Patient Information

Jeff Davis Hospital and staff are dedicated to provide the best quality of care to Jeff Davis County and surrounding counties. We are here when you need us to take care of your medical needs. The following information will provide you with some of the hospital policies you will need to know.

Admitting/Registration Services

Contact Number: 912-375-7781

Open Admission Policy

It is the policy of the Jeff Davis Hospital to admit and treat all persons without regard to race, color, sex, handicap, national origin or religious creed. Admission requirements and assignments of hospital facilities are the same for all persons.

Your Admission

You will be asked to sign a consent form for admission to the hospital and for medical treatment. An identification bracelet will be prepared and placed on your wrist. Federal regulations require hospital personnel to inquire as to the presence of an Advance Directive. This includes a Living Will or Healthcare Power of Attorney. Information on Advance Directives is provided to every patient upon admission.

Outpatient Admission Office

The outpatient admission office hours are Monday through Friday from 7:00 am - 7:00 pm. The outpatient admission office may be reached by calling 912-375-7781 ext 6256. After hours admitting/ registration is handled through our emergency department, 912-375-7781. The admitting representative will ask you for information related to your admission. This information is required by law and by private insurance companies as well as Medicare and Medicaid. We appreciate your patience and cooperation during this process. While some of the information is necessary for a complete understanding of your medical history, this information is held in strictest confidence and will be used to ensure report accuracy.

To assist with the registration and admission process, you should bring:
●Social security card
●All active insurance cards
●Picture ID
●Advance Directive (if you already have one)
●Written orders from your physician

Emergency Department Registration

The Emergency Admissions office is located within the Emergency Department waiting area. This office is open 7 days a week, 24 hours a day. The emergency department registration area may be reached by calling 912-375-7781

Tobacco Free Facility

Jeff Davis Hospital is committed to the promotion of health, which includes prevention as well as treatment of disease. Cigarette smoking is the single greatest cause of preventable illness in this country. Its damaging effects on smokers as well as non-smokers exposed to secondhand smoke are seen in the more than 1000 deaths in the U.S. daily from smoking related illnesses. As a major provider of health care, Jeff Davis Hospital has taken an active role in the prevention of smoke related illnesses by promoting and maintaining a smoke-free environment for every patient, staff member, student, physician and visitor.

WE ARE A TOBACCO FREE CAMPUS. NO TOBACCO PRODUCTS ARE ALLOWED ON ANY OF JEFF DAVIS HOSPITAL'S BUILDINGS OR PROPERTIES.

We can provide you with information on tobacco cessation along with contact numbers for assistance. Please let your physician or nurse know if you are interested in this information and they will be happy to provide it. Thank you for your cooperation in maintaining a tobacco free environment.

Georgia Tobacco Quit Line: 1-877-270-STOP

Telephone Services

While you are a patient at Jeff Davis Hospital, telephone service is available to you. However, no phone calls are transferred to your room from 9:00 PM until 6:00 AM in order for you to get the appropriate rest. You may call out at any time.

Local Calls: Dial 9 for a dial tone and then dial the phone number.

Long Distance: Dial 0 for the hospital switchboard operator to connect you to a long distance service.

Calls must be dialed collect or placed on a credit, debit or calling card.

Within the hospital: The following extensions may be dialed directly within the facility. If you reach a voice mail, please leave your name and room number and a staff member will return your call.

Operator	6117
Nurses Station	6117
Financial Department	6173
Medical Records	6214
Social Services	6240

Calls from Family and Friends: To reach your room directly your loved ones can dial the hospital 912-375-7781; when the operator comes on line dial your room number.

Waiting areas: There is a phone in the ICU waiting area. This area can be reached by dialing the hospital number 912-375-7781; when the attendant comes on line dial #177.

Financial Counseling

We assist patients and their families with information about programs of assistance, which may be available to them. We also provide information and assistance to our patients regarding the Indigent Care Trust Fund application process.

Indigent Care Trust Fund

Healthcare is Available
Jeff Davis Hospital is committed to providing quality, cost-effective, personal and progressive healthcare. If you or someone you know hesitates to seek healthcare because of financial limitations, ask about our Indigent Care Program which may assist with JDH hospital bills.

