UAB ŽIŪRA

INTERNAL RULES

 

  1. General provisions and basic concepts

1.1. UAB “ŽIŪRA” is a health care institution providing ophthalmic personal health care services according to the professional qualification of an ophthalmologist.

1.2. The services are provided with a license to engage in the activity of personal health care and to provide these services.

1.3. Services are provided to UAB ŽIŪRA in accordance with the Description of Requirements for the Provision of Ophthalmology Outpatient Health Care Services, which was approved by the Company’s Director’s Order No. 104 of 2014. February 26

1.4. The purpose of the company’s activities is to improve a person’s health, to provide outpatient health care services in accordance with the established procedure, and to ensure their quality.

1.5. The internal rules of the company (hereinafter – the Rules) regulate the general internal and work procedure of UAB “ŽIŪRA” (hereinafter – the company).

1.6. The duties and rights of the company’s employees are regulated by job descriptions, occupational safety and health instructions, and work regulations.

1.7. A patient is a person who uses personal health care services provided by a company, regardless of whether he or she is healthy or ill.

1.8. Patient documents – a person’s health history (Form No. 025 / a), in which the patient’s state of health is recorded, and the person’s health care is applied to him or her.

1.9. A minor patient is a patient under the age of 18, except for persons between the ages of 16 and 18 who have been recognized by the court as fully involved (emancipated).

1.10. Patient representative – a representative by law (parents, adoptive parents, guardians, caregivers) or a representative by appointment.

1.11. Insured persons with compulsory health insurance (hereinafter – insured persons) are persons insured with compulsory health insurance who pay or are paid contributions in accordance with the procedure established by the Law on Health Insurance of the Republic of Lithuania.

1.12. Compulsory health insurance contributions – contributions in the amount established by the Law on Health Insurance of the Republic of Lithuania paid by the state, employers or the insured themselves.

1.13. Compulsory health insurance – a system of personal health care and economic measures established by the state, guaranteeing the provision of health care services and reimbursement of expenses for provided services, medicines and medical aids to persons insured with compulsory health insurance in the event of an insured event on the grounds and under the conditions established by the Law on Health Insurance .

1.14. Supplementary (voluntary) health insurance – personal health care services specified in supplementary (voluntary) health insurance contracts, which are remunerated under these contracts after the supplementary health insurance insured event.

  1. Requirements for specialists

2.1. Services are provided by an ophthalmologist with a general practice nurse.

2.2. The ophthalmologist providing the services has a valid medical practice license, which gives the right to practice medicine according to the professional qualification of an ophthalmologist.

2.3. A general practice nurse has a valid nursing practice license that entitles her to practice general nursing practice.

  1. Requirements for premises

3.1. The institution is equipped with (Appendix No.1):

3.1.1. waiting room;

3.1.2. patient reception room;

3.1.3. dark examination room;

3.1.4 two treatment rooms.

  1. Requirements for medical devices

4.1. The institution shall provide medical devices and medical aids for the performance of prescribed diagnostic and therapeutic activities.

  1. Organization of service provision

5.1. Types of services and their application:

5.1.1. The company provides secondary outpatient health care services – ophthalmology.

5.1.2. The company also provides paid personal health care services, for which the recipients, legal and natural persons, must pay in accordance with the procedure for the provision of paid services established by the company.

 

5.2. Organization of working time:

5.2.1. The company is open from 9.00 am. until 7 p.m. workdays.

5.2.2. Saturdays from 10 a.m. until 3 p.m. The company is closed on public holidays.

5.2.3. The patient can get the necessary information about the working hours of each ophthalmologist in the company, by phone or on the company’s website (www.ziura.lt).

5.3. The ophthalmologist provides services in accordance with the competence established in the Lithuanian Medical Standard MN 63: 2005 “Ophthalmologist. Rights, Duties, Competence and Responsibility ”, approved by the Minister of Health of the Republic of Lithuania in 2005. December 1 by order no. V-935 (Official Gazette, 2005, No. 146-5335).

5.4. The ophthalmologist must ensure that assistance is provided in cases where the patient is referred to him or her for a disease or condition that does not fall within the competence of the ophthalmologist. If, due to the patient’s condition or the complexity of the services, the services required for the patient’s examination and / or treatment cannot be provided at the institution to which the patient is referred, the ophthalmologist must refer the patient to that person’s office. care institution (hereinafter ASP) where the patient can be provided with services.

