Patient Information - Marshall Medical Center

Patient Informationwww.marshallmedical.orgwww.marshallmedical.org • 1

WelcomeWelcome to Marshall HospitalThe staff, physicians and volunteers welcomeyou to Marshall Hospital.In the late 1950’s a group of local citizens saw agreat need for improved healthcare services in ElDorado County. The citizens formed a committeeto petition the State of California for a nonprofitcharter under which a hospital could bebuilt and operated. As a result of this, plans weredrawn, funds were solicited, Michigan Californialumber company donated ground for a hospitalsite, and Marshall Hospital opened its doors in1959. Marshall Hospital derives its name fromthe pioneer James Marshall, who discovered goldat Sutter’s Mill a few miles north of Placerville.We are an independent healthcare organizationserving the western slope of El Dorado County.We have a local board of directors who volunteertheir time to represent the needs and interests ofa growing community. We are wonderfully supportedby over one hundred auxiliary memberswho volunteer year-round to provide assistanceto patients and their families.We have 105 licensed beds at the main site inPlacerville which includes an intensive care/cardiaccare unit, 24-hour emergency department,general medical and surgical units, cardiac monitoringunits, pediatric rooms, birthing rooms,and a transitional care center. Throughout thewestern slope of El Dorado County, we also providea wide variety of services such as lab, x-ray,primary care and home care. The Divide WellnessCenter in Georgetown provides primaryand urgent care services and counseling.More than 160 physicians representing mostmedical specialties have staff privileges at MarshallHospital. Nurses, technicians and otherhealthcare specialists support them. The entirehealthcare team, while valuing the currentmedical technology available at Marshall Hospital,places equal value on the importance ofpersonalized care.All of us at Marshall Hospital will make everyeffort to extend the utmost care and courtesy toyou. If there is anything we can do to make yourstay more comfortable, please let us know.This patient informationbrochure is dedicated toKay Railey, RN,past Assistant Administrator forPatient Services, who servedMarshall Hospital’spatients from 1986 - 2000www.marshallmedical.org • 3

Patient Safety InformationTwo-way CommunicationEffective communication between our patients and care providers is essential. We encourage questionsand want to know if there is anything we can do to make your stay more comfortable. Duringyour stay, you may think of questions you want to ask your physician or nurse, so please use thespaces below to write them down, as well as noting responses you receive. We’re committed to providingyou complete and understandable explanations regarding your diagnosis, care and treatment.Questions for My Physician(s)/Registered Nurse_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Answer____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Our Request Regarding Your NeedsYour comfort and care are important to us. Please tell us while you are still in the hospital if we arefailing to meet your needs. We want to succeed in providing for your comfort as well as your medicaland informational needs.4 • www.marshallmedical.org

Patient Safety InformationPatient Medication and Equipment SafetyWhat You Need to Know While in the Hospital…Medication SafetyWelcome to Marshall HospitalA key element in safe medication use while inthe hospital is careful communication betweenyou, your physicians and each of your nurses.Here are some things that you should know tohelp ensure medication safety during your stay.• It is extremely important that you provideyour physician(s) and nurses with a currentlist of all medicines, including non-prescriptionmedicines as well as dietary and herbalsupplements.• Provide your physician(s) and nurses with acomplete list of allergies and the type of reactionyou experienced. This includes food andother allergies.Other medication safety suggestionsto consider:• Tell your doctor or nurse how you actuallytake your medication, especially if this is differentfrom the originally prescribed directions.• Ask for information about your medicinesin terms you can understand to include whyyou are taking them, when your medicineswere prescribed and when you receive them.The following are the Five “Rights” nurses usewhen giving medicine to patients:1. Right drug2. Right patient3. Right dose4. Right route5. Right timeIn addition, your nurse will provide informationto you regarding each of your medications thefirst time it is administered. This informationincludes:• The name of the medicine• Why it is being given• What side effects it could cause• The dose, or strength• How often it will be givenProper IdentificationFor your safety, before medication is given toyou, your nurse will verify your identity andcompare this with information on the medicationrecord.Other things that you can do• Notify your nurse if you have any unexpectedsymptoms after taking a medication,especially if this is a new medicine for you.• Make sure you have a special wristband statingyou have an allergy; let your nurse knowright away if that wristband comes off.• Ask to speak to a pharmacist. If you haveany questions or concerns regarding yourmedication, a pharmacist is available to talkto you one-on-one.• Speak up if you have questions or concerns,and if you don’t understand, ask again. Youand your family members can play a vitalrole in making your care safe by becomingan active, involved, and informed memberof your healthcare team.www.marshallmedical.org • 5

