FirstHealth Montgomery Memorial Hospital
520 Allen Street, Troy, NC 27371
In this section:
- Our Services
- Patient Information
- Visitor Information
- Insurance and Billing
- Insurances Accepted
- Your Rights as a Patient
- Patient and Family Advisory Council
- Community Needs Assessment and Implementation Plan
FirstHealth Montgomery Memorial Hospital has served the emergency, outpatient and acute care needs of the people of Montgomery County and the surrounding area since 1950. Consistently high patient satisfaction scores for the past three years at Montgomery Memorial indicate that patients are very pleased with the care they receive at their local hospital.
Montgomery Memorial provides acute care for both medical and surgical patients, outpatient surgical services, imaging and other diagnostic services as well as an emergency department that is staffed with 24-hour in-house physician coverage.
Welcome to FirstHealth of the Carolinas. We want your time with us to be as comfortable and as healing as possible.
You should bring the following items with you on the day you arrive:
- Your health insurance card
- Personal identification (such as a driver’s license)
- HMO/PPO referral forms (if required)
- Medical records, X-ray films, or prior test results (if asked to bring)
- Written letter of authorization from insurance (if you are covered by worker’s compensation)
- A copy of your advance directives (your living will and/or Health Care Power of Attorney), if available
- Your medication list, including over-the-counter medicines, vitamins and herbs
Leave any valuable items such as handbags, wallets and jewelry at home. Storage space for these kinds of items is limited within the hospital.
You can pre-register for future services at Montgomery Memorial Hospital by calling (910) 571-5156 Monday through Friday from 8:30 a.m. until 5 p.m. Please have your physician order and your insurance card in front of you when you call.
Safety is a patient right! While you are a patient at FirstHealth we encourage you to:
- Speak up if you have questions.
- Have staff check your ID bracelet and ask your name and date of birth before you are given medications or have a procedure.
- Have all caregivers clean their hands when entering and leaving your room.
- Make sure your visitors clean their hands when entering and leaving your room.
- If you are in pain, discuss a plan with your doctor and nurse.
- Call for help to get out of the bed or chair - don’t risk falling!
A complaint is an allegation of dissatisfaction expressed by a patient or their authorized representative concerning the quality of service, care provided or a violation of rights to privacy under the HIPAA privacy act. General complaints can be submitted by telephone or in writing to the Patient Advocate at:
Montgomery Memorial Hospital
520 Allen Street
Troy, NC 27371
Privacy complaints may be submitted on-line by clicking here, or by contacting the HIPAA Privacy Office at (910) 715-2434.
To request an amendment or correction to your medical record, click here.
FirstHealth’s Notice of Privacy Practice explains our privacy policies regarding your personal health information and details your health-information rights under HIPAA (Health Insurance Portability and Accountability Act of 1996).
A grievance is a formal, written or verbal complaint that is filed by a patient or his/her parent or guardian in the case of minors, when the staff member who is present cannot resolve an issue promptly. Issues should first be addressed with the staff, the Patient Advocate and/or the patient’s physician. When the resolution to the patient complaint is not satisfactory to the patient, then the patient can file a grievance.
To file a grievance:
- The patient and/or family member is requested to contact the Patient Advocate. From a hospital phone, dial “0,” or ask for the service/unit manager during the evenings and weekends.
- The grievance can be filed in writing, in person or by telephone. Grievance Forms are available from the Patient Advocate and/or the service/unit manager.
You may submit a grievance in writing to the Patient Advocate at:
Montgomery Memorial Hospital
520 Allen Street
Troy, NC 27371
- Written notice of the status of the grievance process - including acknowledgement of receipt of grievance, name of the hospital contact and the steps to be taken on behalf of the patient to investigate that grievance - will be shared with the individual filing the grievance within seven days of the date of filing. A final review of the grievance will be provided in writing once a thorough investigation has been conducted. This could take up to thirty days from the date of filing.
- An appeal process can be initiated by the individual filing the grievance if the initial results are not satisfactory.
If your concerns are still not addressed, you are encouraged to contact DNV GL Healthcare to report your concern regarding patient care and safety.
Individuals wishing to file a complaint against a DNV GL accredited hospital, please contact us via email at: email@example.com
Or send via regular mail to DNV GL Healthcare corporate office:
DNV Healthcare USA Inc.