5.5. A general practice nurse shall provide services in accordance with the competence established in the Lithuanian Medical Standard MN 28: 2011 “General Practice Nurse. Rights, Duties, Competence and Responsibility ”, approved by the Minister of Health of the Republic of Lithuania in 2011. June 8 by order no. V-591 (Official Gazette, 2011, No. 72-3490).

5.6. An ophthalmologist providing services according to his / her competence shall be able to use information technologies and perform diagnostic and therapeutic procedures assigned to his / her competence:

5.6.1. defects of the detected refraction and selects the optical correction;

5.6.2. performed an external examination of the eye and its accessories;

5.6.3. conducted a study of the passage of the tear ducts;

5.6.4. conducted a tear secretion study;

5.6.5. translucent eye media;

5.6.6. established leukemia;

5.6.7. performed indirect and / or direct ophthalmoscopy;

5.6.8. performed gonioscopy;

5.6.9. measures corneal diameter and / or thickness;

5.6.10. performed eye biomicroscopy;

5.6.11. performed autorefractometry;

5.6.12. performed ophthalmometry;

6/5/13 explores dark adaptation;

6/5/14 performs a standard automatic perimeter;

6/5/15 explores the sense of color;

6/5/16 performs exophthalmometry;

6/5/17 determines the size of the glare angle and eye movements;

6/5/18 performed impression or applanation and / or non-contact tonometry;

5.6.19. conducted convergence, accommodation, binocular vision studies;

5.6.20. take the test substance;

5.6.21. diagnoses and removes superficial foreign bodies of the conjunctiva and cornea;

5.6.22. performed massage in case of neonatal dacriocystitis;

5.6.23. washes and probes the tear ducts;

5.6.24. add the solution to the conjunctival bag, lubricate the conjunctival bag with the ointment, inject the medication under the compound.

5.7. The ophthalmologist providing services may also perform other diagnostic and therapeutic procedures assigned to his / her competence:

5.7.1. widen the tear point;

5.7.3. photograph the anterior and posterior segment of the eye;

5.7.4. perform mirror biomicroscopy;

5.7.5. determine the strength of optical lenses;

5.7.6. perform pachymetry;

5.7.7. perform a stereo test.

5.8. The institution has concluded agreements with other personal health care institutions for the provision of the following services:

5.8.1. Materials and instruments sterilization agreement with UAB Baltupių family medicine center;

5.8.2. Laboratory research agreement with UAB Medicina practica laboratorija;

5.8.3 Cytological and histological examination agreement with UAB Patologijos diagnostika;

5.8.4 Agreement on computed tomography with MCT computerized tomography.

 

  1. Medical documentation

6.1. The medical documentation of UAB ŽIŪRA is completed and managed in accordance with the procedure established by the legal acts of the Republic of Lithuania.

  1. Procedure for patients to contact the company

7.1. The company shall ensure that all necessary information is provided to the patient during his / her stay or visit to the company. Prior to the visit, the patient is given a signed consent to provide healthcare. By signing, the patient agrees to the institution’s internal rules and agrees to be able to receive health care at our institution.

7.2. A personal health history (Form 025 / a) is completed for each patient.

7.3. A visit to an ophthalmologist is recorded when the patient calls by phone, email, or at the company. The time of admission and the surname of the doctor are indicated to the patient.

7.4. If a patient, when registering with an ophthalmologist, notifies that he or she will submit a referral from a primary care physician or other medical professional (Form No. 027 / a), such patient will be informed to bring an identity document upon arrival at the ophthalmologist.

7.5 Patients are admitted at the indicated time.

7.6. Emergency (first and urgent) medical care is provided to the patient as soon as possible.

7.7. If the insured is entitled to reimbursement for the purchase of medicines and medical aids, he must provide proof of the benefit. When issuing reimbursable prescriptions, the name and number of the document certifying the benefit shall be indicated on the outpatient card (personal health history (form 025 / a)).

7.8. The patient can apply to the company as a private individual.

  1. The budget of the Compulsory Health Insurance Fund (PSDF) covers personal health care services

8.1. The following personal health care services are paid from the budget of the Compulsory Health Insurance Fund (PSDF): outpatient medical care, preventive examinations, secondary personal health care services, kompens Reimbursements of insured expenses for medicines and medical aids established by the Law on Health Insurance of the Republic of Lithuania.

