WelcomeI would like to personally thank you for choosing Fort Madison Community Hospital for your healthcare needs. I feel confident that our dedicated team of professionals will work together to make sure all of your needs are met. Each member of your healthcare team is held to the highest standards of expertise, communication and patient satisfaction.

As your community hospital, it is our goal to provide quality care in a safe, compassionate environment. If at any time we have not met your expectations, please let us know so that we may continue to improve our services. We feel you will find the information in this booklet helpful and informative.

FMCH is proud to be an integral part of your good health.

Sincerely,

C. James PlattCEO, FMCH

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Revised: 2-2014

Table of Contents Table of Contents1. About Us ...................................................................Page 1

Mission Statement ........................................................................................... 1History of FMCH ............................................................................................... 1FMCH Website .................................................................................................. 2Joint Commission Accredited ...........................................................................2Ethics ................................................................................................................ 2Hardwiring Excellence - Standards of Behavior .............................................2-5The Voice of the Patient ................................................................................... 5

2. Find a Health Care Provider ................................... Page 6-73. Contact Us .................................................................Page 8

Direct Dial List .................................................................................................. 84. PatientPolicies ..........................................................Page 9

Patient’s Bill of Rights ....................................................................................... 9Patient’s Responsibilities ................................................................................10SPEAK UP ........................................................................................................ 10Privacy Notice ............................................................................................10-12Safe Haven ...................................................................................................... 12Advance Directives ........................................................................................ 13

5. PatientResources ....................................................Page 14Transportation ................................................................................................ 14Gift Shop ......................................................................................................... 15Five Wishes .................................................................................................... 15Notary Public .................................................................................................. 16Interpreters .................................................................................................... 16Hearing Impaired............................................................................................ 16Clergy On-Call ................................................................................................. 16Chapel ............................................................................................................ 16Walking Track ................................................................................................ 16Palliative Care ................................................................................................. 17

6. Admissions & Surgery ..............................................Page 18Admissions ..................................................................................................... 18Surgi-Center ..............................................................................................18-19Facts About Deep Vein Thrombosis & Pulmonary Embolus ...........................19

7. YourInpatientAccommodations ..............................Page 20Your Hospital Team ......................................................................................... 20Butterfly Garden ........................................................................................20-21Your Private Room Accommodations .............................................................21

Your Hospital Bed ..................................................................................21Room Temperature ...............................................................................21Calling Your Nurse .................................................................................21Leaving the Unit ....................................................................................21Telephones ............................................................................................ 21Internet Access .....................................................................................21Housekeeping/Maintenance .................................................................21

For Your Convenience ................................................................................21-22ATM ....................................................................................................... 21Cheer Cards ........................................................................................... 22Gift Shop ................................................................................................ 22Mail ....................................................................................................... 22Newspapers .......................................................................................... 22Web Nursery ......................................................................................... 22

For Your Safety ..........................................................................................22-24Fire & Disaster Preparedness ................................................................22Medication Safety ............................................................................22-23Oxygen .................................................................................................. 23Smoking/Tobacco Use ...........................................................................23Wheelchairs........................................................................................... 23 Valuables ............................................................................................... 23

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Lost & Found .................................................................................23Condition Reports .........................................................................23Fall Prevention ...............................................................................23Fall Prevention ...............................................................................23Infection Prevention ......................................................................24

Pain Management ..................................................................................25FMCH Food Services ...............................................................................26

Patient Meals ................................................................................26Cafeteria ........................................................................................26Vending Machines .........................................................................26

Visitors ....................................................................................................27Visiting Hours ................................................................................27Visiting Regulations .......................................................................27Bringing Gifts for Patients ..............................................................27Parking...........................................................................................27Accommodations for Visitors ........................................................27Waiting Areas ................................................................................37

For Your Reference .................................................................................28Abbreviations ................................................................................28Hospital Phone Extension Directory ..............................................28TV Channel Listing .........................................................................29

8. Discharge ...........................................................Page 30Case Management & Discharge Planning ..............................................30Leaving the Hospital ...............................................................................31

9. Financial Arrangements .....................................Page 31Billing Procedures ...................................................................................31

Payment Options ...........................................................................31Business Office Hours/Contact Information ..................................31

10. PatientSupportServices ....................................Page 32FMCH Anticoagulation Clinic ..................................................................32FMCH Diabetes Self Management Class ................................................32FMCH Home Health Care Services .........................................................32FMCH Sleep Studies Center ....................................................................32FMCH Wound Healing & Hyperbaric Center ..........................................32

11. Community & Wellness ......................................Page 32Educational Services ...............................................................................32

Tours & Educational Speakers .......................................................33CPR Training ..................................................................................33Expectant Parent Classes ...............................................................33Health Fairs ...................................................................................33

Support Groups ......................................................................................33FMCH Baby Weigh-In ....................................................................33Children in the Middle Class ..........................................................33FMCH Diabetes Support Group .....................................................33

Medicare Counseling ..............................................................................33S.H.I.I.P. ..........................................................................................33

Volunteers ..............................................................................................34FMCH Auxiliary ..............................................................................34Volunteers .....................................................................................34

12. Foundation ........................................................Page 35FMCH Foundation ..................................................................................35FMCH Guardian Angel Program .............................................................35

13. Facility Maps ......................................................Page 36FMCH Hospital Services Map .................................................................36FMCH Physician Offices Map ..................................................................37FMCH Outpatient Rehabilitation Services Center Map ..........................38FMCH Parking Map .................................................................................39

Page 1

About UsMission, Vision & Values StatementMission StatementFort Madison Community Hospital’s mission is to advance the health and well being of all people through compassionate quality care, education and community service.

Vision StatementTo be the Southeast Iowa healthcare provider most admired for its people, partnership with the community and quality of service.

ValuesIn fulfilling our mission, FMCH values our commitment to: Growth; People; Quality and Service; Finance and Infrastructure and Community. These values will be realized by living our Standards of Behavior.

GuestRelations. Each guest is an individual entitled to our respect and compassion.Respect. We believe in behaviors that demonstrate privacy and dignity.Privacy. A secure and trusting environment promotes peace of mind.PositiveAttitude. A sincerely good attitude means smiling and being friendly and courteous.Commitment to Co-Workers. We believe in each other.Personal Accountability. Each employee will strive for competency and professionalism.Morale. Spirit and pride in FMCH and our community creates a positive atmosphere.Personal Appearance. We will present a positive image of FMCH through our outward appearance.Communications. All communication is a reflection of FMCH.RespectforOurResources. We value a clean, safe environment with readily available resources.

History of Fort Madison Community HospitalFort Madison Community Hospital has a long history of excellence in Healthcare. What began as Sacred Heart Hospital in 1912, is now Fort Madison Community Hospital. Sacred Heart Hospital was operated by the Sisters of the Third Order of Saint Francis from 1912 to 1977. During that time the hospital went through many additions and improvements creating a state of the art facility. But as time progressed it became harder and harder for the Sisters to maintain operation of the hospital and the building and equipment were sold for $1.00 to a non-profit Board of Directors and the name was changed to Fort Madison Community Hospital. The old building now houses the Kensington Assisted Living Facility. It was in 1986 that the ground breaking of the current location along Highway 61 was held. In May of 1987 the new 58,000 square foot hospital and adjoining office building was open to the public. Since then there have been multiple additions and improvements made to the facility again making it a state of the art hospital complete with private in-patient rooms, expanded surgery center, themed birthplace rooms, a Wound Center and a functional business center with three conference rooms.Fort Madison Physicians & Surgeons Clinic and The Women’s Center are an intimate part of Fort Madison Community Hospital. They continue to expand their services to provide comprehensive and quality care to the community. The addition of a dedicated Pediatric suite helps keep our young patients happy, too.Fort Madison Community Hospital is committed to providing the highest quality healthcare to the community they call home. We continue to explore the best way to do this through staffing, equipment, services and facilities. We welcome you to take a look around at what FMCH has to offer during your stay with us.