Patient Safety InformationPatient Medication and Equipment SafetyWhat You Need to Know While in the Hospital…Medical Equipment SafetyIt is likely that you’ll use medical equipmentwhile in the hospital. Most likely you will beconnected to an IV Pump and/or other equipmentduring your stay. Staff receive trainingin the use of all medical equipment and willexplain to you what each device is for.If you are unsure if a device is working properly,press your call button to tell your nurse yourconcerns.Do not turn off alarms or attempt to change thesettings on medical equipment.Do not allow family members to adjust settingson any medical equipment.Ask QuestionsIf you want more information about a medicationor medical device, or if you are not certainthe nurse is aware of all of your medical historyand allergies – ask.If you have concerns about the safety of careprovided, please talk to your nurse, Case Manager,or ask to speak with the Nurse Manager.You can also call the Patient Safety Hotline atextension 320.We hope that you are feeling better soon.Preventing InfectionAt Marshall Medical Center, we strive to providequality patient care in a safe and caring environment.One of the best ways to prevent infectionsis for our health care providers to clean theirhands with either soap and water or with analcohol-based hand sanitizer prior to providingyour care. Patient placement is also determinedbased on Infection Control principles and practices.Medical equipment is cleaned betweenpatients and each patient room undergoes athorough disinfection/cleaning procedure bythe Housekeeping staff between patients. Roomsand bathrooms are cleaned at least daily. Visitorsshould not visit if they have cold or flu symptoms.Visitors should wash their hands thoroughlybefore and after visiting. If you have anyquestions regarding infection control practices atMarshall medical Center, don’t hesitate to speakwith your Registered Nurse or ask to speak withthe Infection Control Nurse, who is typicallyavailable M-F.6 • www.marshallmedical.org

Pain ManagementOur CommitmentWe are committed to the attentive managementof your pain and discomfort.What is pain?Pain is an uncomfortable feeling that tells yousomething may be wrong in your body.Why manage pain?• Increase comfort.• Promote healing.• With less pain, you can increase your activityand strength.Pain Rating Scale• You may be asked to rate your pain on ascale of 0 - 10, or you may choose words thatbest describe the pain.• You may also set a pain control goal (such ashaving no pain that’s above 3 on the scale).• Reporting your pain as a number helps thedoctors and nurses know how well yourtreatment is working and whether to makeany changes.How can pain be managed?Pain medication may be given by a variety ofmethods, which include, but are not limited to:• By mouth (liquid or pills)• Adhesive skin patches• Injection into an arm or leg, or• By injection into a vein.Pain medication may be given on a continuous,scheduled or as-needed basis.You may discuss which method of administrationwould work best for you with yourphysician(s) and nurses or pharmacist.What can you do to manage yourpain?• Ask your doctor, nurse or pharmacist whatto expect from your illness, injury or surgeryand what to expect from hospitalization.• Discuss your pain control plan with yourdoctors, nurses and pharmacist. Tell thedoctor what medication has worked well ornot so well in the past.• If your pain medication is ordered on anas-needed basis (prn), request it as soon asthe pain starts. It is harder to ease pain onceit has taken hold.• If your pain medication is not controllingyour pain, tell your doctor, nurse or pharmacist.• Do not worry about getting ‘hooked’ onpain medications. Studies show that this isvery rare unless you have a problem withdrug abuse.• Use distractions like watching TV, listeningto music or listening to meditation tapes.• Ask your nurse, doctor or physical therapistif massage, warm packs or cold packs wouldbe helpful.• Relaxation exercises such as jaw relaxationor slow rhythmic breathing may be helpful.www.marshallmedical.org • 7