8.2. UAB ŽIŪRA provides personal health care services paid from the budget of the Compulsory Health Insurance Fund (PSDF) (Appendix No.2).

8.3. UAB Žiūra has entered into an agreement with the Vilnius Territorial Health Insurance Fund. For those who have compulsory health insurance and have a referral from a family doctor (Form 27 / a) The consultation is free of charge, the services are paid for by the territorial health insurance fund. The price of the service reimbursed by ICD is 16.79 EUR.

  1. Procedure for Provision of Personal Health Care for Insured Persons with Compulsory Health Insurance Specified in the Law on Health Insurance of the Republic of Lithuania

9.1. Compulsory health insurance is provided by the following institutions:

9.2. Compulsory health insurance covers:

and minors in their families;

points.

has concluded international agreements on compulsory health insurance, and citizens of these countries permanently or temporarily residing in the Republic of Lithuania are insured with compulsory health insurance in accordance with the procedure established by these agreements.

9.3. The following are considered to be compulsory health insurance (hereinafter referred to as the insured):

compulsory health insurance contributions established in Paragraphs 1 and 3 of Article 17 of this Law and persons who pay compulsory health insurance contributions established in accordance with the procedure established by the Law on Health Insurance of the Republic of Lithuania established in Paragraphs 2, 3, 4, 5, 7, 8 and 9 of Article 17 of this Law parts.

9.4. The following are considered to be insured persons who are insured with state funds (except for persons who are obliged to pay or for whom health insurance contributions are paid in accordance with Paragraphs 1, 2, 3, 4, 5 and 8 of Article 17 of the Law on Health Insurance of the Republic of Lithuania):

compensation;

willing and able to do a certain job;

length of pension insurance to receive a state social insurance old-age pension;

women during pregnancy 70 days (at 28 weeks of gestation or more) before delivery and 56 days after delivery;

more minor children;

pupils and students of the departments, as well as citizens of the Republic of Lithuania and citizens of other states and stateless persons permanently residing in the Republic of Lithuania, studying in the full-time departments of higher education institutions of the Member States of the European Union;

level of disability (disabled child), or a person declared incapable of work (until 1 July 2005 – Group I disabled) under 24 years of age, or a person recognized as incapable of work (until 1 July 2005 – Group I disabled person) until 26 years of age due to illness before the age of 24 or a person with a special need for permanent care (until 1 July 2005 – total disability);

The list approved by the Ministry of Health of the Republic of Lithuania;

prisoners and persons treated as such, deportees and persons treated as such, and victims of in defense of Lithuania on January 13 or other events

independence and statehood;

students and novices in monastic formations in monastic novitiates;

who have been diagnosed with a disease or condition listed in the list approved by the Ministry of Health of the Republic of Lithuania, single parents s minor children, women during the pregnancy 70 days (at the age of 28 weeks and more) before childbirth and 56 days after childbirth, persons who have reached the retirement age established by the laws of the Republic of Lithuania;

spouse – during the term of office of the President of the Republic.

  1. Reimbursement of expenses to the insured for the purchase of medicines and medical aids

10.1. Insured persons are reimbursed for the costs of reimbursable medicines and medical aids prescribed for outpatient treatment in accordance with the procedure established by the Ministry of Health of the Republic of Lithuania. The lists of diseases and reimbursable medicines for their treatment, the lists of reimbursable medicines and reimbursable medical aids and the procedure for reimbursement of acquisition costs shall be approved by the Ministry of Health of the Republic of Lithuania after evaluating the opinions of the State Health Insurance Fund and the Compulsory Health Insurance Council. Expenses for medicines and medical aids are reimbursed according to the basic prices calculated in accordance with the procedure established by the Government of the Republic of Lithuania.

10.2. The following insured persons shall be reimbursed 100 per cent of the basic price of reimbursable medicinal products included in the List of Diseases and Reimbursable Medicinal Products for their treatment and in the List of Reimbursable Medicinal Products and medical aids included in the List of Reimbursable Medical Aids:

the level of significant special needs is determined in accordance with the procedure established by legal acts.

10.3. 100, 90, 80 or 50 per cent of the basic price of reimbursable medicines and medical aids for outpatient treatment shall be reimbursed to insured persons not mentioned in clause 10.2 who have been diagnosed with diseases, syndromes and conditions included in the list of diseases and reimbursable medicines or levels.