FMCH Patient&

Visitors Guide

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Fort Madison Community Hospital WebsiteThe website address for Fort Madison Community Hospital is www.fmchosp.com. Our website enables visitors to browse the many services that we offer. Cheer Cards may be sent to patients from the home page of our site, newborn babies are uploaded to the web nursery for viewing each Monday, and a variety of health information is available at your fingertips. The website also allows visitors to learn about the doctors at FMCH or order a gift from our gift shop to be delivered to a loved one’s room while they are staying at FMCH. Check out our website for job postings and scholarship information as well.

Joint Commission AccreditedFort Madison Community Hospital is accredited by the Joint Commission. The Joint Commission evaluates the quality and safety of care for more than 15,000 health care organizations. To maintain and earn accreditation, organizations must have an extensive on-site review by a team of Joint Commission health care professionals, at least once every three years. The purpose of the review is to evaluate the organization’s performance in areas that affect your care.

Fort Madison Community Hospital Ethics It is the intent of Fort Madison Community Hospital to uphold the highest standards of ethical conduct. To ensure that this is managed on a consistent and professional level, FMCH has established an Ethics committee made up of a diverse group including: members of our community at large, hospital employees, professional representation and members of the clergy. The purpose of the Ethics Committee is to review all concerns in a confidential and professional manner and to take action as they see necessary.

All FMCH Employees are Part of Hardwiring Excellence These are Our Standards of BehaviorGuestRelationsThe definition of a guest is any person who comes through the doors of Fort Madison Community Hospital; whether it is a patient, co-worker, vendor or family member. Each guest is entitled to my respect and compassion.

± I will treat all of our guests as I would want my own family to be treated. ± I will greet our guests with a smile and eye contact; I will introduce myself promptly. ± I will escort guests to their destinations. ± I will listen and avoid interrupting. ± Rudeness will not be tolerated. ± I will help our guests whenever possible or I will find someone who can. ± I will end all guest interactions with “Is there anything else I can do for you at this time?” ± I will apologize for any inconveniences, delays or problems encountered when dealing with our guests. ± I will give our guests 100% of my attention at all times. ± I will show our guests that I value their time; they are the reason I am here. ± I will attempt to put our guests at ease by explaining all treatments and procedures before I begin.

RespectI believe in behaviors that demonstrate courtesy, privacy and dignity for all our guests. I value all people even in our differences. I will always, first and foremost, remember that each guest is an individual deserving of my respect.

± I will use “Mr.”, “Mrs.”, “Dr.” and other respectful titles unless asked to do otherwise. ± I will do my best to avoid endearing terms such as “honey” and “sweetie”. This can be perceived as disrespectful

or possibly an unwillingness to learn a person’s name. ± I will remember that all FMCH employees play a vital role in our success regardless of position. ± I will be tolerant of fellow employees; professional courtesy is expected at all times.

± I will refrain from personal conversation with fellow employees when I am with a guest. ± I will say “Please” and “Thank you”. ± I will be aware that I can personally reduce the noise level at FMCH. ± I will be mindful of what I say and to whom; FMCH is a big part of a small community. ± Privacy ± I believe that Privacy is a right. I will create and maintain a secure and trusting environment with the goal of

promoting peace of mind. ± I will treat all information as confidential when entrusted with a guest’s affairs and share it on a need to know

basis only. ± I will make all guest treatment areas private by closing doors or curtains. ± I will work to ensure our guest’s right to privacy and modesty. ± I will work to eliminate gossip. ± I will explain to the guest what I am doing to protect their privacy. ± I will use discretion during conversations whether in person or on the phone. ± I will knock on each guest’s door, introduce myself and explain my purpose. ± I will always provide adequate coverage for my guest by offering them an extra robe, sheet or blanket.

Commitment to Co-WorkersTeamwork means that we share a common ideal and embrace a common goal. In the end, teamwork can be summed up in five short words…We believe in each other. Every Employee at FMCH is a Part of our Team!

± I will welcome new employees and act as their mentor. ± I will strive to be flexible and adaptable. ± I will discreetly remind my co-workers if their behaviors are not consistent with FMCH standards and I will accept

corrections in a positive manner. ± I will work to make each employee feel valued by complimenting on a job well done. ± I will go above and beyond to help fellow employees. ± I will resolve conflicts quickly by dealing directly with the person involved. ± I will enhance teamwork with open communication. ± I will set aside personal differences when working with fellow team members. ± I will coach in private and compliment in public.

Personal AccountabilityI am FMCH. But I do not stand alone. I wish to demonstrate competency and show mutual respect to those around me. I will strive for organization and professionalism in my duties.

± I will arrive promptly, when scheduled, with a team-driven, positive attitude. ± I will own up to my mistakes and learn from them. ± I will be honest. ± I will respect my co-workers by keeping my work areas clean and free of clutter. ± I will return equipment to the proper place in a timely manner. ± I will be an Ambassador of FMCH whether on duty or on my personal time. ± I will be considerate of my co-workers by taking breaks as workload permits and with appropriate communication. ± I will model the behaviors I expect of those around me. ± I will follow through on my promises and commitments and work to meet all deadlines. ± I will understand that being open to change is necessary to keep FMCH on the leading edge of healthcare.

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MoraleGood morale is an intangible term used for the capacity of people to maintain belief in an institution or a goal, or even in oneself and others. I believe the spirit and pride that I demonstrate at my job at FMCH creates a positive atmosphere that is contagious.

± I will recognize that fun and laughter belong in the workplace. ± I will give so much time to the improvement of myself that *I will have no time to criticize others. ± I will celebrate successes. ± I will recognize team members who participate in FMCH and community activities that promote fun involvement

and team building. ± I will think only the best, work only for the best, and expect only the best. ± I will remember that a heartfelt “thank you” can brighten someone’s day.

Personal AppearanceI will present a positive image of FMCH through my outward appearance. I am never fully dressed without a smile.

± I believe in showing respect for our guests, co-workers and myself through my appearance. ± I will proudly wear my FMCH name badge with my name and original picture clearly visible at all times while on duty. ± I will dress professionally and follow the FMCH Dress Code specific to my department. ± Good personal hygiene is expected. ± I will not use perfume or cologne; they are not appropriate in a hospital setting.

CommunicationsCommunication is the exchange of information between people and can take many forms. It is important that we are aware of the way we communicate in any given situation. All communication is a reflection of FMCH and me.

± I will identify myself and my department when I answer the phone. ± I will answer the phone with a smile in my voice and within three rings whenever possible. ± I will ask the caller’s permission prior to transferring or placing them on hold and wait for a response before doing so. ± I will return all forms of communication promptly. ± I will remember that e-mail is a form of communication and should be used professionally. ± I will limit my personal phone calls. ± I will be mindful of my body language and facial expressions. ± I understand that any communication I have with guests can affect our business. ± I realize that my personal cell phone is a means of private communication and will be used on my personal time.

I will not use it in patient care areas.

