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Patient Financial Services |
Patient Handbook |
Business Office FAQ
Advance Directive Form |
Contracted Insurance Providers
Patient Information
Patient Handbook
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Mission, Vision, Purpose, Values, and Ethics |

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Mission Statement
The mission of Crittenden County Hospital is to provide high-quality, cost-effective health care in a positive and productive work environment.
Vision Statement
Crittenden Health Systems will be the best health care organization in the nation as viewed by its patients, the community, the board, its physicians, and its staff in providing a continuum of primary care.
Purpose
To make our patients healthier through caring service.
Values

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Respect: | 

A high regard for the worth of each person. |

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Quality Service: | 

Commitment to excellence through teamwork and a focus on continuous improvement. |

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Teamwork: | 

Working together to achieve a common goal. |

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Simplicity: | 

Honesty, integrity, and straightforwardness. |

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Creativity: | 

Innovative, imaginative, and willing to change. |
Ethics
You will be asked during the admission process if you have ever executed an Advance Directive. An Advance Directive may include a Living Will, a Designation of Care Surrogate, or an anatomical gift donation.
If you have an Advance Directive in place, the hospital staff and physicians will make every effort to comply with your expressed wishes to the extent permitted by existing laws. If the hospital or physicians are unable to comply with the Advance Directive and no alternatives can be agreed upon, then arrangements will be made to transport you to a hospital that can comply with your wishes.
When appropriate, and in keeping with Kentucky state regulations, family members will be asked of your expressed desire or their wishes in regards to organ donation to the Kentucky Organ Donor Affiliates (KODA).
Progress and knowledge in the medical field have permitted many advancements and procedures. Such progress may sometimes create an ethical dilemma for you and your family. We believe in your rights and those of your family in choosing and directing your medical treatment.
An Ethics Committee comprised of physicians, a chaplain, and representatives from Nursing Services and other disciplines, serves as an advisory committee to physicians, other health care professionals, patients, and patients' families in making decisions when dilemmas arise from ethical issues in patient care.
A hospital chaplain is on call at all times to help you with ethical and religious decisions and to offer uncompromised acceptance, care, and hope.
If you need to talk to a member of the Ethics Committee or the Chaplain on call, ask your nurse or call the customer service line, extension 1149.
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Patients are admitted upon orders from their health care provider, either as an inpatient or for outpatient observation. The decision to admit on an outpatient observation level or at the inpatient level rests with your health care provider.
Inpatient admissions may be at any of the following levels:

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1.) Intensive Care |

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2.) Acute Care |

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3.) Skilled Care |
The appropriate level of service for your inpatient admission is also the health care provider’s decision in collaboration with Care Management staff.
Identification Bracelets
An identification bracelet will be placed upon your wrist following admission. This bracelet contains your name and patient number to help the people caring for you. If you have any known medical allergies, a red band that lists these allergies will also be placed upon your wrist.
For Your Protection
You may notice hospital personnel wearing gloves, masks, and other special clothing while performing certain procedures. These items are designed to prevent the spread of infection and are for your protection and the protection of others.
Fire Drills
Government regulations require hospitals to conduct regular fire drills. During all drills, alarms will ring and patient doors will be closed as a matter of routine. We appreciate your cooperation in following your nurse’s instructions during practice drills.
Valuables
Since Crittenden County Hospital cannot be responsible for articles kept in patient rooms, we ask that all valuables be sent home. If this is not possible, ask your nurse to contact the Business Office. They will arrange to have your valuables stored in the hospital safe until you are discharged.
Smoking Policy
Effective September 1, 1992, Crittenden County Hospital recognized the need to set high standards of health awareness and became a smoke-free health care facility.
Patients may not smoke in their rooms. Patients and visitors are allowed to smoke in the courtyard area with the exception of patients in the ICU/CCU. Patients who are ill enough to be in this unit are not allowed to smoke. Visitors may also smoke outside the front lobby area.
Patient Meals
Meals are one of the most important aspects of your hospital stay. A well-balanced diet with proper nutrients aids in your treatment, recovery, and continued health. Patient meals are normally served at the following times:

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Breakfast: | 
6:45 a.m. – 7:00 a.m. |

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Lunch: | 
11:45 a.m. – 12:15 p.m. |