10.4. 50 per cent of the basic price of reimbursable medicinal products included in the list of reimbursable medicinal products and medical aids included in the list of reimbursable medical aids for outpatient treatment shall be reimbursed to the following insured persons not mentioned in clauses 10.2 and 10.3:

the level of working capacity is set at 30–40 per cent.

  1. Patient rights and responsibilities

11.1. The right to quality health care:

11.1.1. The patient has the right to quality healthcare.

11.1.2. The indicators of quality health care services and the requirements for their content are established by the Minister of Health of the Republic of Lithuania.

11.1.3. The patient has the right to conditions that do not degrade his or her honor and dignity and the respectful conduct of healthcare professionals. The patient should be provided with science-based painkillers to avoid suffering from their medical conditions.

11.2. The right to choose a health care institution and a health care professional:

11.2.1. The patient has the right to choose a health care institution in accordance with the procedure established by legal acts.

11.2.2. The patient has the right to choose a healthcare professional.

11.2.3. The patient has the right to the opinion of another specialist with the same professional qualifications. When exercising this right, the patient’s right to receive free health care may be restricted in accordance with the procedure established by the Ministry of Health of the Republic of Lithuania or its authorized institutions.

11.2.4. The conditions and procedure for reimbursement of healthcare provided to patients abroad shall be established by the Ministry of Health of the Republic of Lithuania or an institution authorized by it.

11.3. Right to information:

11.3.1. The patient receives information about the ophthalmological services provided by UAB ŽIŪRA, their prices, possibilities to use them, the ophthalmologist providing health care services (name, surname, position) and information about his / her professional qualification in the company, on its website (www.ziura.lt) , in the doctors’ office.

11.3.2. Upon arrival at UAB ŽIŪRA, the patient applies to the reception and submits the identity documents registered with the ophthalmologists of the secondary personal health care. The ophthalmologist shall inform him / her of his / her eye condition, diagnosis of the disease, other treatments or tests used or known to the doctor, possible risks, complications, side effects, prognosis and other circumstances that may influence the patient’s decision to accept or refuse the proposed treatment. as well as the consequences of refusing the proposed treatment. This information is provided to the patient by the doctor according to his age and state of health, in a form he understands, explaining the special medical terms.

11.3.3 . This information may be withheld from the patient only in cases where this would endanger the patient’s health or endanger his or her life or if the patient refuses this information in accordance with the procedure established by this Law. The decision not to provide information to a patient that may endanger the patient’s health or endanger his or her life shall be made by the attending physician, unless the law provides otherwise. In cases where the notification would presuppose harm to the patient, all information shall be provided to the patient’s representative and shall be treated in the same way as information to the patient.

The information is provided to the patient when the risk of injury has disappeared. The peculiarities of the right of a mentally ill patient to receive information are established by the Law on Mental Health Care of the Republic of Lithuania.

11.4. Right not to know:

11.4.1. Information about the patient’s state of health, diagnosis of the disease, other treatments or examinations used in the company or known to the doctor, possible risks, complications, side effects, prognosis of treatment may not be provided to the patient against his will. Refusal of information must be clearly expressed and signed by the patient.

11.4.2. 4.1 of this section. The restrictions on the provision of information to the patient referred to in paragraph 1 shall not apply where the patient’s refusal to provide the information may have harmful consequences for the patient or other persons.

11.5. Procedure for providing information to the patient, his / her relatives, other natural and legal persons about the patient’s health condition, making copies of medical documents:

11.5.1. At the patient’s request, he or she may be provided with his or her medical records by contacting the physician directly or the company director. When contacting the company director, the patient fills out an application stating what medical records and how (a copy or just an explanation of the records) they want access to.

11.5.2. The provision of medical records to a patient may be restricted if the information contained therein would endanger the patient’s health or endanger his life. The decision not to issue medical documents to a patient is made by the attending physician. The doctor shall record the decision not to issue a medical record and the reasons for it in the patient’s personal medical history, in-patient medical history or other medical records.

11.5.3. The doctor shall explain to the patient, within his / her competence, the meaning of the entries in his / her medical records.

11.5.4. Inaccurate, incomplete, ambiguous data or data not related to diagnosis, treatment or care shall be corrected, supplemented, completed, deleted and / or modified by the doctor within 15 working days at the reasonable request of the patient. The director of the company shall resolve the dispute between the doctor and the patient regarding the correction, supplementation, termination, deletion and / or change of the entries in his medical records.