Attn: Hospital Complaints
4435 Aicholtz Road, Suite 900
Cincinnati, OH 45245
Or you may call us toll-free at 1(866) 496-9647.
Patients can also file a grievance with the Division of Health Service Regulation as well as, or instead of, using this grievance process. The telephone number to file a grievance is (800) 624-3004.
The mailing address is:
Complaint Intake Unit
2711 Mail Service Center
Raleigh, NC 27699-2711
For Mammography complaints, refer to the following:
The American College of Radiology (ACR)
1891 Preston White Drive
Reston, VA 22091
FirstHealth of the Carolinas strives to create a patient-centered setting and promote healing. An important part of the healing process is patient visitation. FirstHealth ensures that all visitors will enjoy full and equal visitation rights. These rights are given based on the patient’s approval. FirstHealth does not limit or deny visitation based on race, color, national origin, religion, sex, gender identity, sexual orientation or disability.
FirstHealth respects and supports each patient’s right to have an approved patient designee/support person. One patient designee/support person is allowed while being cared for in any FirstHealth hospital. Every effort will be made to accommodate a patient’s support person. This is done in hopes of providing support and comfort to the patient. Please be aware that the patient or support person designated by the patient has the right to allow or deny visitation.
If visitation restrictions in specialty areas are clinically necessary, a patient care staff member or physician will explain this to the patient and/or patient’s designee/support person. If a patient is unable to communicate his/her wishes and has not presented an advance directive, but an individual asserts that he/she, as the patient’s spouse, domestic partner, parent or other family member/friend, is the patient’s designee/support person, the hospital will accept this assertion without request for documentation
The patient (or patient designee/support person, where appropriate) has the right, subject to his or her consent, to receive visitors and withdraw or deny visitors whom he or she designates, including, but not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member or friend.
- All FirstHealth facilities are tobacco-free. That means we prohibit the use of all tobacco products on our campuses and in our facilities and vehicles.
- The use of cellphones is allowed in all areas of the hospital except those noted as no-cell zones. No-cell zones are marked with signage.
- FirstHealth provides wireless Internet access at no charge. Any computer or hand-held device with a wireless network card should recognize our "guest" wireless network when turned on.
- Cafeteria services are provided for Montgomery Memorial patients only; however a vending area is available on the second floor for employees and visitors. This is area is open 24 hours a day, seven days a week.
Insurance and Billing
We are committed to working with you, your doctor and your insurance carrier to make sure you have full access to all the services provided by FirstHealth. Our staff is here to help, so you can focus on your treatment and getting well.
This section provides information to help you find out if FirstHealth accepts your health insurance plan and learn about billing, health insurance and financial assistance programs.
Because hospital billing procedures can be confusing; FirstHealth provides professionally trained financial counselors at all three hospitals to provide you with information about financial assistance.
Patients who do not have insurance coverage, are unable to provide FirstHealth with adequate insurance information or who wish to file their own insurance claims must pay FirstHealth in full at the time services are provided or make satisfactory arrangements for payment.
Patients with health insurance coverage will be expected to pay any copays, deductibles, co-insurance or any other patient portion at the time services are provided, or make satisfactory arrangements for payment. All requests for payment are estimated amounts due. Any additional amount owed will be billed to you and is due when you receive the bill from FirstHealth.
FirstHealth offers a number of ways to pay your bill:
- Check/Money Order
- Debit Cards
- Credit Cards: Visa, MasterCard, Discover and American Express
- Online Bill Payment
FirstHealth has other options that we can discuss with you, such as government-assisted programs and our Financial Aid Program. Assistance is based on financial need, and we will make every attempt to provide you with payment solutions to fit your circumstances. If you have any questions, contact one of our financial counselors at (910) 715-1010.
During your hospital stay, you may receive treatment from physicians and/or other health care providers who will also bill you for their services.
