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INTERNAL RULES AND REGULATIONS

OF PUBLIC INSTITUTION VILKPĖDĖ HOSPITAL




1. General Provisions

1.1. Public Institution Vilkpėdė Hospital (hereinafter referred to as the Hospital) renders palliative care and supportive care and nursing services.

1.2. The Internal Rules and Regulations of the Hospital are mandatory to all Hospital employees, patients, their representatives, visitors and other individuals present in the territory and premises of the Hospital.

2. Procedure of Admission and Hospitalization of Patients at the Public Institution Vilkpėdė Hospital

2.1. Patients shall be hospitalized at the Hospital only in the event of holding a physician’s referral issued as set forth in the applicable laws. The referral shall contain the referral diagnosis, brief anamnesis, examination data, any performed tests and recommended treatment.

2.2. Patients shall be hospitalized at the Hospital with a final diagnosis, when there is no need for any additional tests and when specialized inpatient treatment of higher level or rehabilitation treatment are not considered purposeful.

2.3. At the Admissions Department, the patients shall present the following documents:

2.3.1. Referral for hospitalization (Form No. 027/a);

2.3.2. Personal identification document.

2.4. In the event that a patient arrives for scheduled hospitalization but is unable to provide the necessary information about oneself or unable to sign the necessary documents due to his/her health condition, the said patient must be accompanied by an authorized representative holding a document confirming his/her right of representation and a personal identification document.

2.5. If the patient arrives in a condition described in Article 2.4. hereof and is not accompanied by his/her authorized representative, the social worker of the Hospital shall find the legal representative of the patient as soon as possible, notify him/her about the patient’s hospitalization and inform about the Internal Rules and Regulations of the Hospital.

2.6. The patient can register for hospitalization either by phone or at the Hospital. The patient or his/her authorized representative shall be notified of the date and time of the scheduled hospitalization by the indicated contact phone number 1-3 days in advance.

2.7. After arrival at the Admissions Department, the patient shall be examined by the Head of the Admissions Department or on-call physician. The patient is informed about the Internal Rules and Regulations of the Hospital and the informed consent forms approved by the Director of the Hospital that the patient (or authorized representative) must sign. The patient is then prepared for hospitalization and referred to the Supportive Care and Nursing Department.

2.8. In case of necessity, the attending physician retains the right to change the patient’s room, depending on the circumstances, during the patient’s treatment at the Hospital.

3. State Funded (Free) Services and their Provision

3.1. The patient shall receive the following free services at the Hospital:

3.1.1. Supportive care and nursing services rendered to patients covered by mandatory health insurance, 120 days per year;

3.1.2. Supportive care and nursing services rendered to patients not covered by mandatory health insurance, whose treatment is paid for by Vilnius City Municipality (only for residents of Vilnius City);

3.1.3. Palliative care services to patients covered by mandatory health insurance.

4. Provision of Paid Services

4.1. The Hospital may provide paid personal health care services that need to be paid for in advance by their recipients (natural persons).

4.2. Paid personal health care services are the services, the provision of which is not compensated by either of the following:

4.2.1. State or municipal budget;

4.2.2. Mandatory health insurance fund (hereinafter referred to as the Health Fund) budget;

4.2.3. State, municipal, corporate or other organization health funds and assets intended to finance health promotion programs.

4.3. All services rendered at the Hospital to patients not covered by mandatory health insurance, except emergency medical services, shall be paid services.