Your Stay at MarshallWhat to Keep with You• List of current prescriptions and over-thecountermedication, including herbs andvitamins (not the medications themselves);always bring this list to the hospital or officevisits• List of any allergies• Medical insurance cards and insuranceforms• Your advance directive• You might like to have pajamas, robe orslippers• Dentures and hearing aids. Please be especiallycareful of your dentures and hearingaids. Frequently patients wrap these itemsin tissue or napkins, and they get lost in thelaundry or thrown away accidentally withthe disposal of food. Ask your nurse for adenture cup and keep it in your bedsidetable.What To Send HomeWe want to protect your valuables. Therefore, weask that you send the following items home withfamily and/or friends.• Cash, credit cards and jewelry• Cellular phones, laptops, ipods• Personal plug-in electrical devices, hair dryers,etc.• Medications, vitaminsPlease leave valuables, such as cash, jewelry, andelectronics at home. Any valuables that you cannotsend home should be stored in the hospitalsafe while you are here. Ask your nurse for a bag,which will be tagged with your name and bednumber and placed in the safe. You should notkeep any medications or vitamins/supplementsin your room. These should be sent home or sentto the pharmacy until discharge.Your RoomRooms are assigned based on the kind of medicalcare you need, infection control principlesand room availability.Your room is equipped for comfort and safety.Nursing staff will show you how to use the followingequipment:• Adjustable bed• Bathroom emergency bell• Call button• Telephone• TelevisionPlease discuss with your caregivers whether ornot you should get out of bed without assistance.If you need to speak to a nurse, press the callbutton.Most inpatient rooms accommodate two patientswith a shared bathroom. There is a commonshower available on each patient unit, for thosepatients whose medical condition allows.Each bed has an adjustable head and knee.The bed will be kept in the lowest position withwheels locked for safety. Keeping upper side railsup is advised.For your privacy, each patient bed has an individualprivacy curtain.Each bed and bathroom is equipped with a patientcall button. This button rings the main station.The station clerk will speak with you aboutyour needs and/or requests and communicatethis to the most appropriate care provider whowill assist you.Due to space limitations in patient rooms, thereis only one chair per patient available for visitors.Patient room entry and bedside areas arekept clear for emergencies.“continued”8 • www.marshallmedical.org

Your Stay at MarshallEach patient has a small individual television.As a courtesy to your roommate, please use earphoneswhen watching television. Ask the nurseor aide if you need a set.Each room has a window. To maintain properheating and air ventilation, please keep the windowclosed at all times.Patient room assignment may be changed duringthe hospital stay in response to changesin patient condition, infection control needs,special precautions, needs of newly admittedpatients and other safety criteria. We apologizefor the inconvenience of moving patients duringtheir stay.TelephoneYour family and friends may call you by dialing(530) 622-1441 or (916) 933-2273 or toll-free(866) 340-1441 and asking the hospital operatorto ring your room.My room number is:________ ________ ________To use the telephones in the patient rooms:Dial “9” and then the telephone number for localcalls. Local calls are only in the 530 area code,and are free of charge.Cellular phones can be used in most areas of thehospital, including most patient rooms. Theycannot be used at all in the Emergency Room,ICU or Surgery areas.If you would like to make a long distance callfrom a hospital phone, please contact the hospitaloperator, by dialing “O”, for assistance.This includes collect calls, calling card calls andprepaid telephone card calls.Daily RoutineMornings and early evenings are a very busytime at our hospital. This is when special proceduresare often scheduled, when many doctorsmake their patient rounds and when thehousekeeping staff come through to tidy up therooms.Most patients require early morning “fasting”lab draws and many are also weighed each dayin the early hours before breakfast arrival.Nursing staff will assess and monitor your condition,take your vital signs approximately every4-6 hours, review your test results, communicatewith your physician, provide indicated treatmentsand medications, and coordinate yourcare with other disciplines. The registered nurseis always available to answer your questions andprovide you with information and explanations.Care requirements continue throughout thenight and many patients are admitted duringlate night hours. We make every effort to keepthe noise level to a minimum while continuingnecessary care, treatment and medicationcommunication. If you experience disruption toyour sleep, ask the Nursing Staff how they canhelp to make your experience less disruptive.“continued”www.marshallmedical.org • 9