11.5.5. Representatives of a minor patient under the age of 16 have the right to have access to his or her medical records.

11.5.6. After submitting the documents confirming the identity of the person to the director, the patient and his / her representative shall fill in a request stating which copies of the medical documents he / she wishes to have.

11.5.7. The director of the company obliges the employee of the company to make copies of medical documents in accordance with the rules of clerical work.

11.5.8. Copies are made at the patient’s expense in accordance with Order No. 103 of the Director of the Company of 2014. January 23, approved rates.

11.5.9. The patient pays for the copies at the company’s checkout.

11.5.10. A company employee makes and issues certified copies of the patient’s medical records.

11.6. Right to privacy:

11.6.1. The patient’s private life is inviolable. Information about a patient’s life may be collected only with the patient’s consent and if it is necessary to diagnose, treat, or care for the patient.

11.6.2. Data on the patient’s presence in the company, his / her state of health, diagnostic and treatment measures applied to him / her are recorded in the person’s medical history (form No.025 /) and the patient’s medical documents of the prescribed form and type are entered into the company’s medical information system database. The form, content and procedure for the use of these documents must ensure the protection of the patient’s privacy.

11.6.3. All information about the patient’s presence in the company, treatment, medical condition, diagnosis, prognosis and treatment, as well as all other personal information about the patient must be kept confidential even after the patient’s death. The right to receive information after the death of the patient belongs to the heirs according to the will and according to the law, the spouse (partner).

11.6.4. Confidential information may be disclosed to other persons only with the written consent of the patient, stating the basis for the purpose of such provision and the purposes for which it is used, unless the patient has signed the medical record to which such person is entitled, and the extent and timing of the provision of such information. The patient has the right to identify persons to whom confidential information cannot be provided. Persons directly involved in the treatment or care of a patient who are subject to a patient’s medical examination may, without the patient’s consent, be provided with confidential information in such cases and to the extent necessary to protect the patient’s interests. When the patient is kept

unable to reasonably assess their interests, confidential information may be provided to the patient’s representative, spouse (partner), parents (adoptive parents) or adult children to the extent necessary to protect the patient’s interests.

11.7. Peculiarities of the right to privacy.

11.7.1. Without the patient’s consent, confidential information may be provided to state institutions to which the laws of the Republic of Lithuania grant the right to receive confidential information about the patient in accordance with the procedure established by legal acts. Confidential information may be provided to such persons only upon their written request, stating the grounds for the request for confidential information, the purposes for which it is to be used and the extent of the information required. In all cases, the provision of confidential information must comply with the principles of reasonableness, fairness and the protection of patients’ rights and interests.

11.7.2. Illegal collection and use of confidential patient information is the responsibility of the law.

11.7.3. The patient’s right to privacy must be based on the principle that the interests and well-being of the patient take precedence over the public interest. The application of this provision may be restricted in cases provided for by law where this is necessary for the protection of public security, the prevention of crime, public health or the rights and freedoms of others.

11.8. Patient’s right to anonymous healthcare:

11.8.1. Patients at least 16 years old suffering from a list of diseases established by the Government of the Republic of Lithuania or an institution authorized by it have the right to health care services without disclosing their identity. The patient pays for the healthcare without disclosing his / her identity, except for the exceptions established by law.

11.10. Right to compensation

11.10.1. The patient is entitled to compensation for damage caused by the violation of his or her rights in the provision of healthcare. The conditions and procedure for indemnification are set forth in Paragraph 14.2 of these Rules, the Civil Code of the Republic of Lithuania, the Law on Insurance of the Republic of Lithuania and other legal acts.

11.11. Responsibilities of the patient

11.11.1. The patient must sign the company ‘s internal rules.

11.11.2. The patient must take care of their health, exercise their rights fairly, do not abuse them, cooperate with the company’s specialists and employees.

11.11.3. Patients must provide proof of identity in order to receive healthcare, except in the case of emergency care.

11.11.4. The patient shall, to the extent possible, provide healthcare professionals with information about their health, illnesses, surgeries performed, medications used and consumed, allergic reactions, genetic inheritance, and other data known to the patient necessary for the proper provision of health care services.

11.11.5. Upon receipt of information about the healthcare provided to him, the patient must confirm his consent or refusal to provide healthcare in writing.

11.11.6. The patient must follow the appointments and recommendations of the healthcare professionals or refuse the assigned healthcare services. The patient must inform healthcare professionals of any deviations from the appointments or regimens for which he or she has given consent.