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Supper: | 
4:45 p.m. – 5:00 p.m. |
Your physician prescribes your diet. A representative from the Food and Nutrition Services Department will visit your room to obtain your food preferences and discuss any special dietary needs.
Hospital Cafeteria
From Monday through Friday, the hospital cafeteria is open from 7:00 a.m. to 7:00 p.m. to meet the needs of visitors, hospital employees, medical staff members, and volunteers. Hot meals are served in the Cafeteria during the following hours:

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Breakfast: | 
7:00 a.m. – 9:30 a.m. |

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Lunch: | 
11:00 a.m. – 2:00 p.m. |

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Supper: | 
5:30 p.m. – 7:00 p.m. |

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* Canteen: Open 24 hours per day.
The Canteen is located near the front lobby. |
On Saturday and Sunday, the hospital cafeteria is open from 7:00 a.m. to 2:00 p.m. Hot meals are served in the cafeteria during the following hours:

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Breakfast: | 
7:00 a.m. – 9:30 a.m. |

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Lunch: | 
11:00 a.m. – 2:00 p.m. |

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* Canteen: Open 24 hours per day.
The Canteen is located near the front lobby. |
Your Room
To provide the most efficient care, rooms are arranged by medical specialty. We make every effort to place you in the appropriate unit and in the type of room you request. During times when many people need to be hospitalized, this may not be possible. If we cannot honor your request on admission, we will transfer you when another room is available. We appreciate your cooperation in accepting room assignments.
If you request a private room, a three-day deposit of $25 per day or $75 must be paid in advance.
Telephone
For your convenience, telephone service is available in your room. To make calls to a local number, dial 9 then the seven-digit number you wish to reach. To place a long-distance call, call the switchboard by dialing “0”. The hospital operator will connect you with the outside operator to place a collect or calling-card call, or to charge the call to your home telephone number. To call into a patient’s room from outside the hospital, dial 965-1 plus the patient’s room number.
Hospital Extensions:
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| Auxiliary: | 1059 | CCU Waiting Room: | 231 |
| Gift Shop: | 1086 | ER Waiting Room: | 234 |
| Customer Service: | 1149 | OB/Surgery Waiting Room: | 228 |
For other extensions dial: 0
Television
Your television volume and channel control are located on your bed, either on your pillow speaker or directly in the handrails. In consideration of fellow patients, we ask that you turn off your television by 10:30 p.m. The following channels are available:
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ABC-WEHT Evansville |

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ABC-WSIL Harrisburg |

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NBC-WSMV Nashville |

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CBS-WTVF Nashville |

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NBC-WPSD Paducah |

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FOX-WTVW Evansville |

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Local Access |

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WGN Chicago |

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WB-WDKA Paducah |

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CBS-WEVV Evansville |

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CBS-KFVS Cape Giradeau |

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KET-WKMA Madisonville |

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TV Guide |

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IND-WKAG Hopkinsville |

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Home & Garden TV |

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The Health Network |

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QVC |

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WTBS Atlanta |

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Black Entertainment TV |

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Food Network |

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Nickelodeon |

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ESPN 2 |

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ESPN-Total Sports Network |

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MTV |

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Inspirational Network |

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AMC-American Movie Classics |
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TNN-The Nashville Network |

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Lifetime TV |

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Country Music TV |

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Headline News |

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VH-1 |

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C-SPAN |

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Fox Family Channel |

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Discovery Channel |

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CNN |

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TNT-Turner Network Television |

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TWC-The Weather Channel |

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TLC-The Learning Channel |

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Bravo |

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Animal Planet |

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A&E Arts & Entertainment |

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TV Land |

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TBN-Trinity Broadcasting Network |