Your Stay at MarshallPhysicians make patient rounds at least daily.The time of patient rounds depends on manyfactors including patient condition, surgeryschedule, office hours and other emergenciesthat physicians respond to daily. Keep a list ofquestions for your physician (see front of booklet)and don’t hesitate to ask the physician tore-explain.Special diagnostic tests may be needed duringyour stay. Some will occur in the morning andrequire special preparation, such as fasting thenight before. Testing times will vary, and emergenciesmay need to take priority over a scheduledtest. Results are provided directly to thephysician who will discuss the test results withyou. Ask your Nurse if you have questions duringyour diagnostic testing.VisitorsNormally visiting is encouraged between 12:00noon and 9pm on medical/surgical floors.Special care units have individualized visitinghours.In the Birthplace, the age limit is waived forsiblings of a newborn who may visit you duringregular visiting hours. Grandparents and thefather of your newborn may visit at any time.Parents of hospitalized children are encouragedto stay with the child.Due to the special circumstances related topatients in the intensive care unit, visiting is limitedbased on your condition. Your visitors mustcheck with the ICU nurses by using the intercomin the ICU waiting room.Only 1-2 visitors should be at the patient bedsideat any given time and stay only a short period(no more than 15-30 minutes) if you have aroommate.There are times when it is not appropriate forvisitors/family members to be at your bedside.These times include:• Nurse or physician to speak privately withpatient or roommate.• Any time a procedure is being performed on apatient or roommate• When roommate needs to use the bathroom,bedpan or bedside commode• When roommate is being treated by a therapistor nurse• When roommate is speaking with a dietician,case manager or social worker.Due to space limitations and need to keep roomsclear for potential emergencies, only one bedsidechair per patient is kept in each room. Please donot remove chairs from room to room or use morethan one chair per patient in double rooms.Food ChoicesMealsAfter your first day, you will be visited daily andoffered a menu to select your food for the followingday. If you would like something that is not onyour menu, or have a special request just contactyour nurse or call extension 2755. Meal times areapproximately:Breakfast 7:30-8:30amLunch 11:45am-12:15pmDinner 5:30-6:15pmDining Room For VisitorsOur dining room is open seven days a week,from 7:00am to 7:30pm. Freshly-prepared hotfood is available from 7:00 to 9:30am, 11:00am to2:30pm, 4:30 to 7:30pm.“continued”10 • www.marshallmedical.org

Your Stay at MarshallSmoke-FreeMarshall hospital is a smoke-free campus.Smoking is not permitted inside or on thegrounds of this facility.If you are physically able, you may be able tosmoke in a designated area.HospitalistsDuring your stay, you may be seen by physicianson our medical staff who are board certified inInternal Medicine and are experts in the care ofhospitalized patients. Unlike other physicianswho are office-based, our Hospitalists are fulltime in the hospital, focusing solely on inpatients.This additional time and focus can makea significant difference. Although you will likelyspeak with and receive care from more than oneHospitalist during your stay, rest assured thatthey communicate closely with each other, thenursing staff, and ultimately with your regularphysician as you become ready for discharge.Patient Education ChannelPatient education television viewing is availablein every patient room on Channel two. A varietyof programs are available several times each dayincluding topics such as preventing the spreadof infection, the importance of your hospitalID band, smoking cessation, newborn care andmany more. Ask the nursing staff if you havequestions regarding the program schedule.www.marshallmedical.org • 11

