Ellsworth Municipal Hospital

Healthcare You
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Patient Rights & Responsibilities

Because of our belief in the dignity and value of persons, Ellsworth Municipal Hospital affirms that each patient will receive accessible, respectful, skillful, and compassionate care without discrimination as to race, color, creed, gender, marital status, beliefs, national origin, age, disability, diagnosis, or ability to pay.

You have the Right...To make informed decisions regarding your own health care, and be involved in the development and implementation of your plan of care.

  • To be informed of your health status
  • To discuss with your physician (in terms understandable to you), your diagnosis, the treatment prescribed for you, the prognosis of your illness, and any instructions required for follow-up care.
  • To receive from your physician, information necessary to give informed consent, and to ask questions prior to the start of any procedures and/or treatment.
  • To request a consultation or second opinion.
  • To have your family involved in the decision-making process, if allowed by the patient.
  • To formulate Advance Directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives.
  • To request or refuse treatment to the extent permitted by law, and to be informed of the medical consequences of your decision.
  • To inform the hospital personnel of your Advanced Directive (Durable Power of Attorney for Health Care or Living Will) and provide a copy to the hospital.
  • To have access to the Ethics Committee for assistance in personal decision-making.
  • To obtain information about any relationship the hospital and physicians have with other institutions and physicians, as far as your care is concerned.

You have the Right...To compassionate and respectful care of body, mind, and spirit provided in a collaborative and interdisciplinary manner by qualified individuals.

  • To receive health care that meets (or exceeds) professional standards.
  • To appropriate assessment and management of pain.
  • To expect continuity of care.
  • To expect reasonable safety in the performance of procedures and safety in the environment.
  • To be free from restraints and seclusions of any form that are not medically necessary or are used as a means of coercion, discipline, or convenience or retaliation by staff.
  • To receive kind and considerate care at all times and shall be free from all forms of abuse or harassment.
  • To have a family member or other representative of your choice and your family physician be notified promptly of your admission to the hospital.

You have the Right...To Spiritual Counseling.

  • To confidential spiritual counseling.
  • To choose or refuse a visit by clergy or any spiritual care person.
  • To request religious observances of your choice.

You have the Right...To personal privacy and confidentiality of health information.

  • To expect to have your personal and physical privacy maintained and have your property treated with respect.
  • To expect that all communications and records pertaining to your care will be treated as confidential.
  • To privacy concerning discussions and consultations related to your care.
  • To access the information contained in your clinical records within a reasonable time frame and to have it explained to you.
  • To examine and receive an explanation of your bill.
  • To have unrestricted access to communication (visitors, mail, telephone calls or other forms of communication available within the medical center), unless your condition warrants restriction or limitation.
  • To accept or refuse visitors.

You have the Right...To education regarding your condition, its causes and treatment.
To receive the appropriate information and education necessary to manage your condition which enables you to achieve the healthiest lifestyle possible.

You have the Right...To know your rights, exercise your rights, and have access to a grievance process for unresolved complaints.

  • To receive a copy of the Patient Rights and Responsibilities brochure.
  • To know what hospital rules and regulations apply to you as a patient.
  • To change health care providers, i.e., physicians or hospitals. This change may be based upon your decision regarding a certain course of medical care and treatment that cannot be honored for reasons of legal liability, medical ethics, personal conscience, or other appropriate reason. You will be informed of this fact and your physician will be assisted, where appropriate, in making arrangements for the transfer of your care to another physician and/or health facility.

To file a grievance in the hospital during your stay contact:

  1. The manager of the department where you are receiving care.
  2. The Patient Advocate at Ext. 7013.
  3. If your complaint/grievance is not resolved to your satisfaction, you may write or call the Administrator (Cherelle Montanye, 641-648-7012) or the Assistant Administrator/DON (Steve Mulford, 641-648-7012) at 110 Rocksylvania Avenue, Iowa Falls, IA 50126.

Recognizing that better outcomes are achieved when a spirit of cooperation exists between yourself and those providing care to you, we, the medical center, affirm certain patient responsibilities.

You have the Responsibility...

  • To participate in your plan of care, cooperate and follow the care prescribed or recommended for you by your physician, nurses, or allied health personnel.
  • To accept the consequences for your actions if you refuse treatment or do not follow the instructions of your caregivers.
  • To provide your caregivers with accurate and complete information about symptoms, complications and side effects, past illnesses, hospitalizations, medications, and other matters relating to your health care.
  • To notify your physician or nurse if you do not understand your diagnosis, treatment or prognosis.
  • To accept the financial obligations associated with your care and to fulfill these obligations as promptly as possible.
  • To know and to follow rules and regulations of the hospital.
  • To protect your valuables by sending them home with family members or having them placed in the medical center safe.
  • To sign required consents and releases for care.
  • To inform the hospital personnel of your Advance Directives (Durable Power of Attorney for Health Care or Living Will) and to provide a copy to the hospital.
  • To advise your nurse, physician, or other caregivers of any dissatisfaction you may have in regard to your care at the hospital.
  • To be considerate of the rights of other patients and hospital personnel, and to assist in the control of noise and the number of visitors you receive.
  • To file a written or verbal grievance with the Iowa Department of Inspection and Appeals, Division of Health Facilities, Lucas State Office Building, Des Moines, IA 50319, Phone: 515-281-4115.
©  2014 

Hansen Family Hospital | 920 South Oak Street | Iowa Falls, Iowa 50126 | 641-648-4631

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