For patients

As a patient, 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 protected from harassment, neglect, mental abuse, and physical abuse.
• 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 Healthcare policies and procedures.
• Be informed about your health status, including unplanned outcomes, in a manner you can understand.
• Have free and timely interpretation and document translation from qualified individuals.
• Have free and timely auxiliary aids (including forms in alternate formats) and services for visual, speech, hearing, or cognitive disabilities.
• Participate in decisions about your healthcare, give or withhold informed consent, and be involved in your plan of care.
• Create or update your Advance Directive and choose a healthcare representative or surrogate agent to make decisions for you. (Additional information is available at your request.)

Coordination of care

• Prompt notification of your admission to your own doctor, family member, or healthcare representative.

Receive good care

• Receive reasonable access to care offered by Intermountain Health.
• Request or refuse care to the extent allowed by law. Learn of medical consequences and risks of your decision if you refuse treatment.
• Receive considerate care in a safe setting.
• Receive examinations and care in settings that allow for your privacy.
• Meet privately with an attorney, a physician, a licensed independent practitioner, a representative of the state protection and advocacy group and/or child protection agency.
• Receive appropriate pain management.
• Receive information about the people providing care, services, and treatment.
• 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 and give and receive verbal and written communication to and from visitors, except when doing so would interfere with your plan of care, or with the safety of other patients and staff.

For your personal safety, as a patient you have the responsibility to:

• Follow instructions in support of quality care and a safe environment for all individuals in the hospital.
• Support mutual consideration and respect by maintaining civil language and conduct with interactions among staff and licensed independent practitioners.
• Cooperate, show respect and consideration to all persons providing your care.
• Respect the property, comfort, and privacy of other patients.
• Try to understand and follow instructions about your care and ask questions if you do not understand.
• Provide correct and complete information about your health problems and medical history.
• Pay for your care and to be cooperative in providing insurance information.
• Tell the nurse of any medication you brought from home.
• Accept responsibility for consequences following the decision to refuse treatment or instructions.

During your stay, you'll learn a lot about your care-your medications, your treatment, and your progress. That means you may be the first to notice if something isn't quite right. We encourage you to ask us questions, raise concerns, and probe for answers until we've made things clear to you.

You can ask us about anything. It won't hurt our feelings. In fact, we'll be glad you did.

"Who are you?"

You can expect healthcare workers to wear badges and introduce themselves. If you're unsure about who's caring for you, we hope you'll ask.

"What do you mean?"

You have the right to understand every word caregivers say to you—whether they're talking about medications, test results, or treatments. If it's not making sense to you, please ask us to explain things in a way you can understand.

"What does this form mean?"

You should fully understand everything you're given to read or asked to sign. Forms can be confusing, so take your time and ask questions.

"Do you know who I am?"

Nurses and doctors should check your identity, and call you by name, before they give you medication or treatment. Show your wristband. Speak up if you think a caregiver has confused you with someone else.

"Stop. Have you marked my procedure site?"

For most surgeries and procedures, it's our practice to use a special pen to mark the part of your body where the procedure or surgery will be done. We may also recheck and discuss the site with you before the start of your procedure. If you have any concerns, please let us know.

"Have you met my family?"

If you're nervous or embarrassed to ask a question or raise a concern, sometimes a family member or "designated spokesperson" can do it for you. If we have your permission, we're happy to talk with them and share your confidential information. Just let us know.

"Did you wash or sanitize your hands?"

Everyone who comes in to provide care for you—nurses, doctors, and even friends and family—should wash their hands. Please remind them if they forget.

"Is that my medication?"

Please provide a complete list of your home medications, allergies, and reactions. If you don't recognize a medication or think it's the wrong one, ask if it's really for you. If it's new, have the possible side effects described in a way you can understand.

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, send an email to PatientFeedback@imail.org, or call the Intermountain Patient Advocacy Line at 1 (855) 442-7855 from 9:00 a.m. – 5:00 p.m.

To file a grievance with the State of Utah, call 1(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. To file a grievance with the State of Idaho, call Idaho Bureau of Facility Standards at 1(208) 334-6626, by mail to: P.O. Box 83720, Boise, Idaho 83720-0009 or 3232 Elder Street, Boise, Idaho 83705 or call the Idaho Board of Medicine at 1(208) 327-7000.

To report a patient safety concern, you can reach The Joint Commission:

• By calling 1(800) 994-6610 or by fax to (630) 792-5636
• At www.jointcommission.org, using the “Report a Patient Safety Event” link in the “Action Center” on the home page of the website
• 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:

• Utah - KEPRO QIO 1 (888) 317-0891
• Idaho - KEPRO QIO 1 (888) 305-6759
• Contact the Office of Medicare Ombudsman at http://www.cms.gov/center/ombudsman.asp.

Any patient or other person who believes he/she may have been subject to discrimination can file a discrimination complaint or grievance by contacting Intermountain’s 504/Civil Rights Coordinator at 1 (800) 442-4845 (TTY Users: 711) or compliance.hotline@imail.org.

You can also contact the Office for Civil Rights at 1 (800) 368-1019 (TTY Users: 1 (800) 537-7697), through the Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf, 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 at http://www.hhs.gov/ocr/office/file/index.html.