4.4. Patients covered by mandatory health insurance shall pay for the health care services rendered at the Hospital, provided that such services are not emergency medical services, in the following cases:

4.4.1. The patient had no referral by a physician (who works in a personal health care institution that has concluded an agreement with regional health care fund concerning the provision of the services indicated in the referral) and arrived at the Hospital for the provision of palliative care services, supportive care and nursing services or personal health care services that are not deemed emergency medical services;

4.4.2. The patient receives services paid for by the Health Fund and, with the permission of the attending physician, wishes to get additional services, i.e. services, substances, tests, medications, medical aid measures and procedures that are not necessary to diagnose or treat the main disease;

4.4.3. The patient chooses more expensive health care services. The more expensive health care services are deemed cases when the patient himself/herself chooses, with the permission of the attending physician, services, substances, tests, medications, medical aid measures or procedures that cost more. In this particular case, the patient shall pay for the difference in the price of the chosen services, substances, tests, medications, medical aid measures or procedures compared to the free services, substances, tests, medications, medical aid measures or procedures. Services that provide the patient with no alternative, i.e. when the patient cannot choose between free or more expensive services, shall not be attributed to such services;

4.4.4. The patient has used up the limit of 120 days of supportive care and nursing services at the inpatient department as approved by the order of the Minister of Health and contacted the Hospital concerning further provision of the said services during the same calendar year.

4.5. Paid services shall be rendered to foreign citizens who are not holders of the European Health Insurance Card and are not covered by mandatory health insurance, provided that they contacted the Hospital concerning palliative care services or supportive care and nursing services.

5. Rights of the Patients

5.1. Right to receive high quality health care services.

5.2. Right to choose a health care institution or health care specialist.

5.3. Right to receive information.

5.4. Right not to know.

5.5. Right to be informed about entries in his/her medical documents.

5.6. Right to inviolability of private life.

5.7. Right to choose to take part in the education process.

5.8. Right to file complains.  

5.9. Right to reimbursement of damages.

6. Obligations of the Patients

6.1. The patient shall view and sign the presented Internal Rules and Regulations of the Hospital and other documents set forth by the Hospital and shall fulfill the undertaken obligations.

6.2. The patient shall take care of own health and personal hygiene as much as possible, exert own rights in a fair manner without abusing it and cooperate with the Hospital’s physicians, nurses, other specialists and staff.

6.3. The patient shall endeavor to inform the health care specialists about own health, previous diseases, surgeries, former and current medications, allergic reactions, genetic and hereditary diseases and other known data that might be required to properly render health care services.

6.4. The patient who has registered for health care services and is unable to arrive as scheduled shall inform the personal health care institution no later than twenty-four hours to the scheduled services.

6.5. The patients who wish to receive health care services shall present their personal identification documents, except in cases of provision of emergency medical services.

6.6. Having received information about the prescribed health care services, the patient shall express his/her consent or refusal regarding the provision of any such services in writing.

6.7. The patient shall adhere to the prescriptions and recommendations of the health care specialists or refuse the prescribed health care services following the applicable procedure. The patient shall inform the health care specialists about any deviations from the prescriptions or the regimen that he/she has consented to.

6.8. The provision of health care services to the patient who breaches the undertaken obligations and thus threatens the health and life of other patients or prevents other patients from receiving high quality health care services may be terminated, except when danger to the patient’s life arises.

6.9. The patient shall follow the assigned regimen at the Hospital.

6.10. The patient shall inform the nursing staff when going outside to the courtyard.

6.11. The patients shall not drink alcohol, smoke, take medications not prescribed by the attending physician or psychoactive and toxic substances at the Hospital facilities or within its territory.

6.12. The patients arriving for scheduled hospitalization shall have their own personal hygiene means, suitable clothing and shoes.

6.13. The patient shall be respectful to and behave well with regards to all the staff of the Hospital and other patients. The patients are prohibited from making noise and bothering other patients, using the belongings of another person, visiting other departments of the Hospital or rooms of patients of the opposite sex on their own.

6.14. When watching the TV, listening to the radio or speaking on the mobile phone, the patient shall respect other patients and their right to a quiet environment with no noise.

6.15. The patient who wishes to go outside the territory of the Hospital or his/her authorized representative wishing to take the patient outside the territory of the Hospital shall submit a written request to the attending physician or on-call physician or the Head of the Supportive Care and Nursing Department and receive his/her consent. In such a case, upon leaving the territory of the Hospital, the patient or his/her authorized representative shall take full liability for the health of the patient.