Concerned About Your Hospital Bills?
If you qualify for the Indigent Care Trust Fund, your concerns over your financial obligations for hospital healthcare can be eased. The program was created to offer peace of mind to those who simply are unable to pay their hospital bills due to limited income.

Eligibility Criteria
Household income must meet federal poverty guidelines. These guidelines are determined each year and printed in the Federal Register.

How to Apply
Call 912-375-7781 extension 6203 or 6207 for information. At your appointment, you will need verification of all income for ALL household members with income. For each household member with income you need to provide the latest Federal Income Tax Return and W2 form. For each working household member you need to provide the last 3 paycheck stubs.

Patient Financial Services

Patient Financial Services is located in the Business Office at the front hospital entrance. Our regular office hours are 8:00 a.m. until 4:30 p.m., Monday through Thursday, and 8:00 a.m. until 3:30 p.m. on Friday. We assist patients, their families and responsible parties with inquiries and resolution of JDH medical bills.

It is the policy of JDH to request payment when services are rendered and to assist patients in meeting their financial obligations. As a courtesy, we will file your insurance. You will be responsible for any balances not paid by your insurance carrier.

Billing

Shortly after your discharge, JDH will submit a claim to your insurance carrier in accordance with the information provided at the time of registration. You will receive a bill for any unpaid balance. You can pay your bill with a credit card. Please call the Financial Services department at extension 6209.

You may receive additional bills from physicians who assisted with your care while you were a patient at JDH (For example, your physician, any physicians that he or she consulted with during your stay, the radiologist, the pathologist, the emergency room physician, etc). You may not have met them during the course of your treatment but their services were requested and utilized by your physician for your care. To assist you, we have provided a list of the most frequently requested phone numbers below.

Emergency Physicians: SouthlandMD (229) 236-0831

South Georgia Radiology Associates/South Georgia Medical Billing Associates (888) 760-2455

Southeastern Pathology Associates (800) 342-7149

JDH Financial Policy

●Payment plans and extended payment plans are available.
●Free or reduced cost services are provided to responsible parties if financial criteria are met as set forth in our Indigent and Charity Care Programs.

Uninsured Assistance

To access tools that can help you identify free and low-cost health insurance options that can assist you and your loved ones with future healthcare expenses, please visit www.coverageforall.org or call the U.S. Uninsured Help Line at (800) 234-1317.

JEFF DAVIS HOSPITAL NOTICE OF AVAILABILITY OF LANGUAGE ASSISTANCE SERVICES AND AUXILIARY AIDS AND SERVICES

Jeff Davis Hospital is committed to ensuring that all patients, visitors, and members of the public have equal
access to our healthcare services and can communicate effectively with our staff.

FREE LANGUAGE ASSISTANCE SERVICES

If you speak a language other than English or have difficulty understanding English, free language assistance
services are available to you. These services may include:
 Qualified medical interpreters, including in-person, telephone, or video interpretation.
 Translation of important written healthcare information into your preferred language.
 Assistance communicating with healthcare providers and hospital staff.
 Assistance understanding medical information, treatment options, discharge instructions, and patient rights.

FREE AUXILIARY AIDS AND SERVICES

If you are deaf, hard of hearing, blind, have low vision, or have another communication-related disability,
appropriate auxiliary aids and services are available free of charge. These may include:
 Qualified sign language interpreters.
 Written communication and communication boards.
 Large-print materials and accessible electronic documents.
 Braille materials, when appropriate.
 Assistive listening devices and other communication aids.
 Other reasonable accommodations necessary to ensure effective communication.

HOW TO REQUEST ASSISTANCE

Please notify any hospital employee, registration representative, nurse, or department manager if you need
language assistance or an auxiliary aid or service.

CONTACT
Attention: Compliance Officer
Phone: 912-699-6105
Address: 163 South Tallahassee Street, Hazlehurst, GA 31539

All language assistance services and appropriate auxiliary aids and services are provided FREE OF CHARGE when
necessary to ensure meaningful access and effective communication. You will not be denied services or experience delays in receiving necessary medical care because you require communication assistance.