11.11.7. The patient must treat all employees of the company and other patients with respect and due care.

11.11.8. For a patient who breaches his or her duties, thereby endangering the health and lives of himself or herself and other patients, or obstructing their access to quality healthcare, the provision of healthcare may be suspended unless the life of the patient is endangered.

  1. Informed Patient Consent

12.1. Prohibition on providing healthcare without the patient’s consent:

12.1.1. Healthcare is provided to a patient from the age of 16 only with his or her consent, except in cases where the patient is unable to express his or her will.

12.1.2. Healthcare is provided to a minor patient under the age of 16 only with the consent of his or her representatives, except in the case of the provision of emergency medical care. Healthcare professionals must in all cases choose the methods of diagnosis and treatment which are most in the best interests of the minor, having regard in particular to the will of the minor and his or her representatives. If there is a disagreement between the patient under 16 years and its representatives, the methods of diagnosis and treatment shall be chosen by the council of doctors in the interests of the minor.

12.2. Requirements for consent to provide healthcare.

12.2.1. Consent to the provision of healthcare is given (expressed) by the patient or his / her representative.

12.2.2. The patient’s consent to the provision of healthcare must be informed and appropriate.

12.2.3. Consent shall be deemed to be informed and appropriate if it meets all the following conditions:

12.3. Expression of consent for healthcare:

12.3.1. A patient who enters the facility voluntarily is considered to be informed and agrees to be examined by an ophthalmologist, to have his or her health assessed, and to have the necessary examinations and treatments performed.

The company ensures that all the necessary information is provided (accessible) to the patient during his visit.

12.3.2. The information referred to in point 12.3.1 shall be deemed to be information on the prices of paid and services provided in the enterprise, free services and access to them, the procedure for referral to other health care institutions, the institution’s internal rules, professional qualifications of health care professionals. the specialist, as well as the patient’s obligation to cooperate with the healthcare professional who has prescribed (or provides) healthcare services, to carry out his or her appointments and instructions, to report any deviations from the appointments.

12.4. Written form of patient consent:

12.4.1. If there is a choice of diagnostic and treatment methods, the patient must be informed and his choice must be confirmed by the patient’s signature.

12.5. No contingencies:

12.5.1. When personal health care is to be provided to a patient from the age of 16 who cannot be considered to be able to reasonably assess his or her interests, and 13.4.3 of these Rules. the persons referred to in point (a) are not present or have refused to be represented or are not able to be contacted as soon as necessary or to obtain their informed consent in a timely manner, the choice of alternative to be made where appropriate, a medical council solely in the interests of the patient. The decision to form a council must be substantiated by the physician in the patient’s medical records: in the person’s medical history (Form 025 / a).

12.5.2. When health care is to be provided to a minor patient under 16 years of age and there is no provision of these Rules 13.5.1. The decision as to the extent of the healthcare to be provided to the patient shall be taken by the healthcare provider and, where appropriate, by the medical council, solely in the interests of the patient. The decision to form a council must be based on the patient’s medical records.

12.5.3. In the case of a minor patient under the age of 16, whose parents avoid acting as a legal representative and for whom temporary custody or guardianship has not been established, when the parents (adoptive parents) of the minor patient do not agree on the scope of health care, the choice of alternative choice is made by the attending physician. and, where appropriate, a medical council solely in the interests of the patient.

  1. Representation

13.1. General provisions on representation:

13.1.1. The patient acquires the rights, assumes the responsibilities and implements them himself or through his representatives.

13.1.2. Representatives, acting on behalf of the patient, must provide proof of representation and their own identity documents.

13.1.3. Representatives of a patient from the age of 16 may be: representatives by law and representatives by appointment.

13.2. Representation of an incapacitated and incapacitated patient:

13.2.1. The patient who has been declared incapacitated by the court is represented by a designated guardian.

13.2.2. A patient who has been recognized by the court as a limited person acquires rights and assumes obligations, as well as enforces them to the extent that those rights have not been restricted by the court.

13.3. Patient representatives by appointment:

13.3.1. The patient from the age of 16 can choose a representative by appointment. This representation is notarized or the patient can sign about his / her chosen representative in his / her medical documents: in the person’s medical history (form No.025 / a).

13.4. Patient representatives according to the law:

13.4.1. A minor patient under the age of 16 is represented by his or her legal representatives: one of the parents (adoptive parents), guardian, caregiver.