Some of these providers may include:
- Your physician/surgeon or consultant
- Radiologists (physicians who read and review X-rays)
- Anesthesiologists (physicians who administer anesthesia during certain procedures)
- Pathologists (physicians who read and review tissue and lab specimens)
- Emergency physicians (physicians who provide emergency department care/Sandhills Emergency Physicians)
(Updated January 2019)
- ACS Consulting (currently for Moore Regional Hospital only)
- America's 1st Choice
- America's Health Plan
- Beech Street
- Benefit Management Service (BMS)
- Blue Cross Blue Shield of NC PPO, Medpoint, POS
- Blue Cross Blue Shield of NC Blue Care, PCP, HMO
- Blue Cross Blue Shield Medicare Advantage
- Cigna Indemnity
- Cigna Perdue
- Cigna PPO/HMO/POS Open Access
- Doctor's Health Plan
- FirstCarolinaCare Insurance Company
- First Health Direct
- First Health Network
- Golden Rule
- Great West Life
- Health Advantage Network
- Health Partners
- Medicare (Traditional)
- FirstMedicare Direct HMO
- FirstMedicare Direct PPO
- Medicare Humana PPO
- Medicare Evercare
- MVP Healthcare
- National Provider Network/CCN/PPN/Med Advantage
- N.C. Health Choice
- N.C. Medicaid
- PPO Next
- Primary Physicians Network
- Private Healthcare Systems
- State of N.C. Teachers and State Employees Health Plan
- UHC Silver Compass
- United Healthcare
Your Rights as a Patient
If you are no longer able to make your own decisions about your medical care, you do not lose your right to accept or refuse treatment. To ensure your wishes are respected, you can complete an “Advance Health Care Directive.” This document gives instructions, in advance, about your wishes regarding your health care.
You are not required to complete an advance directive, and you will receive the same quality of health care whether you complete one or not. If you become unable to make your own decisions and do not have an advance directive, your family or others close to you may be asked to make decisions for you based on what they believe you would want. If you are under age 18, your parent or guardian will usually make decisions about your medical care.
Advance directives can be completed through your attorney’s office, or you can download the necessary forms at http://www.secretary.state.nc.us/ahcdr/.
As a FirstHealth patient, you have the right to:
- Reasonable access to care.
- Care that is considerate and respectful of his/her personal values and beliefs.
- Be informed about and help make decisions about your care and help develop and implement your treatment care plan, discharge plan, and pain management plan.
- Relevant, current, and understandable information concerning his/her diagnosis, treatment including alternatives of care, and prognosis from his/her physician.
- Know the name of the physician and other direct caregivers responsible for coordinating his/her care.
- Right to refuse any drugs, treatment or procedure offered by the facility, to the extent permitted by law, and a physician shall inform the patient of his/her right to refuse drugs, treatment or procedures and of the medical consequences of the patient’s refusal of any drugs, treatment or procedure.
- Have an Advance Directive (such as a living will, health care proxy, or durable power of attorney for health care) concerning treatment or designating a surrogate decision maker with the expectation that the hospital will honor the intent of that directive to the extent permitted by law and hospital policy.
- Security and personal privacy.
- Confidentiality of all communications and records pertaining to his/her care, except in cases such as suspected abuse and public health hazards when reporting is permitted or required by law.
- A patient who does not speak English shall have access, when possible, to an interpreter.
- A patient, or patient designee/support person, upon request, shall have access to all information contained in the patient’s medical records.
- Review the records pertaining to his/her medical care and to have the information explained or interpreted as necessary, except when restricted by law and in accordance to hospital policy.
- Reasonable response by the hospital, within its capacity and policies, to the patient’s request for appropriate and medically indicated care and services.
- Information on the hospital’s business relationships with educational institutions and other health care providers or payers who may influence the patient’s treatment and care.
- Participate in or decline proposed research studies or human experimentation affecting care and treatment or requiring direct patient involvement and care.
- Reasonable continuity of care, and to be informed by physicians and other caregivers of available and realistic patient care options and health care requirements following discharge and the means for meeting them.
- Access to protective services.
- Information on hospital policies and practices that relate to patient care, treatment, and responsibilities.
- Be informed of available resources for resolving disputes, grievances, and conflicts, such as ethics committee, patient representative, and the grievance process.
- An appropriate assessment and management of their pain
- To expect emergency procedures to be implemented without unnecessary delay
- Good quality care and high professional standards that are continually maintained and reviewed
- Be informed and give consent prior to the start of any treatment or procedure or both, unless it is an emergency situation. Consent then may be withdrawn at any time that the patient does not wish to participate in the procedure or treatment.
