a health care agent will make decisions only after you lose the ability to make them yourself. But, if you wish, you can state in the Power of Attorney for Health Care that you want the agent to begin making decisions immediately.

How does my agent know what I want?
After you choose your agent, talk to that person about what you want. Sometimes treatment decisions are hard to make, and it truly helps if your agent knows what you want. You can also write your wishes down in your advance directive.

What if I don’t want to name an agent?
You can still write out your wishes in your advance directive, without naming an agent. You can say that you want to have your life continued as long as possible. Or you can say that you would not want treatment to continue your life. Also, you can express your wishes about the use of pain relief or any other type of medical treatment. Even if you have not filled out a written Individual Health Care Instruction, you can discuss your wishes with your doctor, and ask your doctor to list those wishes in your medical record. Or you can discuss your wishes with your family members or friends. But it will probably be easier to follow your wishes if you write them down.

What if I change my mind?
You can change or cancel your advance directive at any time, as long as you can communicate your wishes. To change the person you want to make your health care decisions, you must sign a statement or tell the doctor in charge of your care.

What happens when someone else makes decisions about my treatment?
The same rules apply to anyone who makes health care decisions on your behalf—a health care agent, a surrogate whose name you gave to your doctor, or a person appointed by a court to make decisions for you. All are required to follow your Health Care Instructions or, if none, your general wishes about treatment, including stopping treatment. If your treatment wishes are not known, the surrogate must try to determine what is in your best interest.
The people providing your health care must follow the decisions of your agent or surrogate unless a requested treatment would be bad medical practice or ineffective in helping you. If this causes disagreement that cannot be worked out, the provider must make a reasonable effort to find another health care provider to take over your treatment.

Will I still be treated if I don’t make an advance directive?
Absolutely. You will still get medical treatment. We just want you to know that, if you become too sick to make decisions, someone else will have to make them for you.

Remember that:
A Power of Attorney for Health Care lets you name an agent to make decisions for you. Your agent can make most medical decisions—not just those about life sustaining treatment—when you can’t speak for yourself. You can also let your agent make decisions earlier, if you wish.
You can create an Individual Health Care Instruction by writing down your wishes about health care or by talking with your doctor and asking the doctor to record your wishes in your medical file. If you know when you would or would not want certain types of treatment, an Instruction provides a good way to make your wishes clear to your doctor and to anyone else who may be involved in deciding about treatment on your behalf.
These two types of Advance Health Care Directives may be used together or separately.

How can I get more information about an Advance Directive?
Ask your doctor, nurse, social worker, or health care provider to get more information for you. You can have a lawyer write an advance directive for you, or you can complete an Advance Directive by filling in the blanks on a form.

For more information about Advance Directives, you may call the Saint John’s Ethics Consultation Service at 310-582-7140.

To implement Public Law 101-508, the California Consortium on Patient Self-Determination prepared this brochure in 1991; it was revised in 2000 by the California Department of Health Services, with input from members of the consortium and other interested parties, to reflect changes in state law.

Long Term Care Resources
If you or a loved one anticipate a need for long term care, either at the time of discharge or in the future, please ask your Case Manager or Social Worker for assistance. Your may also obtain information about community-based long-term care options from the following public or not-for-profit agencies:

City of Los Angeles Department of Aging:
http://aging.lacity.org
(213) 252-4000 or (800) 510-2020
(213) 252-4030 for information and assistance

City of Los Angeles Area Agency on Aging (AAA):
http://css.lacounty.gov
(800) 510-2020 or (866) 452-2489

Westside Center for Independent Living (WCIL):
http://www.wcil.org
(888) 851-WCIL [(888) 851-9245)]

WISE-Healthy Aging:
http://www.wiseandhealthyaging.org/
(310) 394-9871, ext. 217

SMOKING CESSATION

American Cancer Society:
(800) 227-2345
Support Groups
Self Help Materials

California Health Department:
(800) NOBUTTS
Literatures
Referral for local smoking cessation programs

American Lung Association:
(800) 586-4872
Self Help Kit with audio tape
On line smoking cessation program
Support Groups

Nicotine Anonymous:
(800) 642-0666
Support group based on the 12-step Alocoholics Anonymous program

The above are referrals to community resources. Saint John’s Health Center does not endorse or recommend any particular resources. Saint John’s Health Center did not intentionally exclude any local resources from this list. Each recipient of this list is responsible for investigating and deciding whether any of the resources listed will be suitable to each recipient’s needs. Saint John’s Health Center cannot or does not vouch for agencies/organizations and their employees. Saint John’s Health Center disclaims any liability to any person, organization or agency for any loss or damage caused by omissions or errors in this list or for the action or conduct of any organization or individual contained in this list of referral resources.

Smoking Policy:
Saint John’s Health Center is a smoke-free facility. Smoking is not allowed in any building. The city of Santa Monica enforces strict no smoking ordinances that can result in expensive fines.
Saint John’s offers a highly effective, seven-week Freedom from Smoking program.
Please call 310-829-8453 for more information.