Patient Rights and Responsibilities
You are a full partner in your hospital care.
When you are well informed, participate in treatment decisions and communicate openly with your physician and other health professionals, you help make your care as effective as possible.
We respect your personal preferences and values. UnityPoint Health – Allen Hospital promotes the rights, interests and well being of our patients.
It is our policy that these rights shall be respected, and no patient shall be required to waive these rights as a condition of treatment.
As a patient, parent or legally responsible representative of a patient, you have the right to:
1. Be informed in writing of your rights before patient care is furnished or discontinued whenever possible.
2. Receive effective communication. When written information is provided, it is appropriate to your age, understanding and language appropriate to the populations we serve.
3. Have language interpreters available at no cost to you.
4. Be provided with information which meets the needs of patients with vision, speech, hearing, language or cognitive impairments.
5. Be treated kindly and respectfully by all hospital personnel.
6. Receive complete and current information concerning your diagnosis, treatment and prognosis in terms you can understand. When it is not medically advisable to give such information, it should be made available to an appropriate person on your behalf.
7. Consult with a specialist of your choosing at your request and expense if a referral is not deemed medically necessary by your attending physician.
8. Be given an explanation of any proposed procedure or treatment. The explanation should include a description of the nature and purpose of the treatment or procedure; the known risks or serious side effects; and treatment alternatives.
9. Know the name, identity and professional status of the physician or other practitioners providing care, services and treatment to you at the time of service.
10. Know the name of the physician or other practitioner who is primarily responsible for your care, treatment and services within 24 hours after admission.
11. Expect that a family member (or representative) and physician will be notified promptly of your admission to the hospital.
12. Participate in developing, approving and implementing your plan of care.
13. Make informed decisions and be involved in resolving concerns about your care, treatment and services. With your permission and as appropriate by law, your family will be involved in care, treatment and service decisions.
14. Have a surrogate decision-maker, as allowed by law, identified when you cannot make decisions about your care, treatment and services.
15. Have an advanced directive, such as a living will, a healthcare power of attorney, or IPOST, and to have hospital staff and practitioners who provide care in the hospital comply with theses directives. These documents express your choices about your future care or name someone to make healthcare decisions if you are unable. If you have a written advanced directive, you should provide a copy to the hospital, your family and your doctor. If you have an IPOST, you should bring it with you to the hospital. You may review and revise your advanced directive. The existence or lack of an advanced directive does not determine an individual's access to care, treatment or services.
16. Refuse medical care, treatment or services to the extent permitted by law and regulation and to be informed of the medical consequences of such refusal. When you are not legally responsible, your surrogate decision maker, as allowed by law, has the right to refuse care, treatment or services on your behalf.
17. Access to receive treatment, care or services within the capability, capacity and mission of Allen Hospital, in compliance with law, regulation and payment policies.
18. Request transfer of your care to another physician or facility.
19. Receive medical evaluation, service and/or referral indicated by the urgency of your situation. When medically permissible, you may be transferred to another facility only after having received complete information and explanation concerning the need for and alternative to, such a transfer. The facility to which you will be transferred must first accept the transfer.
20. Be involved in decisions subject to internal or external review that result in denial of care, treatment, services or payment based upon your assessed medical needs.
21. Receive care and treatment that maintains your personal privacy and dignity. Discussions about your care, examination or treatment are confidential and should be conducted discretely. You have the right to exclude those persons not directly involved in your care. If you desire to have private telephone conversations, you will have access to private space and telephones appropriate to your needs.
22. Be treated in an environment that preserves dignity and supports your positive self-image.
23. Expect that all communications and clinical records pertaining to your care will be treated confidentially.
24. Access, request amendment to and receive an accounting of disclosure regarding health and clinical services information as permitted by law.
25. Access information contained in your medical records within a reasonable time frame. Information is available on the Allen
Hospital website under: Patients, Medical Records. Information
including requests will be processed and fulfilled within five
(5) working days. There is a fee for copies based on the type of
request and the number of copies made. See UnityPoint Health
System policies: Release of Protected Health Information -
No Authorization Required, Release of Protected Health Information - Authorization Required, and Release of Protected Health Information - Substance Abuse/Mental Health and HIV/AIDS.
26. Have your cultural, psychosocial, spiritual and personal values, beliefs and preferences respected.
27. Exercise cultural and spiritual beliefs that do not interfere with the well-being of others. Certain cultural and spiritual beliefs may nevertheless interfere with the planned course of your medical therapy. You may exercise your cultural and spiritual beliefs and take actions in accordance therein as are legally recognized and permissible in the State of Iowa.
28. Know if your care involves any experimental methods of treatment, and if so, you have the right to consent or refuse to participate. This will not compromise your access to care, treatment and services.
29. Be informed by the practitioner of any continuing healthcare requirements following discharge.
30. Examine your bill and receive an explanation of the charges regardless of the source of payment for your care within a reasonable period of time following receipt of a request.
31. Be informed of the hospital rules and regulations applicable to your conduct as a patient.
32. Use the UnityPoint Health – Allen Hospital grievance (complaint) resolution process for submitting a written or verbal grievance to the Patient Advocate, your caregivers, your healthcare practitioners or Administration. You may freely voice complaints and recommend changes without being subject to coercion, discrimination, reprisal or unreasonable interruption of care, treatment and services. If you submit a complaint or grievance, it will be investigated. Action will be taken to resolve the concern either verbally or in writing when appropriate.
