QUALITY MANAGEMENT SERVICES

Complaints / Grievences

You, your family, or significant other may voice complaints without fear, if you feel your rights have been violated. Ridgeview has a formal complaint and grievance process which allows you to initiate a complaint about the substance or application of written or unwritten rules or policies of the facilities; the lack of rules or policies concerning a matter affecting you; any decision or action directed toward you by an employee of the facility; or fees which you feel are questionable.

The written procedure for handling complaint/grievances consists of notifying a Ridgeview staff member who will inform your advocate. The advocate will coordinate an investigation and resolution of your issue(s). If you are not satisfied with the outcome, you may appeal the decision to the Director of Quality Management at 865-482-1076. If you continue to be dissatisfied with the resolution, you may appeal any complaint/grievance to Chief Executive Officer at Ridgeview at 865-482-1076 and/or the Tennessee Department of Health Appeals at 1-800-560-5767.

Patient Advocacy Program

Ridgeview has a Patient Advocacy program which is provided by designated staff for you/your family regarding complaints or grievances. The role and responsibilities of the patient advocate is to represent your interest, point of view, and rights. Patients, guardians, families, and friends may consult with a patient advocate on issues of patient rights without fear of repercussion. Access to the patient advocate is by service area staff, written request, telephone, or personal contact. When a complaint form is reported, the form is routed to the designated advocate for investigation and/or review. You/your family are informed of the disposition of the problem by consultation with the designated patient advocate. If you are not satisfied with the action taken, you may ask to speak with the Director of Quality Management at 865-482-1076.

Your Rights

To be informed of your rights and responsibilities.

To recommend changes in rights, responsibilities, ethical issues and policies.

To be treated with respect, dignity, consideration, and not be discriminated against on the basis of race, age, gender, gender expression, sexual orientation, religion, ethnic background, handicap, or ability to pay.

To be protected from abuse, neglect, and exploitation.

To have an interpreter, if needed.

To not perform work or service that is assigned to staff.

To know the cost of service, source of reimbursement, any limitations on duration of services, and the amount of co-pays.

To know you can change plans, after an appeal, and/or dis-enroll from TennCare at any time.

Your Treatment Rights

To have your family included to learn about your mental illness, and to participate in and to have periodic review of your treatment, especially in decisions about discharge and/or aftercare planning.

To receive the appropriate level of care in the least restrictive setting, after an informed consent is signed.

To know the nature and type of treatment options and services that might benefit you and to receive information about Ridgeview’s clinical practice guidelines and services in understandable/effective communication.

To request the opinion of a consultant, at your expense.

To refuse treatment/therapeutic activity and know what might happen without treatment, except in the case of an emergency or court order.

To have competent professional staff and to choose or refuse providers within the network.

To get a list and be informed of risks, benefits, side effects of medication and treatment procedures, and unanticipated outcomes of treatment/service.

To refuse to participate in research projects or experimental medication/treatment without compromising your rights to service.

To refuse the use of audio and/or visual techniques to record or observe activities during treatment unless written and signed consent is given. You may change your decision at any time.

To have pain assessed and managed appropriately.

To be notified of discharge rights and how to appeal clinical or administrative decisions.

To refuse to participate in surveys/outcome measures.

To be consulted about the types of mental health care you receive if you become sick: Declaration for Mental Health, Advance Directives, and Health Care Power of Attorney.

To confidential and secure records, unless court ordered, otherwise permitted to be viewed by law, you give consent for them to be shared, or there is an emergency.

To inspect and receive a copy of your record, at your own expense, unless this would be harmful to you.

To ask for a correction of your record if you feel mistakes have been made. You also may place a statement in your record about what you think the error may be.

Inpatient and/or *Residential Rights

To be interviewed and examined in surroundings to assure reasonable visual and auditory privacy.

To have a person of the same gender present during physical exams.

To have free use of common areas, private phone conversations (unless contradictory to your treatment plan), and safe and secure areas for personal possessions.*

To have visitors within the limit of your treatment plan.* (children under 12 restricted from Inpatient Unit)

To send personal mail, unopened, and receive mail which may be opened in presence of staff.*

To be free from seclusion/restraint, unless used as a last resort to protect you or others from injury.

To participate or refuse to participate in cultural, educational, religious, community services, and vocational/recreational activity, if offered and appropriate.*

To be informed about emergency policies/procedures and program rules.*

To share a room with your spouse or have privacy for visits.

Your Responsibilities

Give accurate information and discuss possible risks of caring for you.

Participate in treatment planning, follow the plan, and ask questions if you do not understand your care.

Take medication as prescribed. Notify your MD/nurse about side effects or if you can’t obtain your medication.

Call if symptoms worsen or you have destructive thoughts.

Follow the rules and regulations of Ridgeview to respect the rights and property of others, to be respectful of your provider, and to abide by the laws of the state of Tennessee.

Be prepared to show your ID each time asked.

Joint Commission on Accreditation

Ridgeview is a Joint Commission Accredited organization. If for any reason you believe you have pertinent and/or valid information about quality of care and/or safety issues in the area in which care is provided, we encourage you to notify Ridgeview so improvement can be made. You may also notify JCAHO by contacting them at the following address:

Division of Accreditation Operations

Office of Quality Monitoring
Joint Commission on Accreditation of Healthcare Organizations
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Phone: 1-800-994-6610
E-mail: complaint@jointcommission.org