Patient Rights & Responsibilities

The patient has a right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the facility. Audubon County Memorial Hospital & Clinics will protect and promote the rights of each patient including each of the following rights:


The patient’s rights include the following:

  • The right to be treated without discrimination regardless of diagnosis, age, race, ethnicity, national origin, religion, culture, language, physical or mental disability, gender, gender identity or expression, sexual orientation, marital status, veteran’s status or source of payment for care.
  • The right to considerate and respectful treatment. This includes being treated in a way that respects your dignity as a person and respects your values, beliefs and preferences for your healthcare.
  • The right to consent to receive visitors and to receive visitors whom you designate (either orally or in writing) including, but not limited to a spouse, a domestic partner (including a same sex domestic partner), another family member, or a friend.
  • The right to have an individual of your choosing present as your support person and to withdraw or deny this consent (either orally or in writing) at any time.
  • The right to receive care in a safe setting and to be free from all forms of abuse or harassment, including mental, physical, sexual or verbal abuse, harassment, neglect, exploitation, and corporal punishment. The right to expect reasonable safety insofar as the practice and environment are concerned.
  • The right to be free from restraints or seclusion imposed as a means of coercion, discipline, convenience, or retaliation by staff.
  • The right to personal privacy during examination and treatment. All discussions or consultation involving your case will be conducted in such a manner that your privacy is assured. Individuals not directly involved in the case will not be present without your permission.
  • The right to have your medical records and personal healthcare information kept confidential as set forth in the Notice of Privacy Practices, including who should or should not receive information and be involved in discussions about your healthcare.
  • The right to participate in the development and implementation of the plan of care. The patient or his/her representative has the right to make informed decisions regarding your care, including being informed of his/her health status, being involved in care planning and treatment, and being able to request or refuse treatment.
  • The right to know the names and professional status of your doctors and other healthcare team members.
  • The right to ask for information about your bill, including an itemized explanation of charges.
  • The right to have your doctor and your representative notified if you are admitted to the hospital.
  • The right to make informed decisions about your healthcare. This includes being provided information about your healthcare including the diagnosis, prognosis, care options, risks and benefits of treatments, expected and unexpected outcomes of treatments and discharge and transfer plans.
  • The right to be informed in advance of furnishing or discontinuing care whenever possible and the right to decide which treatment options you do or do not want to accept to the extent permitted by law.
  • The right to request/seek the opinion of additional doctors or healthcare providers. (You may need to pay for these costs.)
  • The right to formulate or update Advance Directive documents to reflect your current healthcare preferences. The right to have these preferences as stated in your Advance Directive document honored by your doctors and healthcare providers, or to be notified by your doctors and healthcare providers about why they cannot honor your preferences.
  • The right to access information contained in your medical record within a reasonable time frame. The hospital will actively seek to meet these requests as quickly as the record keeping system permits.

The right to share your concerns openly and confidentially with your doctors and other healthcare providers.


The patient’s responsibilities include the following:

  • To treat your doctors and healthcare providers with dignity and respect.
  • To treat other patients and visitors with dignity and respect.
  • To respect the rights of other patients and their caregivers.
  • To follow Audubon County Memorial Hospital’s rules and guidelines while in our care.
  • To give correct and complete information about yourself and your current and past health.
  • To be involved in setting goals for your care and making decisions about your treatment.
  • To ask questions when you do not understand any information about your healthcare.
  • To work with your doctors and healthcare providers to meet your goals and carry out your decisions.
  • To follow the treatment plan recommended by your doctor and healthcare team while in our facilities.
  • To take responsibility for the outcomes of refusing treatment or not following instructions of your doctors and healthcare providers.
  • To provide Audubon County Memorial Hospital with a copy of your current Advance Directive documents.
  • To bring your current insurance card, Medicare care or Medicaid or other identification card to your visits.
  • To take care of financial obligations for your care as soon as possible.
  • To tell us about any concerns you have about your safety and comfort.
  • To tell us if you are not satisfied with your care.

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

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: 
  • For more information:
    • Visit and select “Claims & Appeals” to get information about how to get your Medicare questions and complaints handled.
    • Visit 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.