6.16. The patients shall preserve the assets and inventory of the Hospital.

7. Termination of Provision of Health Care Services to Patients

7.1. Health care services shall not be rendered to patients who breach or do not adhere to the treatment or nursing regimen assigned by the attending physician.

7.2. Health care services shall not be rendered to patients who consume alcohol, psychoactive or other substances, or smoke at the Hospital facilities.

7.3. Health care services shall not be rendered to patients who act violently or threaten the health care and nursing staff of the Hospital and other patients.

8. Discharge of Patients

8.1. Patients shall be released from the Hospital in the following cases:

8.1.1. Upon reaching the annual limit of the inpatient supportive care and nursing services funded by the Health Fund;

8.1.2. Upon transfer to other institutions or discharge home;

8.1.3. Upon absence of indications for inpatient treatment at the Supportive Care and Nursing Department. In such a case, if needed, the attending physician or the MDT shall recommend further outpatient treatment or treatment at a care home.

8.1.4. Upon major breach of the Internal Rules and Regulations of the Hospital.

9. Resolution of Disputes and Conflicts between the Hospital and Patients

9.1. In case of believing that his/her rights have been violated, the patient may file a complaint with the health care institution that is believed to have violated the patient’s rights. The patient must conform to the procedure of filing complaints and the complaint content and form requirements.

9.2. The patient has the right to contact the Hospital in writing and ask for an explanation, provision of information or the requested documents.

9.3. The complaint or request may be filed by the patient or his/her authorized representative.

9.4. The complaint or request shall be filed in the official language of the State.

9.5. The Hospital shall analyze written patient’s complaints or requests that have been duly signed by the patient and contain the patient’s first name, family name, actual place of residence, contact details, and subject matter of the complaint or request. If the complaint or request is submitted by the patient’s representative, the said complaint or request shall contain the representative’s first name, family name, place of residence, representation basis and details of the patient on whose behalf the complaint is filed. Illegible complaints and requests and complaints that  do not correspond with the set requirements shall be returned to the patient with the indicated reason for such a return.

9.6. In his/her complaint or request, the patient shall enclose a personal identification document. When the complaint or request is sent by mail or via courier, it shall have an enclosed copy of the personal identification document of the applicant certified by the notary public of attorney at law representing the patient. The patient’s authorized representative shall also enclose own personal identification document and the documents confirming the right of representation.

9.7. The patient may file a complaint no later than one year after finding out about his/her rights being violated and no later than three years from the day the said rights were violated.

9.8. Having received the patient’s complaint or request, the Hospital shall analyze it and notify the patient about the results in writing within 20 business days.

9.9. When the patient’s complaint is related to confidential information about the patient, the provision of such information to the civil liability insurance company of the health care institution and individuals directly involved in the investigation of the complaint shall be deemed legal and reasonable. Individuals who become privy to confidential information shall ensure that it remains confidential.

9.10. The patients may appeal against the decisions of the state institutions hearing the patient’s complaints as set forth in the laws.

9.11. Verbal complaints given directly shall be analyzed immediately, depending on the situation and the possibilities at hand. If the problem cannot be resolved at once, a written complaint shall be analyzed.

10. Procedure in Case of Patient’s Death

10.1. The physician shall confirm and announce the patient’s death to the authorized representatives of the patient (as indicated in the history of present illness of the inpatient department at the time of hospitalization).

10.2. The body of the deceased shall be stored at the Hospital for two hours and later transported to the funeral agency chosen by the patient’s relatives or the funeral agency that has signed a cooperation agreement with the Hospital.

10.3. The medical certificate of death shall be issued by the attending physician or the on-call physician. The said certificate shall be given to the authorized representative of the patient upon presentation of the document confirming representation basis and personal identification document.

11. Final Provisions.

The Internal Rules and Regulations of the Hospital have been prepared pursuant to the Law on Health Care Institutions of the Republic of Lithuania and may be approved and amended by the order of the Director of the Hospital.