- Assistance in obtaining consultation with another physician at the patient’s request and expense
- Medical and nursing services without discrimination based on race, color, creed, religion, sex, sexual orientation, gender identity, national origin or source of payment
- Not to be awakened by hospital staff unless it is medically necessary
- Be free from needless duplication of medical and nursing procedures
- Be transferred to another facility, when medically permissible, after receiving complete information and an explanation concerning the needs for and alternatives to the transfer
- Be informed of their rights at the earliest possible time in the course of their hospitalization
- Be free from physical and mental abuse and corporal punishment and to be free from restraint or seclusion, of any form, imposed by staff as a means of coercion, discipline, convenience, or retaliation
- Right to examine and receive a detailed explanation of his/her bill and a right to full information and counseling on the availability of known financial resources for his/her health care.
- Right to designate a patient designee/support person including, but not limited to a spouse, family member, same-sex partner, domestic partner, friend, or other individual who supports the patient during his or her hospital stay and may exercise the patient’s visitation rights on his or her behalf. There is no limit on who may be designated a support person by the patient and there is no restriction based on race, color, national origin, religion, sex, gender identity, sexual orientation, or disability.
- A patient has the right to designate visitors who shall receive the same visitation privileges as the patient’s immediate family members, regardless of whether the visitors are legally related to the patient.
- Seek a review by the Quality Improvement Organization (QIO) related to quality care issues or coverage issues, or seek appeal for a premature discharge issue (This applies to Medicare beneficiaries only.)
Quality Improvement Organization (QIO)
The Carolinas Center for Medical Excellence
100 Regency Forest Drive, Suite 200
Cary, NC 27511-8598
Toll-free (800) 682-2650
As a patient of FirstHealth, you are responsible for:
- Giving details about past illnesses, hospitalizations, medicines and other matters related to your health
- Asking questions when you do not understand information or instructions
- Telling doctors and other caregivers if you believe they cannot follow through with their treatment
- Being aware of the hospital’s obligation to be reasonably efficient and impartial in providing care to other patients and the community
- Be considerate of other patients and hospital staff
- Giving information for insurance and, when needed, for working with the hospital to arrange payment
- Providing a current copy of your Advance Directive
- Being aware of how your lifestyle affects your health
- Report pain to doctor or nurse
- Asking for pain relief when the pain first begins and whenever the pain is not tolerable
- Learn about pain relief options
- Participating in a pain management plan with patient caregivers
* A spouse, family member, same-sex partner, friend, or other individual who supports the patient during his or her hospital stay and may exercise the patient’s visitation rights on his or her behalf. There is no limit on who may be designated a support person by the patient-there is no restriction regardless of gender, race, color, sexual orientation, religion, disability or age.
Notice of Nondiscrimination
FirstHealth of the Carolinas complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
View FirstHealth's Notice of Nondiscrimination and taglines that alert individuals with limited English proficiency (LEP) to the availability of language assistance services.
Patient and Family Advisory Council
The purpose of the Patient and Family Advisory Council (PFAC) is to act as an advisory resource to FirstHealth staff, administration and board. The PFAC membership includes patients, or family members of patients, who have been hospitalized at a FirstHealth hospital at some point over the last three years. Council members work as partners with FirstHealth physicians and employees to share information and work toward the common goal of an exceptional experience for every patient. Council representation comes from Moore, Montgomery, Richmond and Hoke counties.
A limited number of physicians and hospital staff are also members of the Advisory Council. Advisers were chosen for their personal experience with care and familiarity with the services provided at FirstHealth.
Patient and family advisers must participate in an orientation to receive training about patient confidentiality and HIPAA regulations, council organization and adviser roles and responsibilities. The Council meets monthly, and members serve for two years.
Council accomplishments include:
- Instrumental in implementing emergency department signage changes and physical improvements to waiting areas.
- Joined medical personnel to evaluate the discharge process and provide feedback that resulted in major changes to improve the discharge process.
- Participated in a committee comprised of medical and administrative staff, legal counsel and community representatives to create, publicize and implement a new, community-wide policy for managing medication abuse in the emergency department.
- Worked with hospital staff to improve care and interactions with patients with dementia. This was accomplished through training, modifications to the admissions database and initiation of gray wristbands to identify patients with dementia.
- Membership on a larger committee that implemented new policies to allow greater flexibility regarding the visitation of hospitalized patients.
If you are interested in learning more about FirstHealth’s Patient and Family Advisory Council, please contact Roxanne Elliott at (910) 715-3487.
Community Needs Assessment and Implementation Plan
View the Montgomery Memorial Hospital Community Needs Assessment.
View the Implementation Plan.