33. Receive a written response to your grievance from the hospital within seven (7) calendar days.
34. Refer complaints or grievances regarding quality of care, premature discharge or beneficiary complaints to:
Iowa Department of Inspections and Appeals
Health Facilities Division
Lucas State Office Building
Des Moines, IA 50319
Toll free 877-686-0027
KEPRO (Medicare patients)
5201 West Kennedy Boulevard, Ste 900
Tampa, FL 33609
The Joint Commission (accreditation of healthcare organizations)
One Renaissance Boulevard
Oakbrook Terrace, IL 60181
35. Be free from restraints or seclusion of any form that are not medically necessary or are used as a means of coercion, discipline, convenience or retaliation by staff.
36. Receive information about rights as a Medicare beneficiary at admission.
37. Receive care in a safe and secure environment for you and your property.
38. Be free from all forms of abuse, neglect, exploitation or harassment.
39. Receive appropriate assessment and management of pain.
40. Expect unrestricted access to communication. If visitors, mail, telephone calls, or other forms of communication are restricted as a component of your care, you will be included in any such decision.
41. Be informed of your health status.
42. Have the hospital support your right to access protective and advocacy services by providing a list of community resources.
43. Be informed about the outcomes of your care, treatment and services including unanticipated outcomes that you must be knowledgeable about to participate in current and future decisions affecting your care, treatment and services.
44. Safe and effective care, treatment and services regardless of your ability to pay.
45. Know which patient care areas have limited visitation and if admitted to one of these areas to have these limitations discussed with you (or support person as appropriate) at the time of admission. (Areas with limitations: NICU, Mental Health, PACU, ED and OB).
46. Receive the visitors you designate, including but not limited to: spouse, domestic partner (including same sex domestic partner), another family member or friend, and your right to withdraw or deny such consent at any time.
47. Know that Allen Hospital does not restrict, limit or deny visitation privileges on the basis of race, color, national origin, religion, sex, gender identity, sexual orientation or disability.
48. Know that Allen Hospital is committed to ensuring that all visitors enjoy full and equal visitation privileges consistent with patient preferences.
49. Know that Allen Hospital's informed consent policy includes what care, treatment, and services require informed consent, when a surrogate decision maker can give informed consent, and all the elements that comprise informed consent.
50. Know that Allen Hospital will inform you or your surrogate decision maker of unanticipated outcomes of your are, treatment, and services that relate to sentinel events.
As a patient, you have the responsibility:
1. To provide accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to your health, including advanced directives; and to report perceived risks in your care, unexpected changes in your condition and whether you clearly comprehend a contemplated course of action and what is expected.
2. To follow the treatment plan recommended by the practitioner primarily responsible for your care. This may include following the instructions of nurses and other healthcare professionals as they implement the practitioner's orders and enforce the applicable hospital rules and regulations.
3. For your actions if you refuse treatment or if you do not follow the practitioner's instructions.
4. To assure that the financial obligations of your care are fulfilled as promptly as possible.
5. To follow hospital rules and regulations affecting patient care and conduct. Among these are prohibition of the use of any tobacco products or alcoholic beverages on the premises of the hospital and hospital visitor policies.
6. To be considerate of the rights of other patients and hospital personnel, and for assisting in the control of noise, smoking and number of visitors in your room.
7. To ask questions when you do not understand what you have been told about your care or what you are expected to do.
It is the goal of Allen Hospital that associates closest to the issue address complaints and concerns immediately. Patients have the right to voice complaints or concerns to those immediately involved. However, if you do not feel your complaint or concern is being addressed adequately or in a timely manner, please talk with your nurse or contact the Patient Advocate.
UnityPoint Health – Allen Hospital
1825 Logan Avenue
Waterloo, IA 50703
(319) 235-3567 or 3567 on your room phone
President and CEO
UnityPoint Health – Allen Hospital
1825 Logan Avenue
Waterloo, IA 50703
(319) 235-3987 or 3987 on your room phone
Allen Hospital supports the patient's right to access protective services, including but not limited to guardianship, advocacy and child or adult protective services. You have the right to access state client advocacy groups and to file a complaint if you have a concern about patient abuse, neglect or misappropriation of your property in our facility. The following agencies are available to assist you:
Office of Quality Monitoring
The Joint Commission
One Renaissance Blvd.
Oakbrook Terrace, Illinois 60181
Patient Advocacy Services
3015 Merle Hay Road - Suite 6
Des Moines, Iowa 50310
Medicaid Fraud Control Bureau
Lucas State Office Building, Second Floor
Des Moines, Iowa 50319-0083
Iowa Department of Inspections and Appeals
Lucas State Office Building, Third Floor
Des Moines, Iowa 50319-0083
Iowa Insurance Commission
330 Maple Street
Des Moines, Iowa 50319
Your right to confidentiality is included in your rights as a patient. All Allen Associates are bound to confidentiality by hospital policy and professional and personal ethics. Communications, such as written reports, documents, records, computer printouts, schedules or other written information, is considered confidential. Only persons with legitimate interests, who must utilize information found in clinical records or communications in order to carry out their duties and responsibilities to the patient and the hospital, may have access to this information. In addition, patient information to which Associates have access either formally or informally shall not be disclosed or discussed outside the realm of professional responsibility.
We are required by federal law to maintain the privacy of your medical information and give you our Notice of Privacy Practice that describes our privacy practices, our legal duties and your rights concerning your medical information. This Notice is available in a separate brochure and will be offered to you at the time you are admitted, or prior to receiving outpatient care.
Do Not Announce Status
Confidentiality about your health status is important. Information can only be given to immediate family. You may want to designate a family contact to provide updates to others. We will strive to protect your privacy during your stay. Patients who wish to have complete privacy and avoid all outside contacts may request Do Not Announce status. With this level of confidentiality, our staff will neither confirm nor deny a patient's presence at the hospital. Room and telephone numbers will not be disclosed. Flowers, mail or other parcels will be returned to the sender.