Patient Rights

Access to Care Individuals will have impartial access to accommodations or treatments available or medically indicated, regardless of basis of 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 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 directly connected with his/her care at the hospital, including visitors or employees.
• To wear appropriate personal clothing, religious or symbolic items as long as there is no interference with diagnostic procedures or treatment.
• To privacy during an interview or examination in an area assuring reasonable visual and auditory privacy.
• To request another individual or choice present during portions of a physical examinations, treatments, or procedures performed by a health professional of another sex to promote feelings of safety.
• To not remain disrobed any longer than required. The patient’s modesty, viability, and body temperature shall be protected.
• To expect that any discussion or consultation involving the patient will be conducted discreetly and that individuals not directly involved in patient care will not be present without the patient’s or substitute decision-maker’s permission.
• To expect patient clinical records to be kept confidential as indicated by law.
• To have access to a copy of requested patient records within a reasonable time period, meeting these requests as quickly as the Electronic Medical Record allows.
• To be placed in protective privacy if necessary for personal safety.

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 abate or delay patient efforts to obtain access to their own medical record, verbally or in writing.

Voicing ConcernsA prompt review will be conducted for patient concerns, complaints, or grievances. A patient, family member, other patient support, or staff member has the right to voice concerns without discrimination, reprisal, retaliation or unreasonable interruption of care, treatment, or services. These individuals may voice concerns, file a complaint, or grievance, and recommend changes about the care received at any time during or after the visit to Audubon County Memerial Hospital & Clinics. The concern, compliant, or grievance filed will not alter access or reduce the quality of future services provided. These concerns will be reviewed and, when possible, resolved. It is best to report concerns as they happen. If you or your representative has a concern, please report it to another staff member. If it cannot be resolved immediately, it will be reported to the appropriate department director. The department director will discuss the concern with you or your representative & will do a thorough investigation. You will be provided a written notification of the outcome of this investigation within seven calendar days. For an external review, a patient, representative, or support can contact the appropriate external authority. That office would be responsible for the independent evaluation & follow-up. Submit an internal complaint/grievance contact:ACMH Compliance Officer, 515 Pacific Avenue, Audubon, Iowa 50025, Phone: 712-563-5238, Fax: 712-563-5277. To submit an external compliant/Grievance, contact:Or Health Facilities Division of the Iowa Department of Inspections & Appeals 1-877-686-0027. To report Medicaid fraud, waste, or abuse: call Iowa Medicaid Enterprise, Program Integrity Unit at 1-877-446-3787 (toll-free) or at 515-256-4615 (locally Des Moines). Medicare patient have the right to appeal a hospital discharge by contacting 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. Patients with other insurance plans also have the right to appeal a hospital discharge by contacting member services with his/her respective insurance plan. If a patient does not feel the grievance has been resolved effectively, he/she may contact the governing body to review & resolve grievances.

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

Restraints 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, can request assistance with discharge planning from the time of admission & anytime during the hospitalization related to their health status. A patient has the right to be informed, involved in decisions affecting care, treatment needs or any continuing health care requirements following discharge from the hospital.

Transfer and Continuity of Care Prior to transfer to another facility, the patient will receive a complete explanation of the purpose and possible alternatives to the 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 a safe, clean environment within the hospital. The patient has the right to be free from physical abuse, mental abuse, punishment, or 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 desired, but not limited to a spouse, domestic partner, family member, or friend. Visitors will not be restricted based upon sexual orientation or 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. The patient as the right to legally appoint a medical decision maker to make medical decisions on his/her behalf should he/she become incapacitated. Medical decisions include the refusal of care, treatment, and services. The hospital will comply with advanced directives, subject to limitations required by applicable law or medical standards.

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. The 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, the patient shall be informed. The patient has the right to know who is responsible for authorizing & performing the 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, to include pain, and other matters relating to his/her condition to the responsible practitioner. A patient is responsible for identifying whether he/she clearly comprehends a contemplated course of action and what is expected of him/her. 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 his/her care. This may include following the instructions of nurses or health personnel who are administering the coordinated plan of care, implementing the practitioner’s orders, & enforcing the applicable hospital rules and regulations. The patient is responsible for keeping appointments to include changing or canceling appointments as necessary for any reason.

Financial Charges The patient is responsible for paying hospital bills. Financial counseling is available to make arrangements for financial obligations arising from 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 valuables placed in hospital designated safe area.

Respect and Consideration The patient must be considerate of the rights of other patients and hospital personnel to include 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.

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
Chief Operating Officer / 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: 11/8/2024

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