RespectForOurResourcesFMCH is fortunate to be a profitable healthcare organization. It is through the conscientious effort of all employees that we are able to keep our environment clean and safe for our guests and resources readily available.

± I will respect our environment by picking up litter and disposing of it properly. ± I will manage my supply usage to help keep our costs down. ± I will take personal responsibility for providing a safe environment. ± I will notify the appropriate person as soon as I notice equipment that needs attention. ± I will support our tobacco free policy and help to enforce it. ± I will strive to practice green behaviors to ensure continued availability of our resources. ± I will understand that the internet is a tool and a privilege that I have been provided to do my job.

PositiveAttitudeI will keep a sincerely good attitude by smiling and being friendly and courteous. I am in control of my attitude.

± I will leave my personal problems at the door. ± Smile. Remember a smile is contagious. ± I will strive to find solutions rather than complain. ± I will have fun at work while maintaining my professionalism. ± I will practice an attitude of gratitude. ± I will not share personal problems, frustrations or negative comments with guests. ± “It is not my job” should not be a part of my vocabulary.

The Voice of the PatientFMCH is dedicated to improving the quality of the healthcare that we provide. It is important to us that we exceed your expectations while you are a guest in our facility. If at any time we do not meet this goal, we ask that you let us know so we can address your concerns immediately. We also subscribe to a program that helps us gather feedback from our patients. You may receive a Patient Satisfaction survey after your visit with us and we hope that you will be able to give FMCH a five rating in all areas. The greatest compliment you can give us is to recommend our services to your friends and family. Thank you for choosing FMCH for all of your healthcare needs.

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Find a Health Care ProviderCARDIOLOGY (HEART)Visits FMCH on Tuesday & WednesdayFort Madison Community Hospital

Abdullah Alwahdani, M.D.Linda Lee, M.D.John Mehegan, M.D.Nicholas Walker, M.D.5409 Avenue O, Suite 103• Fort Madison, IA319-376-2725

Fort Madison Community Hospital James Hopson, M.D.Vikass Sharotri, M.D.Ann Aschoff, A.R.N.P.5409 Avenue O, Suite 123 • Fort Madison, IA319-358-2767

COSMETIC(BREASTAUGMENTATION,BODYSCULPTING,&ABDOMINOPLASTY)FORTMADISONPhysicians & SurgeonsTheWomen’sCenter

Timothy Staudte, D.O.5409 Avenue O, Suite 122 • Fort Madison, IA319-376-2400

DERMATOLOGY (SKIN)Visits FMCH on Monday, Wednesday & FridayFort Madison Community Hospital Specialty Clinic

Mark Cleveland, M.D..Amy John, P.A.-C.Carol Menke, P.A.-C.5409 Avenue O, Suite 123 • Fort Madison, IA319-752-1805

EMERGENCYMEDICINE Fort Madison Community Hospital

5445 Avenue O, Fort Madison, IA319-376-2000

FAMILYPRACTICEFort Madison Physicians & Surgeons

Kathy Anderson, M.D.Bryant Mutchler, D.O.William Napier, M.D.Chase Newton, D.O.David Wenger-Keller, M.D.5409 Avenue O, Fort Madison, IA319-376-2134

INTERNALMEDICINEFort Madison Physicians & Surgeons Internal Medicine

Victoria Kogan, M.D.Roseller Libarnes, M.D.5409 Avenue O, Suite 103 • Fort Madison, IA319-376-2725

ArtemioSantiago,M.D.5409 Avenue O, Suite 107 • Fort Madison, IA319-372-7270

MYCAREWALK-INCLINIC Fort Madison Physicians and Surgeons

Nicki Gellatly, F.N.P.Amy Wallis, F.N.P.5409 Avenue O • Fort Madison, IA319-376-2134

NEUROLOGY (NERVOUSSYSTEM)Fort Madison Community Hospital Specialty Clinic

Anil Dhuna, M.D.Jugal Raval, M.D5409 Avenue O, Suite 108 • Fort Madison, IA319-754-4400

OBSTETRICS&GYNECOLOGYFort Madison Physicians & SurgeonsTheWomen’sCenter

Meenakshi Palani, D.O.Timothy Staudte, D.O.Leah Steffensmeier, M.D. Melissa Lambert, WHNP-BC5409 Avenue O, Suite 122 • Fort Madison, IA319-376-2400

OCCUPATIONALHEALTH Fort Madison Community Hospital OccupationalHealthMedicine

Katie Bentler, P.A.-C.5445 Avenue O, Annex • Fort Madison, IA319-376-2100

Find a Health Care ProviderONCOLOGY (CANCER)

Susan Roeder, D.O.Nancy Sharma, M.D.FMCH Annex, 5445 Avenue O, Fort Madison, IA319-376-2718

OPHTHALMOLOGY (EYE)

Jonathan Cutler, M.D.Mark Reynolds, M.D.5409 Avenue O, Suite 118 • Fort Madison, IA319-372-9292

ORTHOPEDICS (BONE&JOINT)Fort Madison Physicians & Surgeons

Joe Darrow, M.D.Brent Woodbury, M.D.Paul Ostby, P.A.-C.Ted Smith, P.A.-C.5409 Avenue O, Suite 113 • Fort Madison, IA319-376-1135

OTOLARYNGOLOGY (EAR,NOSE,THROAT)Visits FMCH on ThursdayFort Madison Community Hospital Specialty Clinic.

Doug Henrich, M.D.5409 Avenue O, Suite 123 • Fort Madison, IA319-376-2096

PATHOLOGYFort Madison Community Hospital

Jon Fagre, M.D.5409 Avenue O, Suite 112 • Fort Madison, IA319-372-6530

PEDIATRICSFort Madison Physicians & Surgeons

Frank Artinian II, M.D.Kolleen Burnett, D.O.Susan Teggatz, M.D.5409 Avenue O, Fort Madison, IA319-372-KIDS (5437)

PODIATRYFort Madison Physicians & Surgeons

Heather Perry, D.P.M.5409 Avenue O, Fort Madison, IA319-376-2134

PSYCHIATRYFort Madison Physicians & Surgeons

Truce T. Ordoña, M.D.Amanda O’Tool, A.R.N.P.5409 Avenue O, Suite 125 • Fort Madison, IA319-376-1130

PULMONOLOGYAlan Moy, M.D.FMCH Annex, 5445 Avenue O, Fort Madison, IA319-376-2100

RADIOLOGYFort Madison Community Hospital

Steven Davis, M.D.Raymond Harre, M.D.Matthew Hoffman, D.O.Pil Kang, M.D.Stephen Murphy, M.D.John Paiva, M.D.5445 Avenue O, Fort Madison, IA319-376-2040

SURGERY,GENERALFort Madison Physicians & Surgeons

W. Riggs Bagan, M.D.Roy Tinguely, M.D.5409 Avenue O, Suite 126 • Fort Madison, IA319-376-2756

UROLOGYFortMadisonPhysicians&Surgeons,UIHC Urology Clinic

5409 Avenue O, Fort Madison, IA319-376-2726

LouisKantzavelos,M.D.5409 Avenue O, Suite 123 • Fort Madison, IA319-768-3925

WOUNDCAREFort Madison Community Hospital Wound Healing & Hyperbaric Center

Katie Bentler, P.A.-C.5409 Avenue O, Suite 115 • Fort Madison, IA319-376-2403

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Patient PoliciesStatement 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 has 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 The Joint Commission at 800-994-6610.