Important Information To ReadPatient RightsMarshall Hospital board of directors, medical staffand employees are committed to assuring that allpatients seeking care at our hospital are informed ofand supported in exercising all rights without regardto gender, economic, educational, cultural or religiousbackground, or the source of payment for yourcare. You have the right to:1. Considerate and respectful care, and to be madecomfortable. You have the right to respect foryour cultural, psychosocial, spiritual, and personalvalues, beliefs and preferences.2. Have a family member (or other representative ofyour choosing) and your own physician notifiedpromptly of your admission to the hospital.3. Know the name of the licensed health carepractitioner acting within the scope of his or herprofessional licensure who has primary responsibilityfor coordinating your care, and the namesand professional relationships of physicians andnonphysicians who will see you.4. Receive information about your health status, diagnosis,prognosis, course of treatment, prospectsfor recovery and outcomes of care (includingunanticipated outcomes) in terms you can understand.You have the right to effective communicationand to participate in the developmentand implementation of your plan of care. Youhave the right to participate in ethical questionsthat arise in the course of your care, includingissues of conflict resolution, withholding resuscitativeservices, and forgoing or withdrawinglife-sustaining treatment.5. Make decisions regarding medical care, andreceive as much information about any proposedtreatment or procedure as you may needin order to give informed consent or to refuse acourse of treatment. Except in emergencies, thisinformation shall include a description of theprocedure or treatment, the medically significantrisks involved, alternate courses of treatment ornontreatment and the risks involved in each, andthe name of the person who will carry out theprocedure or treatment.6. Request or refuse treatment, to the extent permittedby law. However, you do not have the right todemand inappropriate or medically unnecessarytreatment or services. You have the right to leavethe hospital even against the advice of membersof the medical staff, to the extent permitted bylaw.7. Be advised if the hospital/licensed health carepractitioner acting within the scope of his or herprofessional licensure proposes to engage in orperform human experimentation affecting yourcare or treatment. You have the right to refuse toparticipate in such research projects.8. Reasonable responses to any reasonable requestsmade for service.9. Appropriate assessment and management of yourpain, information about pain, pain relief measuresand to participate in pain management decisions.You may request or reject the use of any or allmodalities to relieve pain, including opiate medication,if you suffer from severe chronic intractablepain. The doctor may refuse to prescribe the opiatemedication, but if so, must inform you that thereare physicians who specialize in the treatment ofpain with methods that include the use of opiates.10. Formulate advance directives. This includes designatinga decision maker if you become incapableof understanding a proposed treatment or becomeunable to communicate your wishes regardingcare. Hospital staff and practitioners who providecare in the hospital shall comply with these directives.All patients’ rights apply to the person whohas legal responsibility to make decisions regardingmedical care on your behalf.11. Have personal privacy respected. Case discussion,consultation, examination and treatment are confidentialand should be conducted discreetly. Youhave the right to be told the reason for the presenceof any individual. You have the right to have visitorsleave prior to an examination and when treatmentissues are being discussed. Privacy curtainswill be used in semi-private rooms.12. Confidential treatment of all communicationsand records pertaining to your care and stay inthe hospital. You will receive a separate “Notice ofPrivacy Practices” that explains your privacy rightsin detail and how we may use and disclose yourprotected health 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 toaccess protective and advocacy services includingnotifying government agencies of neglect or abuse.14. Be free from restraints and seclusion of any formused as a means of coercion, discipline, convenienceor retaliation by staff.“continued”12 • www.marshallmedical.org

Important Information To ReadPatient Rights15. Reasonable continuity of care and to know inadvance the time and location of appointmentsas well as the identity of the persons providingthe care.16. Be informed by the physician, or a delegate ofthe physician, of continuing health care requirementsand options following discharge from thehospital. You have the right to be involved inthe development and implementation of yourdischarge plan. Upon your request, a friend orfamily member may be provided this informationalso.17. Know which hospital rules and policies apply toyour conduct while a patient.18. Designate a support person as well as visitorsof your choosing, if you have decision-makingcapacity, whether or not the visitor is related byblood, marriage, or registered domestic partnerstatus, unless:No visitors are allowed.The facility reasonably determines that the presenceof a particular visitor would endanger thehealth or safety of a patient, a member of thehealth facility staff, or other visitor to the healthfacility, or would significantly disrupt the operationsof the facility.You have told the health facility staff that you nolonger want a particular person to visit.However, a health facility may establish reasonablerestrictions upon visitation, including restrictionsupon the hours of visitation and numberof visitors. The health facility must informyou (or your support person, where appropriate)of your visitation rights, including any clinicalrestrictions or limitations. The health facility isnot permitted to restrict, limit, or otherwise denyvisitation privileges on the basis of race, color, nationalorigin, religion, sex, gender identity, sexualorientation, or disability.19. Have your wishes considered, if you lack decision-makingcapacity, for the purposes of determiningwho may visit. The method of that considerationwill comply with federal law and bedisclosed in the hospital policy on visitation. At aminimum, the hospital shall include any personsliving in your household and any support personpursuant to federal law.20. Examine and receive an explanation of the hospital’sbill regardless of the source of payment.21. Exercise these rights without regard to sex, economicstatus, educational background, race, color,religion, ancestry, national origin, sexual orientation,disability, medical condition, marital status,registered domestic partner status, or the source ofpayment for care.22. File a grievance. If you want to file a grievancewith this hospital, you may be do so by writing orcalling:Marshall Medical CenterAdministration Office1100 Marshall WayPlacerville, CA 95667(530) 626-2838The grievance committee will review each grievanceand provide you with a written responsewithin 30 days. The written response will containthe name of a person to contact at the hospital, thesteps taken to investigate the grievance, the resultsof the grievance process, and the date of completionof the grievance process. Concerns regardingquality of care or premature discharge may also bereferred to the appropriate Utilization and QualityControl Peer Review Organization (PRO), HSAG,The Health Services Advisory Group, Inc., at (800)841-160223. File a complaint with the state Department ofPublic Health regardless of whether you use thehospital’s grievance process. The state Departmentof Public Health’s phone number and address is:California Department of Public HealthLicensing and Certification3901 Lennane Drive, Suite 210Sacramento, CA 95815(916) 263-580024. Patients and members of our community are encouragedto share concerns with Marshall MedicalCenter Administration at (530) 626-2838. If concernsare not resolved, the patient or communitymember may also contact the Joint Commission’sOffice of Quality Monitoring at (800) 994-6610 orvia e-mail at complaint@jointcommission.org.This Patient Rights document incorporates the requirementsof the The Joint Commission; Title 22,California Code of Regulations, Section 70707; Healthand Safety Code Sections 1262.6, 1288.4, and 124960;and 42 C.F.R. Section 482.13 (Medicare Conditions ofParticipation).Note: These Patient Rights combine Title 22 and otherCalifornia laws, Joint Commission and Medicare Conditionsof Participation requirements.www.marshallmedical.org • 13

