Patients are to act in accord with Penn Medicine policies, rules, and regulations.
Statement of Patient's Responsibilities
As a patient, you should act in accord with Penn Medicine policies, rules, and regulations and assume responsibility for the following things listed below.
This health care facility expects that you or your designated/legal representative will provide accurate and complete information about present complaints, past illnesses, hospitalizations, medications, "advance directives," and other matters relating to your health history or care in order for you to receive effective medical treatment.
In addition, you are responsible for reporting whether you clearly comprehend a contemplated course of action and what is expected of you.
It is expected that you will cooperate with all hospital personnel and ask questions if directions and/or procedures are not clearly understood. You are expected to be considerate of other patients and health care personnel, to assist in the control of noise and visitors in your room, and to observe the smoking policy of this institution.
You are also expected to be respectful of the property of other persons and the property of the health system.
In order to facilitate your care and the efforts of the health care personnel, you are expected to help the physicians, nurses, and allied medical personnel in their efforts to care for you by following their instructions and medical orders.
Duly authorized members of your family or designated/legal representative are expected to be available to UPHS personnel for review of your treatment in the event you are unable to properly communicate with your health care givers.
It is understood that you assume the financial responsibility of paying for all services rendered either through third-party payers (your insurance company) or being personally responsible for payment for any services which are not covered by your insurance policies.
It is expected that you will not take drugs which have not been prescribed by your attending physician and administered by appropriate staff and that you will not complicate or endanger the healing process by consuming alcoholic beverages or toxic substances during your hospital stay and or visit.
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Garry L. Scheib
Chief Operating Officer
University of Pennsylvania Health System;
Executive Director
Hospital of the University of Pennsylvania
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Michele M. Volpe
Executive Director
Penn Presbyterian Medical Center
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Elizabeth Johnston
Executive Director
Clinical Practices of the University of Pennsylvania
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Theresa Larivee
Executive Director
Pennsylvania Hospital
Further Information
If you have questions or problems concerning your care, please speak with your physician, nurse or other hospital or ambulatory practice representative before you leave the clinical site.
You may also direct your concerns regarding your health care or questions about the Patient Bill of Rights and Responsibilities to the appropriate Patient & Guest Relations Office:
The following organizations may be contacted if concerns about your care or treatment have not been resolved to your satisfaction:
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The Division of Acute and Ambulatory Care
Pennsylvania Department of Health (DOH)
P.O. Box 90
Harrisburg, PA 17120
800-254-5164
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Centers for Medicare and Medicaid Services (CMS)
800-MEDICARE
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The Division of Accreditation Operations
Office of Quality Monitoring
The Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
Tel: 630-792-5800
Fax: 630-792-5636
Email: complaint@jointcommission.org