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Patient Policies

Patient Policies

Statement of Patient’s Bill of Rights:

  1. You have certain rights, under law and regulation, and to be informed of these rights in advance of furnishing or discontinuing care. These rights are extended to you regardless of your age, race, religion, national origin, sex, sexual preference, handicap, diagnosis, ability to pay or source of payment.
  2. You (or your support person, where appropriate) have visitation rights, including any clinical restriction or limitation on such rights. You (or your support person) have the right subject to your consent, to receive visitors whom you designate, including but not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member, or a friend and you have the right to withdraw or deny such consent at any time. Visitors will not be restricted, limited, or denied visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation or disability. All visitors will enjoy full and equal visitation privileges consistent with patient preferences.
  3. You have the right to identify a person who may be present for emotional support during your stay, unless the individual’s presence interferes with others’ rights or safety or is not in your best interest medically, therapeutically or legally. 
  4. You have the right to be informed of your rights and to participate in the development and implementation of your plan of care.
  5. You or your representative have the right to make informed decisions about your care.
  6. Your rights include being informed of your health status, being involved in care planning and treatment, and being able to request or refuse treatment.  This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate.
  7. You have the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives.
  8. You have the right to personal privacy.
  9. You have the right to receive care in a safe setting.
  10. You have the right to be free from all forms of abuse or harassment.
  11. You have the right to the confidentiality of your clinical records.
  12. You have the right to access information contained in your clinical records within a reasonable time frame.
  13. You have the right to have a family member of your choice and your physician notified promptly of your admission.
  14. You have the right to be free from restraints of any form that are not medically necessary.  A restraint can only be used if needed to improve the patient’s well being and less restrictive interventions have been determined to be ineffective.
  15. You and your family have the right to have your compliments, concerns, and complaints addressed.  Sharing your concerns and complaints will not compromise your access to care, treatment and services.  Please call 319-470-0467 and speak to the Nursing Supervisor.  If you have concerns about quality of care issues or premature discharge, you may contact Telligen at 800-752-7014 or CIHQ at 512-661-2813.

No catalogue of rights can guarantee for the patient the kind of treatment he has a right to expect.  A hospital has many functions to perform, including the prevention and treatment of diseases, the education of both health professionals and patients, and the conduct of clinical research.  All these activities must be conducted with an overriding concern for the patients and above all the recognition of his dignity as a human being.  Success in achieving this recognition assures success in the defense of the rights of the patient.

If you wish to write the hospital before or after discharge please address your concern to:

FMCH Administration
Attn: Compliance Officer
5445 Avenue O
Fort Madison, IA 52627

Statement of Patient’s Responsibility:

Because we believe that restoration of health is a team effort shared by the patient, their family, the physician and the health care team, we would appreciate the patient’s cooperation in following these patient responsibilities:

  1. It is important that the patient provides us with accurate and complete information concerning his/her present complaints, past medical history (including illnesses and hospitalizations) and other matters relating to his/her health.
  2. We ask that the patient report any unexpected changes in his/her condition to a member of the health care team.
  3. The patient has the right to understand the course of his/her treatment.  If the patient does not clearly understand the plan of care, he/she informs either their physician or any member of the health care team for clarification.
  4. The patient is responsible for following the treatment plan established by his/her physician, including the instruction of nurses and other health professionals as they carry out the physician’s orders.  If the patient does not feel comfortable with any component of the treatment plan, we ask that he/she discuss it with his/her physician.
  5. We request that the patient and their family are considerate of the rights of other patients and hospital personnel.


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