Important Information To ReadPatient ResponsibilitiesHealing involves cooperation between patientand caregiver. To assist you and our other patientsto get well, we ask that you be responsiblefor:• Providing accurate and complete informationabout present symptoms, past illnesses,hospitalizations, medications and otherhealth matters.• Reporting unexpected changes in your conditionto those giving you care and letting usknow if you don’t understand your treatment.• Following the treatment plan your physicianrecommends, including instructions ofnurses and other professionals carrying outyour physician’s orders.• Learning as much as possible about yourcondition, your medications and your careneeds following your discharge from thehospital.• Meeting the financial obligations of yourcare as promptly as possible.• Being considerate of the rights and propertyof other patients and hospital employees.• Asking questions whenever you are unclearabout any aspect of your care.• Accepting the consequences for decisions inwhich you have participated.Please note: Patients are prohibited from possessingillegal or dangerous items such as alcohol,weapons or drugs (other than those prescribed bya health provider). In order to promote the healingand safety of Marshall patients, as well asthe safety of employees and the community, if aMarshall employee suspects that a patient maybe in possession of any illegal or dangerous item,the patient agrees to allow a Marshall employee tosearch his or her person or belongings.Committee is available to facilitate the resolutionof health care dilemmas that may be faced bypatients, families, physicians, staff members orother concerned persons. Please contact Administrationat (530) 626-5428 to make a request orfor further information.If You Have ConcernsOur staff strives to make your hospital stay ahealing experience. However, there may be anoccasion to voice a concern. Please notify us ofany concerns regarding your experience withyour stay at Marshall Medical Center. Here are afew ways you may alert us to your concern:1. Request to speak to any of the followingindividuals:• Charge nurse• Department manager or the supervisorof the department with which youhave concerns (see list of nursing unitmanager phone #s at the back of the thisbrochure)• Nursing house supervisor (from 6:30p.m. to 6:30 a.m. and weekends)2. Contact our Patient Advocate at x5428.Bioethics CommitteeAs part of Marshall Medical’s commitment toproviding health services of extraordinary valueand quality to our community, the Bioethics16 • www.marshallmedical.org

Planning Your Return HomeA case manager may visit you during your hospitalstay. The case manager will work with you,your family and your physician to coordinateany services you might need during your hospitalizationand after discharge.After your hospital stay you may need nursingcare, therapy or personal assistance at home. Ifso, your physician will refer you to the appropriateservice.Please arrange to have family or friends availableto transport you to your home on youranticipated day of discharge.If transportation by family or friends is not possible,let your case manager know. The case managercan help you make other arrangements.Discharge InformationWhen you are discharged from the hospital youwill receive information regarding follow upcare, medications to take and not take, activitylimitations (if any), diet or food restrictions andall other instructions pertaining to your posthospitalizationcare.Marshall Medical Center’sWeb SiteVisit www.marshallmedical.org for ongoinginformation about hospital services, classes,and local physicians, support groups and healthinsurance information.www.marshallmedical.org • 17

