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Your Privacy

As a patient, your medical information and your health is personal and private. At Monrovia Memorial Hospital we are committed to protecting your medical information. In order to provide you with quality care and comply with legal agreements, we are required by law to create a record of the care and services you receive at our hospital. Please know that all patient health information which could identify individual patients is kept private by law.

This notice of privacy applies to all of the records of patient care generated by the hospital. For more information about Monrovia Memorial Hospital’s privacy practices and how they affect you as the patient, please call us at: (626) 408-9800.

Patient Rights

You have the right to:

  • Considerate and respectful care, and to be made comfortable. You have the right to respect for your cultural, psychosocial, spiritual, and personal value, beliefs, and preferences.
  • Have a family member (or other representative of your choosing) and your own physician notified promptly of your admission to the hospital.
  • Know the name of the licensed health care practitioner acting within the scope of his or her professional licensure who has primary responsibility for coordinating your care, and the names and professional relationships of other physicians and non-physicians who will see you.
  • 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.
  • 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. This includes the right to informed consent for organ and tissue donation. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or non-treatment and the risks involved in each, and the name of the person who will carry out the procedure or treatment.
  • Participate actively in decisions regarding medical care. 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 members of the medical staff, to the extent permitted by law.
  • Be advised if the hospital/licensed health care practitioner acting within the scope of his or her professional licensure 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.
  • Reasonable responses to any reasonable requests made for service.
  • 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 pain, including opiate medication, if you suffer from severe chronic intractable pain. The doctor may refuse to prescribe the opiate medication, but if so, must inform you that there are physicians who specialize in the treatment of severe chronic intractable pain with methods that include the use of opiates.
  • 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 patients’ rights apply to the person who has legal responsibility to make decisions regarding medical care on your behalf.
  • Have personal privacy respected. Full consideration of privacy concerning the medical care program. 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 to semi-private rooms.
  • 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.
  • 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.
  • Be free from restraints and seclusion of any form used as a means to coercion, discipline, convenience or retaliation by staff.
  • 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.
  • 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 this information also.
  • Know which hospital rules and policies apply to your conduct while a patient.
  • Designate a support person as well as visitors of your choosing, if you have decision-making capacity, whether or not the visitor is related by blood, marriage, or registered domestic partner status, 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 healthcare 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. The health facility must inform you (or your support person, where appropriate) of your visitation rights, including any clinical restrictions or limitations. The health facility is not permitted to restrict, limit, or otherwise deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation, or disability.

  • Have your wishes considered, if you lack decision-making capacity, for the purposes of determining who may visit. The method of that consideration will comply with federal law and be disclosed in the hospital policy on visitation. At a minimum, the hospital shall include any persons living in your household and any support person pursuant to federal law.
  • Examine and receive an explanation of the hospital’s bill regardless of the source of payment.
  • Free aids and services to communicate about your care. Monrovia Memorial Hospital provides qualified sign language interpreters, written information, qualified interpreters when the primary language is not English and information written in other languages.
  • Exercise these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, sexual orientation, gender identity/expression, disability, medical condition, marital status, registered domestic partner status, genetic information, citizenship, primary language, immigration status (except as required by federal law) or the source of payment for care.
  • Access information contained in your medical records within a reasonable timeframe. The hospital must actively seek to meet these requests in a non frustrating process for the patient and as quickly as the record keeping system permits.
  • Know the reasons for any change in the care practitioners to include physicians responsible for the care.
  • Know the reason for your transfer from one unit to another or to another facility and/or location outside of the hospital.
  • Know if there is a relationship between the hospital, other persons, or organizations participating in your care.
  • Be informed of the source of the hospital’s reimbursement for your services, and of any limitations which may be placed upon care.
  • File a grievance. If you want to file a grievance freely without being subject to coercion, reprisal, or unreasonable interruption of care, with this hospital, you may do so by writing to: Monrovia Memorial Hospital 323 S. Heliotrope Avenue, Monrovia, CA 91016 or by calling: (626) 408-9800. The grievance committee will review each grievance and provide you with a written response within 7 days. The written response will contain the name of a person to contact at the hospital, the steps taken to investigate the grievance, 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 Utilization and Quality Improvement Organization (QIO)/Quality Control Peer Review Organization (PRO).
  • File a complaint with the California Department of Public Health (CDPH) regardless of whether you use the hospital’s grievance process, by calling (916) 552-8700 or toll free: (800) 228-1019, or writing to CDPH, Health Facilities Inspection Division, Los Angeles District Office, 3400 Aerojet Avenue, Suite 323, El Monte, CA 91731.
  • File a grievance regarding the conduct of a physician by calling the Medical Board of California at (800) 633-2322 or (916) 263-2382, or by fax at (916) 263-2435, or in writing to: Medical Board of California, Central Complaint Unit, 2005 Evergreen Street, Suite 1200, Sacramento, CA 95815.
  • File a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically at the Office for Civil Rights Complaint Portal: ocrportal.hhs. gov/ocr/portal/Lobby.jsf, by phone at (800) 36801019, (800) 537-7697 (TDD) or mail: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building, Washington D.C. 20201. Complaint forms are available at
  • Issues or concerns regarding the quality of care may also be filed with Accreditation Commission for Health Care (ACHC) regardless of whether you use the hospital’s grievance process. ACHC can be contacted at (855) 937-2242.

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