Compliance Hotline
Report concerns of Medicare or Medicaid fraud, waste, and abuse, or other compliance related issues to the Compliance Officer.
Anonymous Compliance Hotline number: 715-684-1675
This number is confidential, anonymous, and monitored on a regular basis.
Compliance concerns can also be directly reported to the Compliance Officer: Stephanie Quam, Director of Risk, Compliance, and Quality Section 1557 Coordinator (Civil Rights Coordinator)
715-684-1106 | Stephanie.Quam@wwhealth.org
- You have the right to receive considerate, respectful, and compassionate care in a safe setting regardless of your age, gender, race, creed, color, ancestry, national origin, religion, sex, sexual orientation, marital status, gender identity, disabilities, newborn status or source or payment.
- Patients shall be treated with consideration, respect, and recognition of their individuality and personal needs, including the need for privacy and confidentiality in treatment.
- You can expect that all communication and records about your care are confidential unless disclosure is permitted by law. You have the right to see or get a copy of your medical records. You may add information to your medical record by contacting the Medical Records Department. You have the right to request a list of people to whom your personal health information was disclosed.
- You have the right to know who has overall responsibility for your care; including names of physicians, nurses, and all health care team members involved in your care.
- You, your family, and friends with your permission have the right to information from your medical team about your diagnosis, treatment options, and prognosis, and to participate in decisions about your care. This includes the right to refuse treatment to the extent permitted by law and to be informed of the medical consequences of the refusal.
- You or your designee will have access, at the time of admission, to a copy of Western Wisconsin Health’s patient rights and responsibilities.
- You have the right to give written informed consent before any non-emergency treatment is administered.
- You or your representative have the right to give informed consent before participation in any form of medical research, or to refuse to participate.
- Except in emergencies, you may not be transferred to another facility without being given a full explanation for the transfer, without arrangements made for continuing your care, and without acceptance by the receiving institution.
- You have the right to receive detailed information about your hospital and physician charges as well as information regarding financial assistance.
- If you have a complaint or concern about your care, you may discuss it with your medical provider, your nurse, or social services. If your concern is not resolved you may speak with the Chief Nursing Officer, the Risk Manager, or the CEO or by addressing your concerns in writing, to their attention at 1100 Bergslien St, Baldwin, WI 54002. If the concern is still not resolved the following agencies may be accessed: call 1-800-MEDICARE (1-800-633-4227). Wisconsin Board on Aging and Long-Term Care Ombudsman Program at 1-800-815-0015. Or you may contact the Division of Quality Assurance (DQA) at 608-266-8481 or toll-free at 800-642-6552 or sent to PL. Box 2969 Madison, WI 53701-2969. For ethical concerns, you may contact the Office of Civil Rights at (800) 368-1019.
- You have the right to have someone remain with you for emotional support during your hospital stay unless your visitor’s presence compromises your or others’ rights, safety, or health. You have the right to determine who may visit at any time.
- If you are receiving treatment for mental illness, a developmental disability, alcohol abuse, or drug abuse you may have additional rights listed in a separate document in your information folder, you may request a written copy of these rights from staff.
- If you are receiving transitional care (skilled rehab care in a hospital setting) You have additional patient rights listed in your informational folder, you may request a written copy of these rights from staff.
- You have the right to make an advanced directive and appoint someone to make health care decisions for you if you are unable. If you do not have an advanced directive, WWH staff can provide you with information and help you complete one.
- You have the right to be involved in your discharge plan. Your discharge plan will be communicated in a timely manner that allows you to question or appeal the plan.
- You have the right to be free from restraints and seclusion in any form that is not medically required
- All patients seeking emergency care will be offered a medical screening exam, and if indicated: stabilized and treated regardless of their ability to pay.
- You are expected to comply with hospital rules, including being respectful of other patients, staff, and property.
- You are responsible to provide complete and accurate medical history and personal information, including your full name, address, and home telephone number, date of birth, Social Security number, insurance carrier, and employer when it is required.
- You are responsible to cooperate with your treatment plan to the extent you are able.
Western Wisconsin Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin (including LEP and Primary language), age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)) Western Wisconsin Health does not exclude people or treat them less favorably because of race, color, national origin (including LEP and Primary language), age, disability, or sex.
If you have any questions about our non-discrimination policy, contact our Director of Risk, Quality and Compliance at 715-684-1106.
Western Wisconsin Health:
- Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats).
- Provides free language assistance services to people whose primary language is not English, which may include:
- Qualified interpreters
- Information written in other languages.
If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact Stephanie Quam, Civil Rights Coordinator.
If you believe that Western Wisconsin Health has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Stephanie Quam, Director of Risk, Quality and Compliance, 1100 Bergslien Street, Baldwin, WI 54002, phone number: 715-684-1106, fax number: 715-684-1119, Stephanie.Quam@wwhealth.org. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Stephanie Quam, Director of Risk, Quality and Compliance, is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at
http://www.hhs.gov/ocr/office/file/index.html.
[If applicable: This notice is available at Western
Wisconsin Health website: https://www.wwhealth.org/