Keeping in TouchMailMail addressed to you at the hospital will be deliveredto your room. Mail should be addressedto your name and room number at:Marshall Medical Center1100 Marshall WayPlacerville, CA 95667E-mailE-mail may be sent to you addressed to mymsg4pt@marshallhospital.org.Your first and lastname must be included in the subject line toensure delivery. We do not have computer resourcesfor patients to return e-mail.NewspapersCopies of the local newspaper, Mountain Democrat,are available free of charge through thegenerosity of local businesses (M-W-F). Requestsfor a copy can be given to your nurse or a hospitalvolunteer. If you wish to purchase a copy ofthe Sacramento Bee, a volunteer can do this fromthe newspaper vending machines outside of thehospital entrance.FlowersFlowers received while you are a patient will bedelivered to your room (with the exception ofICU).BalloonsWe’re a latex-sensitive environment so latex rubberballoons are not permitted in the hospital.Mylar balloons are allowed.Lost and FoundItems lost or misplaced are taken to the securitydepartment where they are kept for 30 days. Afterthis, appropriate items are given to a local charity.Please call extension (530) 626-2812 for assistance.Gift ShopGift items, fresh flowers, stationery, snacks andtoiletry items are available in the auxiliary giftshop. Proceeds are contributed to the hospital.Normal hours are Monday through Friday, 9amto 5pm, and noon to 4pm on Saturday and Sunday.18 • www.marshallmedical.org

ReferencesMarshall Medical CenterImportant Phone NumbersHospital Operator.......................... (530) 622-1441 or (916) 933-2273or toll-free (866) 340-1441Nursing Desk - OB............................................................. (530) 626-2638Nurse Manager - OB.......................................................... (530) 626-2693Nursing Desk - North 1.................................................... (530) 626-2616Nurse Manager - North 1................................................. (530) 626-2659Nursing Desk - North 2.................................................... (530) 626-2663Nurse Manager - North 2................................................. (530) 626-2655Nursing Desk - ICU/CCU................................................. (530) 626-2623Nurse Manager - ICU/CCU.............................................. (530) 626-2662Nursing Desk - TCC........................................................... (530) 626-2822Nurse Manager - TCC........................................................ (530) 626-2851Billing..................................................................................... (530) 626-2618Corporate Compliance Hotline...................................... (530) 626-2800Patient Advocate................................................................. (530) 626-5428Lost & Found....................................................................... (530) 626-2812Medical Records.................................................................. (530) 626-2620Food Services Requests (7am - 7pm)........................... (530) 626-2755Social Worker....................................................................... (530) 626-2633Marshall Golden Club...................................................... (530) 642-9984Marshall Foundation for Community Health.......... (530) 642-9984Administration................................................................... (530) 626-2601www.marshallmedical.org • 19

ReferencesInsurance BillingWill my insurance pay for my care atMarshall Medical Center?To decide, ask yourself these questions:1. Is this care a covered service under my insurancepolicy? Read your policy booklet or callthe customer service number on your insurancecard.2. Have I met my deductible? Call the customerservice number on your insurance card.3. Is pre-authorization required from my insurancecompany? Your doctor may need to getpre-authorization for the care you receive atMarshall. Check your policy booklet or callthe customer service number on your insurancecard. If you think pre-authorization isneeded, find out if your doctor has gottenauthorization before you come to Marshall.If pre-authorization is needed and your doctordoesn’t get it, you may have to pay for thecare.4. Is this an emergency condition? If you cometo our emergency room, you are entitled, bylaw, to receive an emergency medical screeningexam, regardless of your insurance oryour ability to pay. Your insurance must payfor the exam, as long as a prudent personwould have believed an emergency existed.5. Is Marshall a covered provider under myinsurance? Check your policy booklet orlist of providers given to you by your insurancecompany OR call the customer servicenumber on your insurance card to see if careis covered at Marshall. See below for moreinformation about the relationship betweenMarshall and your insurance.NOTE: Even if Marshall bills your insurance, youare responsible for paying for the care you receive.If your insurance does not pay, then in most casesMarshall will bill you for the care.Will Marshall bill my insurance?As a courtesy to you, our business office will billthe following insurance companies:• Primary insurance company• One secondary insurance company• Any third-party insurance companyYou may be asked to give us your insurancecard or other information about your insurance.Even if Marshall bills your insurance,you remain responsible for payment for all careyou receive. This may include care denied ornot covered by your insurance, as well as yourdeductible and co-payment amounts.If you think you will need assistance withyour hospital bill or if you need an itemized bill,call Marshall Billing as soon as possible at530-626-2618.“continued”20 • www.marshallmedical.org