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 have your complaint handled as a grievance you may request the Nursing Supervisor to do so. If your complaint is regarding abuse, neglect, patient harms, or hospital compliance with CMS requirements it will be treated as a grievance. If you wish to write the hospital before or after discharge please address your concern to:

FMCH AdministrationAttn: Compliance Officer5445 Avenue OFort Madison, IA 52601

Contact UsDirect Dial List

Administration .......................................................................................319-376-2250Admissions .............................................................................................319-376-2117Ambulatory Surgery ...............................................................................319-376-2233Annex .....................................................................................................319-376-2718BirthPlace ...............................................................................................319-376-2229Business Office .......................................................................................319-376-2114Cardiopulmonary ...................................................................................319-376-2030Cardiopulmonary Rehab ........................................................................319-376-2237Community Relations .............................................................................319-376-2244Courtesy Van ..........................................................................................319-376-2227Dietician .................................................................................................319-376-2230Education Department ...........................................................................319-376-2223ER ...........................................................................................................319-376-2000FMCH Main Line .....................................................................................319-372-6530FMP&S Clinic .........................................................................................319-376-2134Health Information (Records) .................................................................319-376-2130Home Health Care ..................................................................................319-376-2166Human Resources ..................................................................................319-376-2126Information ............................................................................................319-376-2227Internal Medicine ...................................................................................319-376-2725Laboratory ..............................................................................................319-376-2020Occupational Health Services.................................................................319-376-2100Orthopedics & Sports Medicine .............................................................319-376-1135Patient Accounts ....................................................................................319-376-2245Pediatric Center ........................................................................... 319-372-KIDS(5437)Pharmacy ...............................................................................................319-376-2080Physical Therapy .....................................................................................319-376-2253Radiology ...............................................................................................319-376-2184Rehab Services .......................................................................................319-376-2180Special Care Unit ...................................................................................319-376-2085S.H.I.I.P.. .................................................................................................319-376-2249Sleep Studies ..........................................................................................319-376-2030Specialty Clinic .......................................................................................319-376-2096Social Services ........................................................................................319-376-2160Surgery Waiting Room ...........................................................................319-376-2150Surgery Clinic..........................................................................................319-376-2756Women’s Center .....................................................................................319-376-2400Wound Healing & Hyperbaric Center .....................................................319-376-2403

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Statement of Patient’s ResponsibilitiesBecause 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.

If you do not understand any part of these patient responsibilities, we encourage you to discuss it with your physician, the nursing supervisor or your nurse.

Speak UpFort Madison Community Hospital participates in the Joint Commission of Accreditation’s Speak Up Program that encourages our patients to take a role in preventing health care errors by becoming active, involved and informed participants on the health care team.

S peak up if you have questions or concerns, and if you don’t understand, ask again. It’s your body and you have a right to know.

P ay attention to the care you are receiving. Make sure you’re getting the right treatments and medications by the right health care professionals. Don’t assume anything.

E ducate yourself about your diagnosis, the medical tests you are undergoing, and your treatment plan.

A sk a trusted family member or friend to be your advocate.

K now what medications you take and why you take them. Medication errors are the most common health care mistakes.

U se a hospital, clinic, surgery center, or other type of health care organization that has undergone a rigorous on-site evaluation against established state-of-the-art quality and safety standards, such as that provided by The Joint Commission.

P articipate in all decisions about your treatment. You are the center of the health care team.

Privacy NoticeTHISNOTICEDESCRIBESHOWMEDICALINFORMATIONABOUTYOUMAYBEUSEDANDDISCLOSEDANDHOWYOUMAYACCESSTHISINFORMATION.PLEASEREADITCAREFULLY.The privacy practices outlined in this brochure apply to Fort Madison Community Hospital and its medical staff, including physicians and health care providers attending to patients at the Hospital, Fort Madison Community Hospital Home Health Care, Fort Madison Community Hospital Pharmacy and Fort Madison Physicians & Surgeons, as members of an Organized Health Care Arrangement. Hereafter, these entities will collectively be referred to as “FMCH and its Entities.”

FMCH and its Entities are dedicated to protecting your medical information. We are required by law to maintain the privacy of protected health information and to provide you with this Notice of our legal duties and privacy practices with respect to protected health information. FMCH and its Entities are required by law to abide by the terms of this Notice and we reserve the right to change the terms of this Notice, making any revision applicable to all the protected health information we maintain. If FMCH and its Entities revise the terms of this Notice, they will post a revised notice at the facility and will make paper copies of this Notice of Privacy Practices for Protected Health Information available upon request.

How Your Medical Information Will Be Used And DisclosedFMCH and its Entities will use your medical information as part of rendering patient care. For example, your medical information may be used by the health care professional treating you, by the business office to process your payment for the services rendered and by administrative personnel reviewing the quality and appropriateness of the care you receive. FMCH and its Entities may also use and/or disclose your information in accordance with federal and state laws for the following purposes:

± FMCH and its Entities may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

± FMCH and its Entities may contact you for the purpose of customer satisfaction. ± FMCH and its Entities may disclose information when required by the United States Department of Health and

Human Services as part of an investigation or determination of the Hospital’s compliance with relevant law. ± Unless you object, with the exception of Behavioral Health Patients, FMCH and its Entities will provide general

information, including your name, location in the facility and your one word condition. This information will be released to people who ask for you by name.

± Unless you object, with the exception of Behavioral Health Patients, FMCH and its Entities will provide general information, including your name, location in the facility, your one word condition and religious affiliation to members of the clergy.

± Unless you object, with the exception of Behavioral Health Patients, FMCH and its Entities may use or disclose your medical information to notify a family member, a personal representative or another person responsible for your care, of your location, general condition or death.

± Unless you object, with the exception of Behavioral Health Patients, FMCH and its Entities may disclose to family members, other relatives, or close personal friends the medical information directly relevant to such person’s involvement with your care.

± FMCH and its Entities may disclose your medical information to a public or private entity for the purpose of coordinating with that entity to assist in disaster relief efforts.

± FMCH and its Entities may use or disclose your medical information for public health activities, including the reporting of disease, injury, vital events and the conduct of public health surveillance, investigation and/or intervention. FMCH and its Entities may disclose your medical information to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings.

± FMCH and its Entities may disclose your medical information in the course of certain judicial or administrative proceedings.

± FMCH and its Entities may disclose your medical information for law enforcement purposes or other specialized governmental functions.

± If you are an organ donor, FMCH and its Entities may disclose your medical information to organ donation and procurement organizations.

± FMCH and its Entities may use your medical information for marketing in a face-to-face communication and/or provide you with a promotional gift of nominal value. In other circumstances, we will obtain an authorization prior to using your medical information for marketing.

± FMCH and its Entities may use your medical information for fundraising purposes. ± FMCH and its Entities may use and disclose your medical information to prevent or lessen a serious threat to the

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health or safety of another person or the public. ± FMCH and its Entities may disclose your medical information as authorized by laws relating to workers’ compensation

or similar programs. ± If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release

medical information about you to the correctional institution or law enforcement official. ± FMCH and its Entities may disclose to the FDA health information relative to adverse effects with respect to food,

drugs, supplements, product or product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacement.

± If you are a member of the armed forces, Fort Madison Community Hospital may release medical information about you as required by military command authorities.

± FMCH and its Entities will not use or disclose your medical information for any other purposes without your written authorization. Once given, you may revoke your authorization in writing at any time.