Jeff Davis Hospital • Hazlehurst, Georgia

JEFF DAVIS HOSPITAL
AVISO SOBRE LA DISPONIBILIDAD DE
SERVICIOS DE ASISTENCIA LINGÜÍSTICA Y
AYUDAS Y SERVICIOS AUXILIARES
Jeff Davis Hospital se compromete a garantizar que todos los pacientes, visitantes y miembros del público tengan
igualdad de acceso a nuestros servicios de atención médica y puedan comunicarse eficazmente con nuestro
personal.
SERVICIOS GRATUITOS DE ASISTENCIA LINGÜÍSTICA
Si habla un idioma distinto del inglés o tiene dificultades para entender inglés, puede recibir servicios gratuitos de asistencia lingüística. Estos servicios pueden incluir:
 Intérpretes médicos calificados, en persona, por teléfono o por video.
 Traducción de información médica escrita importante a su idioma preferido.
 Asistencia para comunicarse con los profesionales de la salud y el personal del hospital.
 Asistencia para comprender información médica, opciones de tratamiento, instrucciones al momento del
alta y derechos del paciente.

AYUDAS Y SERVICIOS AUXILIARES GRATUITOS
Si es sordo, tiene dificultades auditivas, es ciego, tiene baja visión o tiene otra discapacidad relacionada con la comunicación, hay ayudas y servicios auxiliares apropiados disponibles sin costo. Estos pueden incluir:
 Intérpretes calificados de lenguaje de señas.
 Comunicación por escrito y tableros de comunicación.
 Materiales en letra grande y documentos electrónicos accesibles.
 Materiales en braille, cuando corresponda.
 Dispositivos de asistencia auditiva y otras ayudas para la comunicación.
 Otros ajustes razonables necesarios para garantizar una comunicación eficaz.

CÓMO SOLICITAR ASISTENCIA

Informe a cualquier empleado del hospital, representante de admisiones, enfermero o gerente de departamento si
necesita asistencia lingüística o una ayuda o servicio auxiliar.

CONTACTO
Atención: Oficial de Cumplimiento
Teléfono: 912-699-6105
Dirección: 163 South Tallahassee Street, Hazlehurst, GA 31539

Todos los servicios de asistencia lingüística y las ayudas y servicios auxiliares apropiados se proporcionan SIN
COSTO cuando sean necesarios para garantizar el acceso significativo y una comunicación eficaz. No se le negarán servicios ni se retrasará la atención médica necesaria porque necesite asistencia para comunicarse.