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Home Shopping Network |

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CNBC |

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USA Network |

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Cartoon Network |

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Comedy Channel |

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Univision |

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The History Channel |

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MSNBC |
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Mail
Volunteers sort and deliver patients’ mail. Mail received after discharge will be forwarded to the patient’s home.
Floral Deliveries
Flowers are delivered to patient rooms daily by the volunteers from 9:00 a.m. until 5:00 p.m. Flowers delivered to the hospital after 5:00 p.m. will be given to the patients by the nursing staff.
Medications
Medications required during your hospital stay will be ordered by your physician and supplied by the hospital pharmacy. We request if you are using an inhaler or eye drops at home that you or a family member bring these in at admission so you may continue their use, under your attending physician’s orders, while you are hospitalized.
If you brought any medications with you, these should be given to the nurse to be documented on your chart. The nurse will then ask you to send these medications home with a family member or they will be locked in the Pharmacy and returned to you at the time of discharge.
Gift Shop
The gift shop is operated by the Volunteer Hospital Auxiliary. The gift shop is well stocked with personal items, magazines, gifts, and toys. The gift shop is open Monday through Friday from 9:00 a.m. to 5:00 p.m.
Hospital Auxiliary Staff
The Hospital Auxiliary staff are volunteers who provide a wonderful service to us. Auxiliary staff manages the information desk in our front lobby. This is staffed Monday through Friday from 9:00 a.m. to 5:00 p.m. Auxiliary members also transport patients to and from their rooms on admission and discharge.
After operating costs, proceeds from the gift shop are used for hospital projects. Some of the projects the Hospital Auxiliary has been responsible for are: 1.) redecorating and furnishing our Labor Room suites; 2.) purchasing games and toys for our pediatric patients; 3.) purchasing and helping maintain the original LifeLine system for our community; 4.) providing the guest services directory for each patient room; 5.) purchasing recliners for each patient room; and 6.) purchasing shelves for each patient room.
The Hospital Auxiliary members are always willing to help us when called upon. They have donated thousands of hours of service to the hospital each year and do this without pay. Hats off to our much loved and appreciated “Pink” ladies.
Pastoral Care
During the admission process, patients will be informed that the hospital will contact their personal minister if they wish. If the patient or family member does not have a personal minister, but a need for spiritual and/or pastoral counseling is recognized, the facility has a “Chaplain on Call” program.
The Marion/Crittenden County Ministerial Association maintains a chaplain for our hospital. This service is made up of six to eight ministers, who serve on a volunteer basis as our hospital chaplain for a week at a time. Their pictures are located in the hallway near the front lobby.
Contacts will be made to personal ministers, or the Chaplain on call, at any time during the patient’s stay if the patient has a spiritual need and presents their request to the nursing staff or Social Services department.
Chapel
The chapel is located near the Canteen. Patients and patients’ families and friends are encouraged to use this chapel for meditation and prayers.
Lullaby
To allow our patients, families, and visitors an opportunity to join in the celebration and joy of the birth of a new baby, we play “Brahms’ Lullaby” over the intercom when a baby is born.
Patient Care Questions, Concerns, or Problems
The staff at Crittenden County Hospital hopes your stay is without complaints or grievances. However, our goal is to provide a mechanism to have your complaints/grievances heard and/or resolved if they do occur. A “Patient Grievance” is a formal, written or verbal complaint that is filed by a patient, when a patient issue cannot be resolved promptly by the staff present. CCH encourages you to voice complaints if you have them. We believe we cannot improve our care unless we know when there are problems. We thank you for discussing your problems with us, rather than others.
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To ensure that your need for rest and recuperation is met, the following guidelines have been established.
Visiting hours are 9:00 a.m. to 9:00 p.m. Visitors should use the main entrance of the hospital and stop at the information desk to verify the patient’s room number. The end of visiting hours will be announced each night at 9:00 p.m. Visitors will be asked to leave the building promptly.
Children age 12 or younger will not be allowed in patient care areas unless attended by an adult.