Your Rights Regarding Your Medical Information ± You have the following rights with respect to your medical information: ± The right to request “restrictions” on certain uses and disclosures of your medical information. FMCH and its Entities

are not required to agree to your requested restriction. ± The right to request communications of your health information by alternative means or at alternative locations. ± The right to inspect and copy your medical information. You must submit your request in writing. This right is

subject to certain specific exceptions and you may be charged a reasonable fee for any copies of your records. ± The right to request an amendment of your medical information in writing. FMCH and its Entities may deny your

request for certain specific reasons, and if denied, FMCH and its Entities will provide you with a written explanation for the denial and information regarding further rights you would have at that point.

± The right to receive an accounting of the disclosures of your medical information made by FMCH and its Entities except for disclosures for treatment, payment or Hospital operational purposes and for certain other specific disclosure types.

± The right to request a paper copy of this Notice of Privacy Practices for Protected Health Information. ± The right to complain to FMCH and its Entities and/or to the United States Department of Health an Human Services

if you believe your privacy rights have been violated. To complain, please contact the FMCH Privacy Officer at 1-800-273-8452 or the Secretary of the United States Department of Health and Human Services. If you choose to file a complaint, you will not be retaliated against in any way.

± If you would like further information regarding your rights or regarding the uses and disclosures of your medical information, you may contact the Director of Information Services.

THISNOTICEISEFFECTIVEASOFAPRIL14,2003.

Safe HavenFort Madison Community Hospital is a “Safe Haven” site, meaning that unharmed newborns, up to 14 days old, can be taken to our facility rather than being abandoned. The State of Iowa has enacted the “Safe Haven” program to end the tragedy of unwanted newborns being hidden and left to die in various locations. This law makes it legal for a parent or another person authorized by the parent to surrender their infant in a safe and anonymous manner, without fear of prosecution. For more information about the Safe Haven Act or program, visit http://www.dhs.state.ia.us/Consumers/Safety_and_Protection/Safe_Haven.html.

Advance DirectivesHealth care decisions have grown in complexity with the advances of medical technology. Some people wish to extend life with every means available. Others do not. People are encouraged to write their choices down in advance. These are called Advance Directives. Advance directives are documents signed by a competent person giving direction to health care providers about treatment choices you want when you are unable to communicate those to your doctor. There are two types of advance directives. A durable power of attorney for health care is one that allows you to name a person to speak in your place. A living will is one that lets you indicate your wishes in writing. When you are admitted to the hospital you will be asked if you have an advance directive. If a copy is on file, we will ask you if this is still consistent with your desires. If a copy is not on file, you will be asked to bring a copy to FMCH to place in your record.

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Gift ShopLooking for that perfect gift? Need a card for a special occasion? Not only will you find fresh floral arrangements, baby gifts, purses, stuffed animals,candy, jewelry, greeting cards, toiletries, seasonal items, and much more at our Gift Shop at very reasonable prices, but you’ll also be supporting the Auxiliary’s scholarship fund with every purchase.

Our Hours of OperationThe Gift Shop is open from 9:00-4:00, Monday - Friday. If you would like to shop after regular business hours, the hostess at our Information Desk would be more than happy to open the shop for you.

Online GiftshopThe FMCH Gift Shop offers online gift items for purchase and delivery to a patient at Fort Madison Community Hospital. You can shop online at the Online Giftshop by going to www.fmchosp.com and clicking on the “Online Giftshop” link. Please keep the following in mind.

± Orders processed 9 a.m. to 4 p.m. • Monday through Friday ± Orders received off hours will be processed as soon as possible the following day. ± We are closed on all major holidays. ± Orders can only be delivered once a permanent room has been assigned. ± To ensure a speedy delivery, we will need both the FIRST and LAST name of the patient (no nicknames please). ± Once you have completed the online order process a confirmation page will display confirming your order has

gone through. ± The actual gift delivered to the patient may not be exactly as pictured but will be similar in nature and value.

Would You Like To Volunteer in the Gift Shop?We are always looking for volunteers to work in our Boutique! Please contact us for more information on volunteering. Call FMCH Human Resources at 319-376-2250 or email HR@fmchosp.com.

Five Wishes

LetanAdvanceDirectivespeakforyou.It’syourvoiceandgifttoyourfamily.The Medical Staff of Fort Madison Community Hospital, in a cooperative effort with the FMCH Ethics Committee, is providing an opportunity for area residents to learn about an important topic, Advance Directives. An Advance Directive allows individuals to communicate their personal, emotional, spiritual and medical wishes in the event that they are unable to do so themselves. It also enables an individual to legally declare another person as a proxy to make medical decisions on their behalf. Five Wishes provides people with an easy to understand way to document their wishes and provide a helpful guide to family members, caregivers and doctors.Members of the FMCH Ethics Committee are willing to speak to community groups, churches, and clubs about this topic. During the seminars, a member of the Fort Madison Community Hospital staff will lead you through the Five Wishes document step-by-step. Five Wishes is the recommended advance directive form at FMCH. In addition to the Five Wishes form, all other types of Advance Directives are accepted and stored at FMCH.The speaker will address the importance of completing an advance directive and will define unfamiliar terms used in the document. Questions regarding end-of-life care will be answered. To schedule a seminar please call Community Relations at 319-376-2244.Completing an Advance Directive is an important activity that should not be overlooked. Too often family members are faced with the difficult situation of having to decide what their loved one would want for end-of-life care. Make these important decisions for yourself and make the time of your death an easier one for your family. To obtain a complimentary copy of the Five Wishes document, submit a written request to: Fort Madison Community Hospital, Attn: Community Relations, 5445 Avenue O, Fort Madison, IA 52627.

Patient ResourcesTransportationFMCH provides free rides for patients and visitors who are unable to drive or need a ride to the hospital. Pick-up points are available in Fort Madison, Donnellson, Montrose, and West Point. The courtesy van runs Monday through Friday but does not run on Saturday or Sunday. When scheduling appointments with your doctor or the hospital, please notify them of your plans to ride the FMCH Courtesy Van. For more information call 376-2227 or dial ext. 222.

Toscheduleavanpickuporformoreinformationcall376-2227ordialext.222.Fort Madison

Courtesy Van picks up passengers in Fort Madison Monday through Friday.Donnellson & West Point

Montrose The Courtesy Van will run by appointment only in Montrose on Monday, Tuesday and Thursday.

Departs FMCH

Departs Donnellson

Departs West Point

Returnsto FMCH

Monday 9:05 a.m.11:30 a.m.

9:20 a.m.11:45 a.m. Not Available 9:35 a.m.

Tuesday 2:05 p.m.3:55 p.m. Not Available 2:20 p.m.

4:10 p.m. 2:35 p.m.

Wednesday

9:05 a.m.11:30 a.m.2:05 p.m.3:55 p.m.

9:20 a.m.11:45 a.m. Not Available

9:35 a.m.

2:35 p.m.Not Available 2:20 p.m.

4:10 p.m.

Thursday 9:05 a.m.11:30 a.m.

9:20 a.m.11:45 a.m. Not Available 9:35 a.m.

Friday

9:05 a.m.11:30 a.m.2:05 p.m.3:55 p.m.

9:20 a.m.11:45 a.m. Not Available 9:35 a.m.

2:35 p.m.Not Available 2:20 p.m.4:10 p.m.

Departs FMCH ReturnstoFMCHRun1 7:50 a.m. 8:40 a.m.Run 2 10:15 a.m. 11:00 a.m.Run 3 1:00 p.m. 1:45 p.m.Run 4 2:40 p.m. 3:20 p.m.

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Notary PublicThe services of a notary are available for patients free of charge through the Administrative Office and the Business Office. Talk to your nurse if you need assistance with obtaining this service.

