Patient Rights

Access to Care Individuals will have impartial access to accommodations or treatment available or medically indicated, regardless of basis of age, race, creed, ethnicity, religion, culture, language, physical or mental disability, sex, socioeconomic status, sexual orientation, gender identity/expression, diagnosis, or source of payment for care, national origin, marital or military status.

Respect, Dignity and Comfort The patient has the right to considerate and cooperative care with respect for their personal values, beliefs, and dignity. The patient has the right to appropriate pain assessment and management.

Privacy and Confidentiality The patient has the right, to make informed decisions within the law, to personal privacy with the following rights:

• To have a family member, support person, representative of choice, or physician notified promptly of his/her of admission to the hospital.
• To personal privacy, receive care in a safe setting.
• To know the reasons for any change in medical provider for patient care.
• To refuse to talk with or see anyone not officially connected with the hospital, including visitors or persons officially connected with the hospital but not directly involved in his/her
• To wear appropriate personal clothing, religious or symbolic items as long as there is no interference with diagnostic procedures or
• To be interviewed/examined in designed area to assure reasonable visual and auditory privacy. Including the right to request another person be present during certain parts of a physical examination, treatment or procedure performed by a health professional of the other sex. The right not to remain disrobed any longer than required. The patient’s modesty, viability, and body temperature shall be
• To expect that any discussion/consultation involving the case will be conducted discreetly and that individuals not directly involved in his/her care will not be present without his/her
• To expect his/her clinical records to be kept confidential as indicated by law, to have access to a copy of those records within a reasonable time period, meeting these requests as quickly as the EMR permits.
• To be placed in protective privacy if necessary for personal

Consultation The patient at his/her own request & expense, has the right to consult with a specialist, change provider, or seek a second opinion. The hospital must not decrease patients’ efforts to obtain access to their own medical record, verbally or in writing.

Grievance Process A prompt review of grievance, resolution & provision of responses for patient grievances, patient concerns regarding quality of care with discharge & appropriate utilization & quality control is established. A patient or staff member has the right to file a complaint or grievance at any time, expect that filing such a grievance will not affect future access or quality of care. The patient will be provided written notice of the decision, steps taken on behalf of the investigation with results of grievance process & date completed in 7 days. Contact Risk Manager at 712-563-5301. If a patient does not feel the grievance has been resolved effectively, he/she may contact Livanta by phone at 1-888-755-5580 or TTY at 1-866-868-2289, or by mail at Livanta, BFCC QIO, 10820 Guilford Rd Ste 202, Annapolis Junction, MD 20701-1262. Or Health Facilities Division of the Iowa Department of Inspections & Appeals 1-877-686-0027. The governing body will approve, be responsible, review & resolve grievances.

Cultural/Spiritual Values A patient has the right to have cultural, spiritual, psychosocial, personal values, beliefs & preferences respected & have access to pastoral & spiritual services.

Restraints The patient has the right to be free from punishment, physical or mental abuse. All patients have the right to be free from restraint or seclusion. Restraints or seclusion may only be used to ensure the immediate physical safety of the patient & others from harm & discontinued at the earliest possible time.

Discharge Planning The patient has the right to participate in the development, implementation of the plan of care, & request assistance with discharge planning from the time of admission & any time during the hospitalization related to their health status. A patient has the right to be informed, involved in decisions affecting care & treatment needs.

Transfer and Continuity of Care Prior to transfer to another facility, the patient will receive a complete explanation of the need for the transfer and of the alternatives to such a transfer. A patient has the right to request or refuse a transfer. The patient has the right to be informed by the practitioner responsible for his/her care, or his/her delegate, of any continuing health care requirements following discharge from the hospital.

Personal Safety/Security The patient has the right to expect reasonable safety and cleanliness per hospital practices and environment are concerned. The patient may expect freedom from all forms of abuse and harassment.

Visitors ACMH provides written policies/procedures regarding the visitation rights of patient, opens visiting hours subject to the patient’s consent, and the hospital’s clinical restrictions. The patient has the right to receive visitors as personally designates, including but not limited to, a spouse, a domestic partner (including a same sex domestic partner), family member or friend. Visitors will not be restricted based upon gender identity which is different than gender expression.

Identity The patient has the right to know the identity, qualifications, and professional status of individuals providing service to him/her and to know which physician or other practitioner is primarily responsible for his/her care.

Information The patient/patient representative has the right to obtain from the practitioners responsible for coordinating & providing care, complete & current information concerning diagnosis, treatment, explanation of all procedures, risks, & any prognosis. The patient has the right to have the bill explained & receive information about charges they may be responsible for.

