Any person, visitor, customer, and/or vendor at Intermountain Health shall:

• Be free from discrimination.
• Respect the property, comfort, and privacy of Intermountain Health patients and employees.
• Treat others with respect and maintain civil language and conduct with all interactions between staff and licensed independent providers.
• Have the right to file a complaint or grievance (see below for more information).

If you have a complaint or grievance about the quality of your care, you, your family member, or surrogate should contact the immediate supervisor of the unit or department. If your concerns are not resolved by your care team, please reach out to Clinical Relations at (855) 442-7855, Monday-Friday 9:00 am – 5:00 pm or send an email to PatientFeedback@imail.org.

To file a grievance with:

• State of Utah, call (800) 662-4157 or send a letter to the Utah Bureau of Health Facility Licensing, Certification and Resident Assessment, P.O. Box 144103, Salt Lake City, UT 84114-4103.
• State of Idaho, call Idaho Bureau of Facility Standards at (208) 334-6626, P.O. Box 83720, Boise, Idaho 83720-0009 or 3232 Elder Street, Boise, Idaho 83705 or the Idaho Board of Medicine at (208) 327-7000.
• State of Colorado, call Colorado Department of Public Health and Environment (303) 692-2827, Health Facilities Division 4300 Cherry Creek Drive South, Denver, Colorado, 80246-1530, cdphehfdintake@state.co.us.
• State of Montana, call the Montana Department of Public Health and Human Services Quality Assurance Division, (406) 444-2099, Fax 406-444-3456, Compliance Coordinator (406) 444-4463, dphhs.mt.gov/qad, 2401 Colonial Dr. PO Box 202953, Helena, MT 59620-2953.

To file a grievance with any state, call the Joint Commission at (800) 994-6610. You can also reach The Joint Commission, using “Report a Patient Safety Event” link in the “Action Center” on the home page of the website, or by mail to The Office of Quality and Patient Safety (OQPS), The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181.

Medicare Beneficiaries can file a complaint regarding the quality of care, disagree with a coverage decision, or to appeal a premature discharge with the Quality Improvement Organization (QIO) in the following ways:

• Colorado, Montana, Utah, Idaho, Wyoming - Acentra Health (888) 317-0891 (toll-free)
• Nevada, Kansas - Livanta 877-588-1123
• Or, contact the Office of Medicare Ombudsman
• Beneficiary and Family Centered Care-Quality Improvement Organizations

Any patient or other person who believes he/she/they may have been subject to discrimination can file a discrimination complaint or grievance by contacting Intermountain’s System Civil Rights Coordinator at (800) 442-4845 (TTY Users: 711) or contact compliance.hotline@imail.org, or mail to: Intermountain Health, Compliance Department (attn: System Civil Rights Coordinator), 36 S. State Street Salt Lake City, UT 84111.

You can also contact the Office for Civil Rights at (800) 368-1019 (TTY Users: (800) 537-7697), through the Civil Rights Complaint Portal, by fax (202) 619 – 3818, or by mail at: U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Ave. SW, Suite 509 F, HHH Building, Washington, D.C. 20201.

Complaint forms are available.

As a patient of Intermountain Health you are responsible to:

Do your part to maintain a safe environment

• Treat others with respect and maintain civil language and conduct with all interactions.
• Respect the privacy, comfort, safety, and property of other patients and employees.

To ask questions or acknowledge when you do not understand the treatment course or care decisions.

• Provide correct information about your health, including medications brought from home, and medical history that facilitates your care, treatment, and services.
• Accept responsibility for what happens if you refuse treatment or instructions.

Meet financial obligations for your care.

• Provide accurate insurance information.
• Discuss payment options and inquire about financial assistance programs.

As a patient of Intermountain Health you have the right to:

Get information about your rights, when possible before receiving care. This includes having your rights read, explained, or interpreted if needed so you understand them.

Be treated with respect

• Be free from discrimination, based on age, race, color, ethnicity or national origin, disability, religion, creed, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity or expression, and/or veteran status.
• Be treated with respect and dignity at all times and under all circumstances.
• Be protected from physical or chemical restraints, except when necessary to protect you from hurting yourself or others.
• Be free from abuse, neglect, exploitation and harassment. Have access to protective services, including guardianship, advocacy services, and child or adult protective services.
• Freedom from retaliation.

Have your personal and medical information kept private

Understand and participate in your plan of care

• Have the reason for your admission explained upon your request.
• Review, request an amendment to, and/or get a copy of your medical record, according to state law and Intermountain Health policies and procedures.
• Be informed about your health status, request or refuse care, participate in your plan of care, treatment decisions and discharge plan. This includes being informed of unplanned outcomes.
• Have free and timely language interpretation, communication aids and accommodations (including services for visual, speech, hearing or cognitive disabilities).
• Give or withhold informed consent.
• Create or update your Advance Directives as well as choose a healthcare representative, surrogate agent or designated caregiver to make decisions for you. (Additional information is available at your request.)

Coordination of care

• Notification of your admission to your own doctor, family member, or healthcare representative.
• An established process for prompt resolution of patient grievances and information on whom to contact to file a grievance.
• File a complaint or grievance without being bullied, discriminated against, threatened or experiencing an unreasonable interruption of care.
• Lawful use of recordings, films and other images as regulated by state law and Intermountain Health policies and procedures.

Receive good care

• Receive reasonable access to care offered by Intermountain Health.
• Receive appropriate and safe pain management.
• Request or refuse care to the extent allowed by law. Learn of medical consequences and risks of your decision if you refuse treatment.
• Receive examinations and care in a safe setting that allows for your dignity and privacy.
• Meet privately with a personal attorney, a physician, a licensed independent practitioner, a representative of the state protection and advocacy group and/or child protection agency.
• Be informed of the individual(s) responsible for, as well as those providing your care.
• Refuse to take part in experimental care or research.

Be made comfortable during your stay in the facility

• Have access to spiritual care and other spiritual services, and be shown respect for cultural and personal values, beliefs, and preferences.
• Keep personal possessions in your room unless the items pose a risk to yourself or others or interfere with your plan of care.
• Have access to visitors except when doing so would interfere with your plan of care, or with the safety of other patients and staff.