13.4.2. A minor patient under the age of 16 who has been placed in institutional care shall be represented by persons appointed by these institutions who have submitted a document confirming the representation.

13.4.3. Spouse of a patient over 16 years of age, married (partner) and, in their absence, one of the patient’s parents (adoptive parents) or one of the adult children is the legal representative of the patient who cannot be considered able to reasonably assess his / her interests. The specified persons shall not be considered as legal representatives of a patient from the age of 16 if they refuse to be representatives, the patient has appointed a representative by appointment or the patient has been assigned guardianship (care).

  1. Dispute resolution and damages

14.1. Right to complain:

14.1.1. A patient who considers that his or her rights have been violated shall have the right to submit a complaint to the company in accordance with the requirements of the content and form of the procedure for the handling of patient complaints set forth in these rules.

14.1.2. The patient or his representative may lodge a complaint. Complaints that are signed by the patient, his / her name and surname, actual place of residence and contact details, the essence of the complaint are examined. If the complaint is made by the patient’s representative, the name of the representative, his place of residence, the document certifying the representation and the patient on whose behalf he is applying shall be indicated. Unreadable complaints that do not meet the requirements of this section shall be returned to the patient and the reasons for the return shall be stated.

14.1.3. The patient must provide proof of identity in the complaint. When such a complaint is sent by post or courier, it must be accompanied by a copy of the applicant’s identity document certified by a notary or the patient’s lawyer. When requesting such information, the patient’s representative shall provide proof of identity and representation.

14.1.4. The patient has the right to lodge a complaint no later than one year after becoming aware that his or her rights have been violated, but no later than three years from the date of the violation.

14.1.5. Patients have the right to apply to the state institutions dealing with patients’ complaints only if they are not satisfied with the handling of complaints in the company.

14.1.6. The company must examine the patient’s complaint and inform the patient in writing of the results of the examination within 20 working days.

14.1.7. Where a patient’s complaint concerns the processing of information about a patient which is confidential, the provision of such information to the undertaking’s civil liability insurance institution to the persons directly examining the complaint shall be lawful and reasonable. Persons who have access to confidential information must ensure its confidentiality.

14.2. Compensation for harm to the patient:

14.2.1. Property and non-property damage caused in violation of the established rights of patients shall be compensated in accordance with the procedure established by this Law and the Civil Code of the Republic of Lithuania.

14.2.2. UAB “ŽIŪRA” has a compulsory disclaimer of civil liability of health care institutions for harm caused to patients.

14.2.3. A patient or other persons who have the right to compensation for the damage referred to in Paragraph 1 of this Part and who wish to receive compensation for it must apply to the Patient Health Injury Commission operating under the Ministry of Health of the Republic of Lithuania. Statements to this commission shall be made in writing. The application must state: the name of the commission, the applicant’s name, personal identification number, place of residence, as well as the name and address of the representative, if any, the name of the clinic, the office, the circumstances on which the applicant bases his claim (factual basis of the application) , evidence confirming the circumstances set out by the applicant, the applicant ‘s claim (breach of law and amount claimed), list of documents attached, place and date of the application. The application shall be signed by the applicant or his representative. The application submitted by the representative must be accompanied by a power of attorney or other document confirming the power of attorney of the representative. The application must meet the requirements of form and content.

  1. Procedures for the provision of written information, including confidential information about the patient and the services provided to the patient, his / her relatives, other natural and legal persons and the payment for this service:

15.1. Persons who have the right to receive written information on the grounds and in accordance with the procedure established by legal acts and wish to receive this information shall submit a written request and written consent of the patient (except for the cases specified in Paragraph 15.9 of this Procedure) to the director of the company. The request shall specify the nature of the information sought and the purpose for which it is to be used.

15.2. A patient requesting written information from a company must provide proof of identity. When such a request is sent by post or courier, it must be accompanied by a copy of the applicant’s identity document certified by a notary or the patient’s lawyer. The patient’s representative shall provide proof of identity and representation when requesting written information. Other persons applying for the provision of written information must submit information and (or) documents proving the procedure together with the request. 14.8. the right to receive written information referred to in

15.3. The director of the company instructs the responsible employee to prepare written information.

15.4. The written information service shall only be provided upon receipt of a prepayment, regardless of who paid for the written information service. Legal entities that have concluded agreements with the company regarding the provision of written information shall report in accordance with the procedure established in the agreement. The price of written information services is set and approved by an order of the company’s director.