InterpretersThe hospital does have access to interpreters for a number of foreign languages. If this is deemed necessary for a patient, please speak to the nurse.

Hearing ImpairedThe hospital does have a hook-up available for using TTY (Telecommunications Device for the Deaf) so patients may communicate with relatives and friends. Arrangements can also be made to have a person who uses sign language help a hearing impaired or deaf patient. Please let a staff member know if you need these services.

Clergy On-CallThe Ethics Committee of Fort Madison Community Hospital, in partnership with the area clergy, has initiated an on-call chaplain program. Fort Madison Community Hospital is dedicated to providing the community with consistently high quality healthcare and wanted to compliment this with consistent spiritual care as well. With the help of the area clergy, FMCH was able to put together a list of clergy members who volunteered to participate in the on-call Chaplain program. This program will allow FMCH to have a designated clergy member on call 24 hours a day, seven days a week. Each participant will rotate on a regular basis. This service becomes invaluable in cases of trauma or medical emergency. It is the goal of the staff at FMCH to first contact the patient’s own clergy or pastor if the need arises; if they are not readily available they will contact the clergy on call. There are many times when spiritual care plays an intimate role in the total care of a patient and this program will allow the staff at FMCH to complete the circle of care. If you wish pastoral care but do not have someone available, please let the hostess at the information desk know (ext. 222) or contact your Nurse Supervisor at 319-470-0467.

ChapelThe FMCH Chapel is located just off the Main Lobby of the Hospital. The Chapel provides a peaceful space for families to gather and pray or just spend some contemplative time. It is open 24 hours a day/7 days a week.

Walking TrackWhether you enjoy walking indoors or out, the staff at FMCH just wants to see everyone moving. And to help you achieve this goal, FMCH has created two great places for our community members to walk.The new indoor walking track on the first floor of the Outpatient Rehabilitation Services Center features a safe, controlled environment to enjoy your daily walk. The carpeted surface is easy on the joints and the wonderful artwork and expansive windows are easy on the senses. Twelve laps equal a mile. The indoor track is open to community members daily from 5:00 a.m. to 9:00 p.m. and is accessible via the elevator on the ground floor of the Center or from the hospital.If walking outdoors is more your speed, check out our newly paved outdoor walking trail. This trail circles the pond and features beautiful landscaping, benches and a fountain to make your daily walk a peaceful experience. Fivetimesaroundthis trail equal a mile.

Palliative Care?Palliative care is comprehensive treatment of the discomfort, symptoms and stress of serious illness. It does not replace your primary treatment, palliative care works together with the primary treatment you’re receiving. The goal is to prevent and ease suffering and improve your quality of life. Palliative care:

± will help you make life choices. ± will help you understand you don’t have to say “yes” to everything offered. ± is a support, enhancement and addition to the treatment provided by your physicians and nurses. ± is a chance to live your life more comfortably.

Gettingpalliativecareisaseasyasaskingforit.The process begins when your doctor refers you to our palliative care team. You can also ask Lindsey Weirather to help you get a doctor referral, contact her at 319.376.2160.

What happens when you leave the hospital?When you leave the hospital, your palliative care team will help you make a successful move to your home, hospice or other health care setting.

BenefitsofworkingwiththeFMCHpalliativecareteam. ± Personalized case management. ± Prevention of AVOIDABLE hospitalizations. ± Enhance the continuum of care within FMCH scope of care. ± Assistance answering the question “What do you hope for?” ± Keep you in your home as much as possible ± Early palliative care intervention provides support for you and your family.

Palliativecarecanimproveyourqualityoflife.Together with your primary health care provider, your palliative care team combines vigorous pain and symptom control into every part of your treatment. Team members spend as much time with you and your family as it takes to fully understand your condition, care options and other needs. They also make sure you experience a smooth transition between the hospital and other services, such as home care or nursing facilities. This results in well-planned complete treatment for all your symptoms throughout your illness-- treatment that takes care of you in your present condition and anticipates your future needs.

Howdoyouknowifyouneedpalliativecare?You may want to consider palliative care if you or your loved one:

± Suffers from pain or other symptoms due to CHF or COPD. ± Experience physical or emotional pain that is NOT under control. ± Needs help understanding your situation and coordination your care.

Working together as a team.YoudoNOTgiveupyourownhealthcareproviderinordertogetpalliativecare.Thepalliativecareteamworksdirectlywith your them.

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Admissions & SurgeryAdmissionsThe admitting department is responsible for registration services and is located inside the main entrance. Registration is open from 8:30 a.m. to 5:00 p.m., Monday thru Friday. Registration obtains necessary information required for proper patient care. Please bring a list of your current medications along with the dosage. If you have any questions feel free to contact Aljean at 319-376-1156.

Surgi-CenterThe FMCH Surgi-Center is unique in that it allows patients to come into the hospital on the morning of their surgery and return to the comfort of their own home shortly after their surgery. At the time your surgery is scheduled, your physician will give you a folder with forms in it. This folder is very important and you will need it on the day of your tests and the day of your surgery. On the day of your tests Admissions will direct you to the place necessary for your testing to be done pre-operatively. Testing is done from 8:00 am to 9:00 p.m. daily. Please complete all tests 48 hours prior to surgery so that your doctor may evaluate the results.On the morning of your surgery, please report to the Surgi-Center. Entering through the Annex doors is the easiest way to get to the Surgi-Center. Inside the Surgi-Center you will be assessed by a nurse and have a chance to speak with your anesthetist. The Surgery Team will transport you to the Operating Room and direct your family to the waiting area. After your surgery your physician will be out to speak to your family. You will be transported to the Surgi-Center where you will be able to rest until the Surgi-Center staff informs you that you meet the discharge criteria and your doctor discharges you. If you have any questions please call 319-376-2233 or 319-372-6530, ext. 209.

Prior to Your Surgery1. Donoteatordrinkanythingaftermidnightonthedayofyoursurgery. This is very important since serious

complications could occur with patients receiving general anesthesia who DO eat or drink any type of liquids, including water. At the time of your telephone consultation, the Nurse will tell you if you are to take your morning medications.

2. DONOT bring any money, jewelry, or any other valuables with you the day of surgery. DONOT wear eye make-up or nail polish.

3. You will not be permitted to drive an automobile for the remainder of the day following your surgery. Please arrange for someone to drive you home, we also advise that you have an adult stay with you the remainder of the day after dismissal from the Surgi-Center for safety reasons.

4. Please keep smoking to a minimum and no ingestion of alcohol for 24 hours before and after surgery.5. If there is any change in your condition prior to surgery, such as cold symptoms, fever, etc, please contact your

surgeon’s office.6. If you are under 18, and not married, you must be accompanied by a parent or guardian.7. Surgi-Center has limited space, therefore only 2 visitors may be with you during your day of stay. Additional family

members will be directed to the Surgery Waiting Room or Lobby Area.8. Approximately 24-48 hours prior to surgery, a Surgi-Center Nurse will phone you. The purpose of this is to get some

medical history from you and let you know what time to report to the Surgi-Center. If you have not received a call by noon the day before your surgery, please call us at 319-376-1156.

9. On the day of surgery, please be prepared to sign a medical authorization form and a statement verifying you have received this information.

After SurgeryJust a word of caution about going home, remember that you had a surgical procedure. You may feel a little weak and nauseated. You need to make plans to spend the rest of the day at home relaxing. Arrange to have an adult friend or family member drive you home and stay with you.