ReferencesInsurance BillingIs Marshall contracted with myinsurance?Your Marshall representative cannot answerthis question. Insurance companies sell manytypes of policies. Marshall may be contractedwith your insurance for some types of policiesand not others. For example, services at Marshallmay be covered for someone with a PPO policyfrom Acme Insurance, but not for someone withan HMO policy from Acme Insurance. Also, yourinsurance policy may say that some servicesmust be provided at places other than Marshall,even if Marshall is contracted with your insurance.We do not have information about thepolicy between you and your insurance company.Understanding your insurance is yourresponsibility. Please call the customer servicenumber on your card to verify that Marshall is acovered provider for the specific care you needunder your particular insurance policy.In addition, certain insurance companies mayuse the provider networks of other insurancecompanies, and not tell Marshall. Therefore,services at Marshall may be covered through oneof these networks, even though your insurancedoes not have a contract with Marshall.Can I still get my care at Marshall,even if my insurance may not coverthe services?We welcome the opportunity to provide youwith excellent health care, regardless of your insurance.You should be aware that you may haveto pay for the services you receive. However, youcan choose to get your health care where youfeel comfortable.Marshall vs. Doctor’s ServicesThe care you receive at Marshall includes facilityservices, provided by Marshall, and may also includeprofessional services, provided by doctors.These doctors are separate from Marshall andwill bill you directly.Your insurance may or may not contract witheither Marshall or the doctors giving you carewithin Marshall. Even if you find that Marshallis a contracted provider with your insurance, thedoctor may not be. Verify that both Marshall andthe doctor are contracted with your insurance.Doctor’s Services provided within Marshall mayinclude some of the following:• Diagnosing, evaluating and managing yourhealth care needs, including emergencyconditions;• Ordering and reviewing your diagnostictests;• Reading and diagnosing your x-ray, CATscan or MRI;• Reviewing and diagnosing your laboratoryand pathology samples;• Supervising the administration of anesthesia;and• Performing surgical and specialized procedures.Some of the doctor groups which provide careat Marshall are the Marshall Physician ClinicServices, Emergency Physicians Medical Group,Placerville Radiology Medical Group, and ElDorado Pathology Medical Group.www.marshallmedical.org • 21

ReferencesMarshall Golden ClubWe take a special interest in the seniors of ourcommunity. The Marshall Golden Club is a freeservice for seniors sponsored by Marshall Foundationfor Community Health. Members haveaccess to the following services:• Free assistance with Medicare and otherinsurance paperwork• Low-cost glucose and cholesterol screeningsby appointment through Marshall’s Diabetes& Nutrition Center in Cameron Park• Low-income funding for emergency responsesystems units• Free notary services• Free yearly pocket calendar• 20% discount on meals in the hospitalcafeteria at any time• Free meals in your room for a spouse whovisits you while you are in the hospital• Estate preservation & planned givingseminarsFor more information, call (530) 642-9984.Marshall Foundation forCommunity HealthMarshall Medical Center is committed to qualityin every aspect of your care. Many of ourpatients seek ways to show their appreciationfor the caring kindness received. Since 1974,Marshall Foundation for Community Health hasassisted grateful patients in benefiting “programsthat care for people.” The sole purpose ofthe Foundation is to help keep the communityhealthier by providing a resource for donors toaccomplish their dreams through philanthropy.Charitable contributions help ensure qualityhealthcare will continue to be available here inour community. You may wish to consider a giftfor a specific purpose or to honor a loved one.For more information, call (530) 642-9984.22 • www.marshallmedical.org

ReferencesMarshall Hospital Main Floor Map2nd Floor Waiting Room/ChapelMarshall Way Cafeteriawww.marshallmedical.org • 23

ReferencesMarshall Hospital Location and Parking24 • www.marshallmedical.org

noteswww.marshallmedical.org • 25

NOTES26 • www.marshallmedical.org

1100 Marshall WayPlacerville, California 95667(530) 622-1441 • (916) 933-CARE (2273)Toll-free (866) 340-1441www.marshallmedical.org FORM# 0589130 (5/12)28 • www.marshallmedical.org