Advanced Directives The patient has the right to receive information about and establish advanced directives about his/her healthcare, and have the hospital comply with those directives subject to limitations required by applicable law or medical standards. The patient has the right to legally appoint someone else to make decisions if the patient is unable to do so and have that person approve or refuse care, treatment, and services.

Communication The patient has the right to access people/visitors outside the hospital by verbal, written or in person communications. When a patient does not speak or understand the predominant language of the community, he/she may have access to an interpreter at no charge. Adaptive equipment will be sought in cases of deafness and/or blindness.

Consent The patient has the right to make reasonable, informed participation in decisions involving his/her health plan of care. A patient should not be subjected to any procedures without voluntary, competent, & understanding consent or of his/her legally authorized representative. When medically significant alternatives for care or treatment exist, patient shall be informed. The patient has the right to know who is responsible for authorizing & performing procedures or treatment.

Experimental Treatment/Organ Donation The patient has the right to say yes or no to experimental treatments. The patient has the right to refuse or decline at any time. The patient has the right to have their wishes followed concerning organ donation when wishes are made known, in accordance with the laws & regulations.

Patient Responsibilities

Provision of Information A patient has the responsibility to provide, to the best of his/her knowledge, accurate and complete information about the present complaints, past illnesses, hospitalizations, medications, any changes in condition, symptoms, including pain, and other matters relating to his/her condition to the responsible practitioner. A patient is responsible for reporting whether he/she clearly comprehends a contemplated course of action and what is expected of them. A patient is responsible for communicating questions or concerns to any member of the patient care team.

Compliance Instructions A patient is responsible for following the treatment plan recommended by the practitioner primarily responsible for their care. This may include following the instructions of nurses/health personnel as they carry out the coordinated plan of care, implement the practitioner’s orders, & enforce the applicable hospital rules and regulations. The patient is responsible for keeping appointments and when he/she is unable to do so for any reason, for notifying the responsible practitioner or the hospital.

Financial Charges The patient is responsible for paying hospital bills or to make arrangements for the financial obligations arising from the care.

Refusal of Treatment The patient is responsible for his/her actions if he/ she refuses treatment or does not follow the practitioner’s instructions. The patient may refuse treatment to the extent permitted by law. When refusal of treatment by the patient or his/her legally authorized representative prevents the provision of appropriate care in accordance with professional standards, the relationship with the patient may be terminated upon reasonable notice.

Hospital Rules and Regulations The patient is responsible for following hospital rules & regulations affecting patient care & conduct. The patient is responsible to protect personal valuables by sending them home with family/support person or have them placed in hospital designated safe area.

Respect and Consideration The patient is responsible for being considerate of the rights of other patients and hospital personnel, and for assisting with the control of noise and the number of visitors. The patient is responsible for being respectful of the property of other persons and of the hospital.

Notice of 24/7 Physician Coverage

A Doctor of Medicine (MD) or Doctor of Osteopathy (DO) is NOT present in Audubon County Memorial Hospital & Clinics at all times. In the case of an emergency medical condition, a physician is on call at all times with EAvera emergency services & will respond to provide medical treatment. Audubon County Memorial Hospital & Clinics utilizes the services of nurse practitioners & physician assistants.

Patients have a right to have a written copy of the Patient Rights document.

To submit a complaint/grievance contact:

You have the right to express concerns, complaints, and/or a grievance. You may do this by contacting:

Melanie Larsen
Director of Performance Improvement / Infection Control / Compliance Officer
Audubon County Memorial Hospital and Clinics
515 Pacific Avenue
Audubon, IA 50025
(712) 563-5238
compliance@acmhhosp.org

According to hospital policy and our regulatory agency requirements, we are required to inform you that you have a right to file a grievance to the following agencies:

• Health Facilities Division of the Iowa Department of Inspections and Appeals by contacting 1-877-686-0027.
• To your Quality Improvement Organization (QIO), Livanta, at 1-888-755-5580 or TTY 1-888-985-9295.
• Office of Medicare Beneficiary Ombudsman at the following website: https://www.cms.gov/Center/Special-Topic/Ombudsman/Medicare-Beneficiary-Ombudsman-Home
• For more information:
  • Visit Medicare.gov and select “Claims & Appeals” to get information about how to get your Medicare questions and complaints handled.
  • Visit Medicare.gov and select “File a complaint” under “Forms, Help, & Resources” to submit feedback about your Medicare health plan or prescription drug plan directly to Medicare.
  • Call 1-800-Medicare.
• Updated: 7/31/2023

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