Patient Bill of Rights

Elm Heights Care Center
1203 South Elm Street
Shenandoah, IA 51601
Phone: (712) 246-4627

Privacy & Rights

Patient Bill of Rights

You have the right to:

  1. Be informed of your patient rights in advance of receiving or discontinuing care when possible.
  2. Have impartial access to care and visitation. No one is denied access to treatment or visitation because of disability, national origin, culture, age, color, race, religion, gender identity or sexual orientation. No one is denied examination or treatment of an emergency medical condition because of their source of payment.
  3. Give informed consent for all treatment and procedures and receive an explanation in layman terms of:
          - Recommended treatment or procedure.
          - Risks and benefits of the treatment or procedure.
          - Likelihood of success, serious side effects and risks including death.
          - Alternatives and consequences if treatment if declined.
          - Whether physicians or qualified medical providers other than the operating physician will
            be performing important parts of the surgery or administering the anesthesia.
  4. Participate in all areas of your care plan, treatment, care decisions and discharge plan.
  5. Have appropriate assessment and management of your pain.
  6. Be informed of your health status and/or prognosis.
  7. Be treated with respect and dignity.
  8. Personal privacy, comfort and security to the extent possible during your stay.
  9. Be free from restraints (physical or chemical) or seclusion imposed as a means of coercion, discipline, convenience or retaliation by staff.
  10. Confidentiality of all communication and clinical records related to your care.
  11. Have access to telephone calls, mail, etc. Any restrictions to access will be discussed with you, and you will be involved in the decision when possible.
  12. Have the right to choose a "visitor" who may visit you, including but not limited to; a spouse, a domestic partner (including a same-sex domestic partner), another family member, or a friend, and your right to withdraw or deny such choice at any time. You also have the right to an identified "support person" who can make visitation decisions should you become incapacitated.
  13. Have access to interpreter services at no cost to you or your companion when you do not speak or understand the language, as well as communication aides, at no cost, for the hearing impaired, visually impaired, speech impaired, etc., as appropriate.
  14. Have access to spiritual and/or pastoral care.
  15. Receive care in a safe setting.
  16. Be free from all forms of abuse or harassment.
  17. Have access to protective services (e.g., guardianship, advocacy services and child/adult protective services).
  18. Request medically necessary and appropriate care and treatment.
  19. Refuse any medication, test, procedure or treatment and be informed of the medical consequences of such decision.
  20. Consent to or refuse to participate in teaching programs, research, experimental programs, and/or clinical trials.
  21. Receive information about Advance Directives. Set-up or provide Advance Directives and have them followed. Designate a surrogate decision-maker (legal representative) as permitted by law and as needed.
  22. Participate in decision-making concerning ethical issues, personal values or beliefs.
  23. Have a family member or representative of your choice and your physician promptly notified of your admission to the hospital.
  24. Know the names, professional status and experience of your caregivers.
  25. Have access to your clinical records within a reasonable timeframe.
  26. Be examined, treated and if necessary - transferred to another facility if you have and emergency medical condition or are in labor, regardless of your ability to pay.
  27. Prior to the initiation of non-emergent care or treatment, request and receive the charges (or estimate of charges) for routine, usual and customary services including any copayment, deductible or non-covered charges, as well as the facilities general billing procedures including receipt and explanation of an itemized bill. This right is honored regardless of the source(s) of payment.
  28. Be informed of the Medical Center's compliant and grievance procedure and whom to contact to file a concern, complaint or grievance.
  29. Patients have the right to receive a complete copy of the hospital's Notice of Privacy Practices.

Note: If you have concerns or questions, please contact
Dennis De Wild at (712) 246-4627.

  • Our priority is for you to have an exceptional patient experience. If you concerns are not being resolved with your immediate caregiver or department manager, please call the Elm Heights Administrator, Sue Wittfhoft at (712) 246-4627.
  • You may also directly contact The Iowa Department of Inspections and Appeals in Des Moines at 515-281-4115, Local LTC Ombudsman South West Iowa at 712-249-7424 or Ombudsman at 800- 532-3213.

Patient Responsibilities

You have the responsibility to...

  1. Ask questions and promptly voice concerns.
  2. Give full and accurate information as it relates to your health, including medication- (prescription and over-the-counter).
  3. Report changes in your condition or symptoms, including pain, and requesting assistance of a member of the health care team.
  4. Participate in the planning of your care, including discharge planning.
  5. Follow your recommended treatment plan.
  6. Be considerate of other patients and staff.
  7. Secure your valuables.
  8. Follow facility rules and regulations.
  9. Respect property that belongs to the facility or others.
  10. Understand and honor financial obligations related to your care, including understanding your own insurance coverage.

Note: a copy of the patient bill of rights and responsibilities is provided upon registration.