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Patient Responsibilities

Statement of Patient Responsibilities

Read the Statement of Patient Responsibilities listed below for Penn Medicine. The responsibilities apply to all patients and visitors at Penn Medicine facilities.

Review our Code of Conduct, which helps us maintain a safe, respectful, and dignified environment for all

To foster our ability to provide safe, quality care you should act in accordance with UPHS and the health care facility’s policies, rules, and regulations and assume responsibility for the following:

  • This health care facility expects that you or your designated/legally authorized 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 for you to receive effective medical treatment.
  • In addition, you are responsible for reporting whether you clearly understand the planned 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 non-smoking policy of this institution. You are also expected to be respectful of the property of other persons and the property of UPHS. Threats, violence, disruption of patient care, or harassment of other patients, visitors, or staff will not be tolerated. You are also expected to refrain from conducting any illegal activity on UPHS property. If such activity occurs, UPHS will report it to law enforcement.
  • To facilitate your care and the efforts of the health care personnel, you are expected to help the physicians, nurses, and other health care personnel in their efforts to care for you by following their instructions and medical orders.
  • Duly authorized members of your family or designated/ legally authorized 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 caregivers.
  • 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 that have not been prescribed by your practitioner 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.

Our entire Penn Medicine team thanks you for choosing to receive your care here. It is our pleasure to serve and care for you.

The Leadership Team at the:

  • Chester County Hospital
  • Clinical Practice of the University of Pennsylvania
  • Hospital of the University of Pennsylvania
  • Lancaster General Hospital
  • Penn Presbyterian Medical Center
  • Pennsylvania Hospital

For 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:

You may direct questions or concerns regarding the Health Insurance Portability and Accountability Act (HIPAA) / privacy-related matters to:

If you have questions or concerns about possible violations of policies or legal requirements, you may contact 215-P-COMPLY Confidentiality Reporting Help Line. The 215-P-COMPLY Confidentiality Reporting Help Line is available to you by calling 215-P-COMPLY or logging onto upenn.edu/215pcomply.

If you or a family member thinks that a complaint or grievance remains unresolved through the hospital resolution process, or regardless of whether you have used the hospital’s grievance process, you have the right to contact the following organizations about your concerns without worry of retaliation.

  • The Pennsylvania Department of Health Division of Acute and Ambulatory Care
    Room 532 Health & Welfare Building
    625 Forster Street
    Harrisburg, PA 17120
    800-254-5164
  • The Centers for Medicare and Medicaid Services (CMS)
    Quality and Appeals 866-815-5440

You may also complete a Medicare Quality Complaint Form found at: www.bfccqioarea1.com/states/pa.html

For concerns related to quality and/or safety of care issues (including premature discharge) or safety of the environment, you may also contact:

  • The Joint Commission
    By website: https://www.jointcommission.org/contact-us/ (click on Patient Safety Complaint)
    By mail:
    The Office of Quality and Patient Safety (OPQS)
    The Joint Commission
    One Renaissance Boulevard
    Oakbrook Terrace, IL 60181
    The Joint Commission Patient Information Line on how to report a complaint, 1-800-994-6610

For complaints/grievances related to civil rights concerns:

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