Shoes and shirts are required. Because of a patient’s condition, and at the discretion of the physician or nursing staff, visitation may be limited. The patient has the right to refuse to see any visitor and should notify the nurse. Food should not be brought in to patients unless this has been approved by the patient’s nurse or physician.
Due to the special nature of some nursing units, exceptions to the normal visitor guidelines are as follows:
Labor Room
Newborn Visitation
Critical Care Unit
Patients’ Overnight Guests
If your illness requires that you need someone to stay throughout the night, please follow these guidelines. Approval must be given by the nursing supervisor.
All pediatric patients age 12 and under are required to have one adult parent or another adult remain with them at all times. Because of this requirement, we will furnish meals to the one adult who stays with the patient. If more than one family member stays, they will be asked to purchase their meals in our dining room or eat from our canteen area.
If a guest stays with a patient overnight at the patient’s request or because of their own wishes but not at the request of the nurse supervisor, meals will not be furnished. They are, however, allowed to purchase their meals in our dining room at posted meal times or eat from our canteen area.
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Clinical Laboratory
The Clinical Laboratory is a full-service and fully accredited laboratory with highly trained and experienced technologists and technicians. Under the direction of a board-certified Pathologist, the laboratory works closely with staff physicians to ensure an extensive menu of tests with state-of-the art technology. Testing is available around the clock, 365 days a year.
Diagnostic Imaging
The Diagnostic Imaging Department provides x-ray, mammography, ultrasound, nuclear medicine, CT, and MRI services. A board-certified radiologist “reads” the exams and a staff of registered radiographic technologists provides these services.
Rehabilitation
The Rehabilitation Services department is dedicated to assisting our patients achieve their rehabilitation goals by restoring their ability to live and work as normally as possible after a disabling injury or illness. The Rehabilitation Services department will provide physical therapy to assist each patient in preserving, developing, or restoring maximum physical function. The occupational therapist will provide assistance to patients by contributing to their ability to perform their life roles in the occupations of work, self-care, and leisure. The speech pathologist will assist patients in achieving their goals associated with speech, language, and swallowing problems. The entire staff of therapists, assistants, aides, and clerical personnel is committed to excellence in all areas of rehabilitation.
Environmental Services
The Environmental Services department provides patients with a clean and pleasant environment during their stay. Normal work hours are: Monday through Friday, 5:00 a.m. to 9:00 p.m., and Saturday and Sunday, 6:30 a.m. to 3:00 p.m.
Patient rooms and baths should be cleaned on a daily basis unless you request not to be disturbed. If your room is not cleaned to your satisfaction, please let a housekeeper know, or dial our customer service line at extension 1149 to voice your problems or concerns. We will make every effort to meet your needs.
If you are the only patient in a semi-private room, we ask that you or your visitors not use the other bed, as it is made and ready for the next patient. Using the bed could cause a delay in the next patient’s admission.
If you need additional chairs, please ask one of our housekeeping or nursing staff and we will try to supply them to you.
Engineering Department
The Engineering department strives to maintain a safe and functional environment for those who visit our facilities. We are here to provide equipment and room repair services for all our customers and guests. If you experience trouble with your nurse call light, television, heating, cooling, lighting, plumbing, or telephone, please inform your nurse. The Engineering department will respond as quickly as possible. An Engineering employee is on call at all times to provide for your needs after hours.
Emergency Medical Services
CHS’s Emergency Medical Services (EMS) affiliate is the primary provider for emergency 911 calls in Crittenden County, with around-the-clock, seven-day-a-week coverage. EMS provides advanced life support for the community and is staffed with professional Emergency Medical Technicians (EMTs) and Paramedics.
Convalescent Transport Services
Convalescent and wheelchair services are also available for patients who need transportation via stretcher or wheelchair to and from the hospital, nursing homes, residences, and doctors’ offices.
Contact Care Management at extension 1014 or 1015 for more information on convalescent and wheelchair transport while staying in the hospital.
Marion Home Health Agency
The Marion Home Health Agency is part of the Crittenden Health Systems’ family, which also includes Crittenden County Hospital, Salem Springlake Care Center, Crittenden County Convalescent Center, and Crittenden Clinic of Family Medicine.
Service Area
We provide service to patients who live in Crittenden, Caldwell, Livingston, and Lyon counties.
Disciplines
Skilled Nursing services are provided by registered nurses and licensed practical nurses. Services ordered by your health care provider may include:

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IV Therapy | 
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Wound Care | 
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Lab for Medication Monitoring | 
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Injections | 
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Foley Catheter Care | 
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Patient and Family Teaching, including:

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Diabetic Care |

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Wound Care |

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Nutrition and Diet |

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Tracheostomy Care |

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Ostomy Care |

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Feeding Tube |
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Maternity Care | 
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Pediatric Care — Apnea Monitors | 
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Home and community-based waiver services | 
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Homemaker, Personal Care, and Respite services to those who qualify | 
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Home Health aides assist patients with personal care activities and homemaker services.
Licensed speech therapists develop a program directed to improving or correcting speech or feeding problems.
Licensed physical therapists develop a program to restore or improve mobility. They develop a home exercise program for the patient after a stroke or a fractured hip.
Licensed occupational therapists develop a program to help the patient function with everyday life skills such as bathing and cooking.
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Payment and Billing Information |

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Insurance
Upon admission to the hospital, you will be asked a number of questions about yourself and your insurance. This information will help us bill your insurance company directly. We ask that you present your insurance card for each visit. We will make copies for our records. We understand that hospitalization may cause financial pressures. Our Business Office is prepared to assist you in interpreting and understanding insurance benefits as they relate to hospital charges. We will work with you in making financial arrangements for charges not covered by insurance. Be assured that our personnel are familiar with commercial insurance carriers, federal and state programs, and financial arrangements.
Some insurance companies place a limit on the length of stay they will pay for, especially for certain surgeries. We will make every effort to inform you if there are limitations set by your insurance company. If you have Medicare coverage, we are required by law to inform you when the 20 days that Medicare will pay at 100% are up. At that point, your Medicare supplemental insurance will be used. If you don’t have Medicare supplemental insurance, you would be responsible for the portion of the bill that Medicare does not pay.
Hospitalization Insurance
For your convenience, we accept payments from Blue Cross, accredited hospital insurance plans, Medicare, and Kentucky and Illinois Medicaid. In addition, we honor MasterCard and Visa for the amount up to your available credit limit. Since hospital insurance coverage varies according to policy, the Patient Accounting staff will verify the amount of coverage available. Whenever possible, this process will occur prior to admission.
So that we may have the information necessary to obtain health care benefit verification, please bring your insurance cards with you at the time of admission. This should eliminate unforeseen problems in billing at a later date. In addition, please be able to provide the name of the insured person and the name and address of the insured person's employer, or if the policy is a private policy, if applicable. Many employers, insurance companies, and local unions require the completion of a claim form or questionnaire to process an account for payment. This form may only be obtained from the employer or insurance company and should be forwarded directly to them once the patient information and physician’s portion have been completed. It is important to complete all insurance information.
Pre-Certification Programs
Many employers, insurance companies, and local unions require that a hospitalization be pre-certified in order for full benefits to be payable. Please check with your employer or insurer to inquire about certain requirements that your insurance company may have. Substantial financial penalties may be imposed on the insured for not complying with pre-hospitalization insurance requirements. We will assist whenever we can; however, it is the insured’s responsibility to comply with these types of requirements.
Hospital Charges
Your daily service charge includes around-the-clock nursing care, room, meals, and general services. If you wish to have a private room, a deposit is required upon admission. Special services, such as operating room fees, lab or x-ray services, and medications, are specifically itemized. Private physician fees are not included.
A detailed description of charges for items and services you received as a patient is available to you upon request. Call the Business Office at 965-1046 for your free copy. Additional copies may be obtained for a small service fee.
Financial Counselors
Our financial counselors are on staff Monday through Friday from 7:00 a.m. to 3:30 p.m. to assist with your insurance coverage and to answer other financial questions. They can be reached at the following extensions:
Workers’ Compensation
When claiming coverage under workers’ compensation, it is necessary to know the date and specifics of the accident and the name of the person informed at your place of employment. Be sure to notify your employer that you are being admitted because of your work-related injury. This will speed the verification process. If your employer contests your work-related injury and refuses to process the claim, you will be responsible for the entire bill.
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Statement of Patients’ Rights and Responsibilities |