Jeff Davis Hospital • Hazlehurst, Georgia
JEFF DAVIS HOSPITAL

THÔNG BÁO VỀ CÁC DỊCH VỤ HỖ TRỢ NGÔN
NGỮ VÀ CÁC PHƯƠNG TIỆN, DỊCH VỤ HỖ TRỢ
BỔ SUNG HIỆN CÓ
Jeff Davis Hospital cam kết bảo đảm tất cả bệnh nhân,
khách đến thăm và thành viên cộng đồng được tiếp
cận bình đẳng với các dịch vụ chăm sóc sức khỏe của
chúng tôi và có thể giao tiếp hiệu quả với nhân viên
bệnh viện.
DỊCH VỤ HỖ TRỢ NGÔN NGỮ MIỄN PHÍ
Nếu quý vị sử dụng ngôn ngữ khác ngoài tiếng Anh
hoặc gặp khó khăn khi hiểu tiếng Anh, quý vị có thể sử
dụng miễn phí các dịch vụ hỗ trợ ngôn ngữ. Các dịch
vụ này có thể bao gồm:
 Thông dịch viên y tế đủ tiêu chuẩn, trực tiếp, qua
điện thoại hoặc qua video.
 Dịch các thông tin y tế quan trọng bằng văn bản
sang ngôn ngữ quý vị ưu tiên.
 Hỗ trợ giao tiếp với các chuyên gia chăm sóc sức
khỏe và nhân viên bệnh viện.
 Hỗ trợ hiểu thông tin y tế, các lựa chọn điều trị,
hướng dẫn khi xuất viện và quyền của bệnh nhân.
PHƯƠNG TIỆN VÀ DỊCH VỤ HỖ TRỢ BỔ SUNG MIỄN
PHÍ
Nếu quý vị bị điếc, khiếm thính, mù, thị lực kém hoặc
có khuyết tật khác ảnh hưởng đến việc giao tiếp, các
phương tiện và dịch vụ hỗ trợ bổ sung phù hợp sẽ
được cung cấp miễn phí. Các phương tiện và dịch vụ
này có thể bao gồm:
 Thông dịch viên ngôn ngữ ký hiệu đủ tiêu chuẩn.
 Giao tiếp bằng văn bản và bảng giao tiếp.
 Tài liệu in chữ lớn và tài liệu điện tử có thể truy cập
được.
 Tài liệu chữ nổi Braille, khi phù hợp.
 Thiết bị hỗ trợ nghe và các phương tiện hỗ trợ giao
tiếp khác.
 Các điều chỉnh hợp lý khác cần thiết để bảo đảm
giao tiếp hiệu quả.
CÁCH YÊU CẦU HỖ TRỢ
Vui lòng thông báo cho bất kỳ nhân viên bệnh viện,
nhân viên tiếp nhận, điều dưỡng hoặc trưởng bộ phận
nào nếu quý vị cần hỗ trợ ngôn ngữ hoặc phương tiện
hay dịch vụ hỗ trợ bổ sung.
LIÊN HỆ
Liên hệ: Nhân viên phụ trách tuân thủ
Điện thoại: 912-699-6105
Địa chỉ: 163 South Tallahassee Street, Hazlehurst, GA
31539
Tất cả các dịch vụ hỗ trợ ngôn ngữ và phương tiện,
dịch vụ hỗ trợ bổ sung phù hợp đều được cung cấp
MIỄN PHÍ khi cần thiết để bảo đảm quý vị có thể tiếp
cận dịch vụ một cách đầy đủ và giao tiếp hiệu quả.
Quý vị sẽ không bị từ chối dịch vụ hoặc bị trì hoãn
việc chăm sóc y tế cần thiết vì quý vị cần hỗ trợ giao
tiếp.
Jeff Davis Hospital · Hazlehurst, Georgia
JEFF DAVIS HOSPITAL
语言协助服务及辅助设备和服务可用性通知
Jeff Davis Hospital 致力于确保所有患者、访客及公众成
员平等获得本院医疗服务，并能够与本院工作人员进行有
效沟通。
免费语言协助服务
如果您使用英语以外的语言，或难以理解英语，您可以免
费获得语言协助服务。这些服务可能包括：
 由合格的医疗口译员提供现场、电话或视频口译服务。
 将重要的书面医疗信息翻译成您首选的语言。
 协助您与医疗服务提供者及医院工作人员沟通。
 协助您理解医疗信息、治疗方案、出院指导及患者权利。
免费辅助设备和服务
如果您是聋人、听力障碍者、盲人、低视力人士，或有其
他影响沟通的残障，本院将免费提供适当的辅助设备和服
务。这些服务可能包括：
 合格的手语翻译人员。
 书面沟通及沟通板。
 大字体材料及无障碍电子文件。
 适用时提供盲文材料。
 助听设备及其他沟通辅助工具。
 为确保有效沟通所需的其他合理便利措施。
如何申请协助
如果您需要语言协助或辅助设备或服务，请告知任何医院
员工、登记处工作人员、护士或部门经理。
联系方式
联系：第1557 条协调员 / 合规官
电话：[填写医院电话号码]
地址：163 South Tallahassee Street, Hazlehurst, GA
31539
为确保您能够充分获得服务并实现有效沟通，所有语言协
助服务及适当的辅助设备和服务均免费提供。
您不会因为需要沟通协助而被拒绝提供服务，也不会因此
延误必要的医疗护理。
Jeff Davis Hospital · Hazlehurst, Georgia