15.5. If a person submits a written request for written information with the indication “urgency” (when the service is requested before the deadline for completion of the service approved by the company’s director, but not later than within 3 working days), the price of the service may be increased up to 50 percent.

15.6. The written information provided about the patient shall be signed by the doctor who prepared it, and the cover letter shall be signed by the director and his / her authorized person.

15.7. In case the company does not have the requested written information (does not have medical documents about the patient and the services provided to him), it informs the applicant in writing no later than within 5 working days from the date of receipt of the request for information.

15.8. The written information service is paid when it is not related to the provision of personal health care and pharmaceutical services.

15.9. Institutions and other institutions to which the laws of the Republic of Lithuania grant the right to receive confidential information about a patient have the right to receive written information free of charge within 10 working days in accordance with the procedure established by legal acts, without the written consent of the patient. The procedure for providing information about a patient to state institutions and other institutions shall be established by the Minister of Health of the Republic of Lithuania in 2001. February 1 order no. 65 “On the Approval of the Procedure for Providing Information on the Patient to State Institutions and Other Institutions” (Official Gazette Valstybės žinios, 2001, No. 13-405):

15.9.1. healthcare institutions where the patient is treated, cared for or examined;

15.9.2. institutions controlling health care services;

15.9.3. courts, the Prosecutor’s Office, pre-trial investigation, municipal child rights protection services and other institutions to which such a right is granted by the laws of the Republic of Lithuania.

15.10. The company shall provide the available information about the patient no later than within 10 working days from the date of payment for this service (receipt of funds at the company).

15.11. In cases provided for by the laws and other legal acts of the Republic of Lithuania (when it is necessary to report a crime, etc.), the company shall provide information about the patient on its own initiative and without the patient’s consent. The information provided about the patient is signed by the treating or treating physician. The cover letter is signed by the director of the company.

15.12. The company will immediately notify the law enforcement authorities of injured patients who may have been harmed by a criminal offense.

  1. Procedure for registration and storage of articles of precious metals, expensive prostheses and money held by a patient:

16.1. Patients carry documents and other items (including articles of precious metals, expensive prostheses, money) with them.

  1. Work safety

17.1. The company’s administration undertakes to create safe, accessible, appropriate, high-quality working conditions for the provision of personal health care services, professional development of employees and to organize mandatory health examinations of employees according to approved schedules.

17.2. Occupational safety and health are all preventive measures designed to preserve the working capacity and life of workers at work, which are used and planned at all stages of the undertaking’s activities to protect or minimize occupational risks.

17.3. The company uses only technically sound work equipment that complies with the requirements of regulatory enactments on occupational safety and health.

17.4. Internal control of occupational safety and health in the company is performed by an occupational safety and health specialist – the company’s director:

17.4.1. organize the internal control of the state of safety and health of employees, work and rest regime so as to create conditions that encourage employees to comply with the requirements of safety and health of employees;

17.4.2. organizes internal control of the state of safety and health of employees:

17.4.2.1. the following general principles of risk assessment and ensuring the safety and health of employees shall be established in establishing the internal control of the state of safety and health of employees in the enterprise and providing for measures to improve the safety and health of employees:

1) provision of personal protective equipment for employees;

2) training and instruction of employees, instructions binding on them to comply with the requirements for the safety and health of employees;

3) the application of other necessary measures for the safety and health of workers.

  1. Procedure for visiting, discharging and transferring patients to other personal health care institutions:

18.1. UAB Žiūra provides only outpatient services, and the inpatient company does not provide a patient company patients are not allowed to visit this institution (we do not provide day surgery services);

18.2. The discharge from the institution is also not carried out, as the patients come only for an ophthalmologist’s consultation and go home. They are issued with a Form 27A describing the examination, the patient’s condition, findings, and diagnosis;

18.3. Sometimes patients are referred to other treatment facilities – they are issued a referral on Form 27A, which states the diagnosis, the patient’s condition and the purpose of the referral.

If the patient needs urgent help due to the deterioration of his general well-being, ambulance doctors are called. The emergency number is 112. Before they arrive, we provide first aid ourselves using a first aid kit and a set of anaphylactic shock medications and medical aids.

 UAB “Žiūra” has introduced the First Aid Instruction No. 10, which is given to all employees working in the company to get acquainted with and sign.