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Patient Rights
Crittenden County Hospital respects you as an individual. As a patient you are entitled to certain rights and privileges when you have been admitted to our facility. Our aim is to provide the highest level of care, on an equal basis, for all our patients.
At Crittenden County Hospital you have the right to:
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Make informed decisions regarding your care, unless you are adjudged incompetent or otherwise found to be incapacitated under the laws of the State. This includes being informed of your health status, being involved in care planning and treatment, and being able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate.
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Pastoral care and other spiritual services. |  |
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Formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives.
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Have a family member or representative of your choice and your health care provider notified promptly of your admission to the hospital.
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Personal privacy and care in a safe setting. |  |
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Access information contained in your clinical record within a reasonable time frame. Your clinical record will be held confidential.
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Be free from all forms of abuse or harassment. |  |
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Be free from restrains of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff. (The term “restraint” includes either a physical restraint or a drug that is being used as a restraint.)
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Be fully informed in language that you can understand of your total health status — including, but not limited to, your medical condition.
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Refuse to participate in experimental research. |  |
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Choose your personal health care provider. |  |
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Be fully informed in advance about your care and treatment and of any changes in your care or treatment that may affect your well-being.
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Privacy in written communications. Any restrictions in communications will be fully explained. |  |
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Private telephone conversations with your family and friends. |  |
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Share a room with your spouse when both consent to the arrangement. |  |
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Receive a complete explanation of the need for transfer and of the alternatives to transfer, if necessary. You will be informed by the practitioner responsible for your care or his/her delegate of any continuing health care requirements following discharge from the hospital.
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Voice complaints about your care, and to have those complaints reviewed and, when possible, resolved.
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Receive visitors from family and friends unless such visits harm your medical condition or you withdraw consent.
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If You Are Admitted to Swing Bed
If you are admitted to Swing Bed, in addition to the rights listed above, you have the right to:
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Be informed of your Medicaid benefits, in writing, at the time of admission, or when you become eligible for Medicaid.
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Be informed before or at the time of admission, and periodically throughout your stay, of services available in the facility and of charges for those services, including any charges for services not covered under Medicare or by the facility’s per diem rate.
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Refuse to perform services for the facility. |  |
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Perform services for the facility if you choose, provided:
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Retain and use personal possessions, including some furnishings and appropriate clothing, as space permits, unless to do so would infringe upon the rights or health and safety of other patients.
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Participate in an activities program designed to meet your physical, mental, and psychosocial needs.
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Receive medically-related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being.
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Receive necessary specialized rehabilitative services as determined by the comprehensive assessment and care plan, in order to prevent avoidable physical and mental deterioration.
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Routine and 24-hour emergency dental care. |  |
Your Responsibilities as a Patient of Crittenden County Hospital
We at Crittenden County Hospital hope that you will in turn extend your respect to us, and believe that our facility was established to provide the highest level of care. As a patient, therefore, you have the responsibility to:
Medicare Patients’ Rights
Your Rights Include:
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Social Services and Discharge Planning
Our goal is to assist you in regaining your health and to make your stay as comfortable as possible while you are in the hospital, so you may return to enjoying life. Social Services and Discharge Planning assist patients and families in obtaining supportive services while in the hospital and obtaining continuing care after leaving the hospital.
Examples of Services Include:
If you have any issues or concerns where Social Services/Discharge Planning area can assist, please let us know. The Discharge Planner/Social Service Designee can be reached at extension 1028.
Thank you for choosing Crittenden Health Systems for your health care.
Talk to Your Doctor About Your Stay in the Hospital
You and your doctor know more about your condition and your health needs than anyone else. Decisions about your medical treatment should be made between you and your doctor. If you have any questions about your medical treatment, your need for continued hospital care, your discharge, or your need for possible post-hospital care, don’t hesitate to ask your doctor. The hospital’s patient representative or social worker will also help you with your questions and concerns about hospital services.
If You Think You Are Being Asked to Leave the Hospital Too Soon:
How to Request a Review of the Notice of Noncoverage:
NOTE: The process described above is called “immediate review.” If you miss the deadline for this immediate review while you are in the hospital, you may still request a review of Medicare’s decision to no longer pay for your care at any point during your hospital stay or after you have left the hospital. The Notice of Noncoverage will tell you how to request this review.
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AN IMPORTANT MESSAGE FROM MEDICARE
Your Rights While You Are a Medicare Hospital Patient
(For Admission to Non-PPS Hospitals and Non-PPS Hospital Units)
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Health Care Excel |
P.O. Box 23540, Louisville, KY 40222 |
502-339-7442 or 1-800-288-1499 |
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Post-Hospital Care
When your doctor determines that you no longer need all the specialized services provided in a hospital, but you still require medical care, he or she may discharge you to a skilled nursing facility or home care. The discharge planner at the hospital will help arrange for the services you may need after your discharge. Medicare and supplemental insurance policies have limited coverage for skilled nursing facility care and home health care. Therefore, you should find out which services will or will not be covered and how payment will be made. Consult with your doctor, hospital discharge planner, patient representative, and your family in making preparations for care after you leave the hospital. Don’t hesitate to ask questions.
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