Post Day Surgery Dietary MenuThe FMCH Dietary Services Department has the following items available for you to choose from.

BreakfastItemsFresh Muffin of the Day • Variety of Cold CerealOatmeal • Assorted Juice • Fresh Fruit

LunchItemsFresh Sandwich & Salad • Cookie of the Day • Ice Cream • Sherbet

BeveragesCoffee • Hot Tea • Ice Tea • 7 Up • Diet 7 Up

Deep Vein Thrombosis & Pulmonary EmbolusWhatareDeepVeinThrombosis&PulmonaryEmbolus?Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) develops in the large veins of the legs or pelvic area. DVT’s can be very painful whereas others have no pain at all. With fast diagnosis and treatment the majority of the DVT’s are not life threatening. Clots that form in the large deep veins are more likely to break loose and travel through the vein. A traveling clot is called an embolus. When an embolus travels from the legs or pelvic area to the lungs it is known as a pulmonary embolus (PE). Pulmonary embolus that are not diagnosed and treated rapidly can be fatal.

WhatRiskFactorsCanIncreaseYourRiskforDVT&PE?Risk factors include people who are over 40 years of age, smoking, COPD, history of DVT/PE, cancer, hormonal replacement therapy, trauma injury, having a total joint replacement, and surgeries lasting longer than 2 hours.

WhataretheSignsandSymptomsofaDVT&PE?Approximately 50% of patients with a DVT do not have symptoms. The most common symptom is pain and tenderness in a calf or leg. Swelling of the leg calf, warmth, and color changes of the leg calf are also symptoms that can occur over a period of time or suddenly. If you feel you are experiencing these signs and symptoms you should contact your doctor immediately. PE symptoms are much different. They include shortness of breath, rapid pulse, and a feeling of apprehension.

CanDVT&PEBeTreated?Yes. They are diagnosed with an ultrasound exam and blood test (D-dimer). Treatment consists of drugs to thin the blood which is delivered by mouth, intravenously, or a shot depending on which your doctor orders based on your needs. Your doctor may place you on bed rest. It is important to follow your doctor’s plan of care and instructions to speed your recovery.

WhatareSomeThingsFMCHisDoingtoPreventPE&DVT?All patients are screened for risk factors preoperatively. Patients are asked to pump their ankles and we try to get them moving as soon as possible to increase their blood circulation. Depending on your procedure, you may be fitted for antiembolism stockings or have sequential compression devices (SCD’s) placed on your legs before during and after surgery. SCD’s are pneumatic compression devices placed on your legs to help circulate your blood.

WhatCanIDotoHelpPreventDVT&PE?Decrease your risks by not smoking, eating healthy to maintain a healthy body weight, avoid sitting for prolonged periods, and moving early and often after surgery. When you are sitting in a chair or lying in bed pump your ankles frequently and wear your SCD’s if they are ordered.

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Your Inpatient AccommodationsYour Hospital TeamMedicalStaffYour own personal/family physician or specialty physician is responsible for directing your care while you are a patient at FMCH. You may also see other doctors who specialize in certain fields of medicine during your stay. Your own physician will be the coordinator of your treatment program, and should be consulted if you have questions.

NursingStaffNursing care is provided 24 hours a day by a team of registered nurses, licensed practical nurses and nurse assistants. A Nursing Unit Director is responsible for coordinating nursing care on each unit. Please feel free to contact your Nurse Director if you have questions or concerns.

DieticianA Registered Dietician oversees your dietary needs during your stay. If you have special dietary needs, or any questions about your diet, please call the Dietician at ext. 572. Questions relating to the meals you are served should be directed to the kitchen staff at ext. 482.

Case ManagerThe Case Managers on staff work as a liaison between the patient, support person, and the physician. They are trained to help patients and family members deal with the financial, social, and emotional problems that relate to illness or hospitalizations. They also provide “discharge planning” which helps patients make arrangements for continued care after leaving the hospital. Case Managers are Registered Nurses that are well-acquainted with the many different organizations and agencies available to provide services in the region. During your stay all “Plan of Care” documentation including prescriptions, diet, exercise and follow-up care will be kept in your own personal binder. This binder will be your guide to take home with you.

TherapistsA variety of therapists are available through FMCH to help patients heal, recover and improve their quality of life. During your hospital stay, you may be treated by a hospital therapist. Our staff include professionals trained in cardiac and respiratory therapy, physical and aquatic therapy, occupational and speech therapy.

TechnicalSpecialistsAs a patient, you may have opportunity to see several professionals who specialize in the technical areas of diagnostic care. Most of these professionals are employed in the radiology and laboratory departments. Their work in research, analysis, and imaging helps your doctor in making a diagnosis and providing quality care.

ClergyOn-CallPlease see page 16.

AirEvacuationThe Air Evac Life Team is available for service to FMCH 24 hours a day in order to help patients receive the level of care that they need.

Butterf ly GardenButterfly Garden patient and family rooms are dedicated comfort care rooms for FMCH patients. Comfort care is when despite the best of medicine the patient probably will not get well and comfort (physical and spiritual) is what the staff at FMCH can offer as well as the accommodations to be with their family and friends. These specially furnished rooms feature soothing and comfortable surroundings for the patient, while the family room is equipped to meet the needs of loved ones

wanting to remain close at all times. The Butterfly Garden rooms are located in a quiet corner on the inpatient floor of the hospital where the medical staff can attend to all of the patient’s healthcare needs. The rooms were made possible by the generosity and commitment of the members of the FMCH Auxiliary who raised the funds through their many community fundraisers. For more information about the use of the Butterfly Garden rooms, contact the Nursing Supervisor at x205 or 319-316-2460.

Your Private Room AccommodationsYour room was assigned at the time of admission. The location may have been chosen due to the physician’s order, the type of care you require, or room availability. If you have questions or concerns about this, speak to your nurse. Hospital staff make every effort to honor requests for specific types of accommodations. At your request, the entry door to your room can be kept closed. All rooms are private rooms, complete with your own bathroom.

YourHospitalBedHospital beds are electrically operated so ask your nurse to show you how to work your bed properly. The bed itself is probably higher and narrower than your bed at home. It also has side rails for your protection. These rails may be raised at night, when you are resting, recovering from surgery, or taking certain medications.

RoomTemperatureAll rooms in the hospital are centrally heated and air-conditioned. If your room temperature is not comfortable, please notify the nursing staff.

CallingYourNurseA button to call your nurse is located on the bedside rail. When you press the button, the nursing station is alerted that you need assistance and a light flashes above your door. A staff member will respond to your signal as soon as possible.

LeavingtheUnitIf you want to leave the unit, please check first at the nurses’ station to make sure your doctor has given approval and to let staff know where you can be reached. It is important to stay in your room until your doctor has made morning rounds and treatments have been completed.

TelephonesA telephone for your use is located within the bedside rail or on the adjacent nightstand. You may receive calls at any time. If your room number is between 101 and 124, tell your family and friends to dial “376-2,” then the last two digits of your room number, then “1” to reach you. If your room number is between 125 and 141, family and friends should dial “376-24” then the last two digits of your room number.Example: Room 101 Dial 376-2011To place a local call outside of the hospital, dial “9,” then the number. To make a long distance call, you must either use a credit card, phone card, or charge the call back to your home number . Long distance and toll calls can be made by dialing “9” and then “0” plus the number.

Internet AccessEach patient room has high speed internet access available. Patients and visitors may connect to this at anytime with their own laptop.

