The right to respectful, skillful and compassionate care of your mind, spirit and body.

• You will receive healthcare that meets professional standards in a safe setting.
• You will receive care without discrimination as to race, color, creed, sex, sexual orientation, beliefs, national origin, age, handicap, diagnosis, or ability to pay.
• You may expect that your personal beliefs and values will be respected.
• You have the right to expect unrestricted access to communication. Sometimes it may be necessary, as a component of your care, to restrict visitors (due to clinically necessary restrictions for health and safety of the patient or of their roommate), mail, telephone calls or other forms of communication. You and your family will be included in any such decision.
• You may expect to have your personal and physical privacy maintained and have your property treated with respect.
• You may have access to hospital financial records pertaining to you and have them explained.
• You may expect to have access to appropriate protective services (i.e. Adult Protective Services).

The right to choose who may or may not visit, regardless of whether the visitor is legally related to you.

• You may withdraw or deny this consent at any time.
• Based on need for reasonable, clinically necessary restrictions, Buchanan County Health Center may refuse or limit visitation.

The right to prompt resolution of grievances.

You may express concerns by:

• Writing comments on surveys.
• Expressing concerns directly to caregivers in charge of patient care.
• If covered by Medicare, initiating external complaints via numbers found in the Message from Medicare.
• If not covered by Medicare, initiating external complaints via:
  Iowa Department of Inspection and Appeals
  Lucas State Office Building
  321 East 12th Street
  Des Moines, IA 50319-0083
  Phone: 515-281-7102
  Fax: 515-242-6863
• Requesting formal action through the Hospital Administrator or designee. They must be notified for formal action and investigation of a grievance. This may be done by writing letters to Administration at 1600 First Street East, Independence, IA 50644 or calling and asking to speak to Administration at 319-332-0999. Upon receipt of concern, Administration has the responsibility to review, investigate and respond to the party initiating the grievance. This investigation will be initiated within two (2) working days of notification of the concern. A written notice of Administration’s decision containing the name of the hospital contact person, steps taken to investigate the grievance, results of the grievance process, and the completion date will be sent to the party initiating the concern. This response will occur within two (2) weeks of the initial complaint.

The right to personal privacy, confidentiality and availability of records.

• You may expect that any discussion or conversation regarding your care will be discreet and professional in nature.
• You may access your information in a reasonable time frame and have it explained to you.
• You have protection from unauthorized review of your records.

The right to information that will permit you to participate in development of an implementation of your plan of care.

• You may make informed decisions regarding your care. This includes choosing a personal attending physician, being informed as to health status, care planning, treatment, and requesting and refusing treatment.
• You may refuse any treatment, procedure or participation in experimental research.
• You may ask questions and expect honest, understandable answers allowing you to participate in and make informed decisions about your care.
• You may assist in the formulation of your health care and Advance Directives and have providers comply with these directives.
• You may have a family member, support person or physician notified promptly of your admission to the hospital.
• You may expect to be informed if the facility will be unable to provide specific specialty care.

The right to education regarding your condition, its causes and treatment.

• You may expect to receive the appropriate knowledge/skills necessary to manage your condition.
• You may expect to receive and use necessary information enabling you to achieve a healthier lifestyle.
• You will be asked to provide information about your health, including past illnesses, hospital stays and medications.
• You may expect to receive appropriate after-care instructions and referral.

The right to spiritual counseling.

• You have access to confidential spiritual counseling.
• You may choose or refuse a visit by clergy or any pastoral care person.
• You may request religious observances of your choice.

The right to be free from restraints of any form that are not medically necessary.

You may only have a restraint used to improve your well-being when least restrictive methods are ineffective. The restraints must be:

• Ordered by a physician, never as a standing or PRN order, and followed by a consultation with the treating physician as soon as possible.
• In accordance with a written modification to the plan of care.
• Implemented in the least restrictive manner.
• In accordance with safe and appropriate restraining techniques.
• Ended at the earliest possible time.
• Your condition will be continually assessed, monitored and re-evaluated while restrained.

Recognizing that a spirit of cooperation must exist between yourself and those providing care to you, we affirm the following patient responsibilities:

• The responsibility to provide truthful and complete health information regarding health problems you experience (including any complications or side effects from the care received).
• The responsibility to tell the hospital or doctor’s office if you have prepared an advance directive for healthcare. (Medical Power of Attorney or Living Will)
• The responsibility to participate in your plan of care and cooperate with your physician and other caregivers.
• The responsibility to sign required consents and release for care, and to pay for care as agreed.
• The responsibility to make it known if you do not understand what you have been given in education, instructions or communication.
• The responsibility to protect your valuables by sending them home with family members or having them placed in the hospital locked area.
• The responsibility to treat hospital personnel with respect and consideration, and to respect the rights of other patients.
• The responsibility to provide the hospital or doctor’s office with your insurance and financial information.

If you have any questions about your rights and responsibilities while in the hospital, contact Steve Slessor, CEO at sslessor@bchealth.org