Housekeeping/MaintenanceYour room is cleaned daily by our Facilities Management Staff, which handles all housekeeping and maintenance duties within the hospital. Often times rooms are cleaned while the patient is out of the room. If you encounter any housekeeping problems or anything in your room that is in need of repair, please notify your nurse or call ext. 459.

For Your ConvenienceATMAn ATM is located in the Main Lobby and available to the public for use.

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Cheer CardsFMCH’s website (www.fmchosp.com) gives family and friends the opportunity to send cheer cards via the internet. Cheer cards are printed and delivered Monday through Friday, 8 a.m. to 4:30 p.m.

FlowersFlowers may be sent to the hospital and are delivered to your room by volunteers. Flowers are also available for purchase in the gift shop.

GiftshopThe Gift Shop is open from 9:00-4:00, Monday - Friday. The FMCH Gift Shop offers online gift items for purchase and delivery to a patient at Fort Madison Community Hospital. Visit the Online Giftshop going to www.fmchosp.com and clicking on the “Online Giftshop” link.

MailLetters and packages for patients are delivered each morning by volunteers. If letters or parcels arrive after you have been discharged, we will forward them to your home. Stamps are available at Registration and in the Business Center.

NewspapersThe local newspaper is delivered to patient rooms. Regional and National papers are available for purchase in the vending machines at the entrance to the hospital.

WebNurseryBabies born at FMCH BirthPlace will have their picture taken. The Monday after birth these pictures will be available for viewing under Web Nursery on the FMCH website (www.fmchosp.com)

For Your SafetyFire and Disaster PreparednessFor your protection, the hospital conducts both fire and disaster drills on a regular basis. This includes drills for dealing with those times when the hospital is under a tornado watch or warning. If you hear any type of alarm warning, please stay calm and stay in your room. Staff on all shifts are trained in what to do should a real situation occur and will inform you of what steps to take.

MedicationSafetyAll medications you take while in the hospital are prescribed by your doctor, dispensed by the hospital pharmacy and administered by a nurse. If you have questions or concerns regarding your medications, be sure to bring these to the attention of your doctor or nurse handling your care. Whenever you visit the hospital or your physician, it is important that you bring a list of medications and dosages with you. This list should include over-the- counter drugs, vitamins, herbal remedies and other supplements. Update this list with any changes that are made. Here are some other tips you can follow for safe medication use in the hospital and at home:

± Get your prescriptions filled at the same pharmacy. ± Tell your physician and pharmacist all the medicines you take, including things you buy “over-the-counter,” such

as aspirin, antacids, ibuprofen, vitamins, or herbal products. ± Make sure you know how to take your medicine; for example, are you to chew a tablet or swallow it whole, take

with or without food, etc. ± Measure your liquid medicines with an accurate dosing spoon, not a regular kitchen spoon, to make sure you’re

getting the correct amount. ± Take your medications at the same time every day so you’re more likely to remember to take them. ± Check with your pharmacist on how to store your medicines; some need to be stored at room temperature in a

dry place while others need to be kept in the refrigerator.

± If you realize you forgot to take your medication, you should take it when you remember if it has not been more than four to six hours since you forgot it. If it is almost time for your next dose, just take your next dose. Do not double up on medications. If you have any questions about missed doses, call and ask your doctor or pharmacist.

± Make sure you can read the handwriting on prescriptions your doctor writes. ± You can ask questions of your nurse, doctor, or pharmacist about medications at any time.

OxygenSpecial regulations are in effect in areas where patients are receiving oxygen. Electrically operated equipment and aerosol products are not permitted in these areas.

Smoking/TobaccoUseIt is the policy of FMCH to promote, health, well being, and safety for all patients, visitors, and employees while on the Hospital grounds. Therefore the use of tobacco products is prohibited:

± In all areas within the hospital buildings ± On all property maintained by the hospital, including parking lots ± In all vehicles owned, or rented by the hospital ± In all employee vehicles when parked on hospital property, or when being used on hospital paid time

This policy covers all individuals working, visiting, or receiving medical care within the boundaries of this hospital property.

WheelchairsWheelchairs are available for all nursing units, but getting in and out of them without assistance may be hazardous. Please ask for help from a member of the hospital staff.

ValuablesPatients are asked not to bring items of value to the hospital. If you do bring a valuable item along, report it to your nurse. The nurse can place the valuable in a locked area until your departure. When turning over such an item, the nurse should note it on your chart so a record of it will be available at your departure time. The hospital does not accept responsibility for items of value unless they are deposited by a nurse in the locked area for safekeeping.

LostandFoundIf you lose something, please notify your nurse immediately. We will make every effort to help you find the article. Unclaimed articles that are found by others are turned in to the Facilities Management office where they are kept for 30 days. To inquire about lost articles, call the office at ext. 459.

ConditionReportsThe local news media frequently call FMCH to get a condition report on victims of accidents or injuries. In these instances, the hospital does release one-word condition reports ( e.g. “good,” “fair,” “critical,”) on patients. Other personal information (about your diagnosis and treatment) must come from your physician and is only available to those members of your immediate family whom you designate to receive it. To protect your privacy, you may at any time, expressly state that you do not want information, including confirmation or your condition or presence in the facility, released. Please report this to your nurse or your physician.

FallPreventionBeing in unfamiliar surroundings and taking medications can increase your chances for falling while in the hospital. FMCH Staff Members will assess your potential for falling and will use hospital resources, such as side rails, identification items and emergency call lights, to help you while in the hospital. They will also orient you to the room and offer to help when you need assistance. It is important that you and your family partner with the hospital staff during this time to keep you safe. We will make hourly rounds to assure your comfort and address your needs. FMCH Staff can be called at any time using the call system.

± While in the hospital, there are also some things you and your family can do to prevent falls from happening: ± Keep your call bell within reach. Ask for assistance when getting out of bed or going to the bathroom especially if

you have oxygen or an IV.

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± Never hesitate to call for assistance - the staff is here to help you. ± Sit on the edge of the bed for a minute before you start to walk. This will help to restore blood flow and lessen the

chance of dizziness. ± Do not lean on your overbed table or nightstand for support. Both have wheels on the bottom and can be dangerous. ± Use your cane or walker as instructed. If you are insecure about using the device wait for assistance. ± Side rails may be “up” to help you turn; do not try to climb over or around them. ± Always ask for help. ± Share your complete medical history with the hospital staff so they can be aware of your risks for falls. ± Any time you feel dizzy or unsteady, ask for help before moving from one place to another. Use the emergency

call light. ± Be aware of your limitations and move slowly. ± Make sure your bed is in the low position before trying to stand. ± Wear socks with slip guards or slippers with soft rubber soles. ± Have a friend or family member stay with you at the hospital. ± Keep the things you frequently need or want, such as eyeglasses or hearing aids, within close reach. ± Fall prevention tips for when you go home… Some of the leading causes of falls in the home are related to

environmental hazards. Here are some things to consider: ± Use adequate lighting with light switches placed at each end of stairs and hallways. Use a nightlight. ± Add electrical outlets to avoid long extension cords. ± Remove oversized furniture and clutter. Arrange furniture so that you can easily move around it. Make sure chairs

and couches are easy to get in and out of. Remove caster wheels from furniture. Do not use furniture for support. ± Secure rugs and carpet edges with nonskid tape; avoid throw rugs. Add nonskid mats or appliqués to bathtubs. ± Use a different or contrast color to denote changes in surface types or levels. ± Install tightly fastened handrails the entire length and on both sides of stairs. Grab bars around the tub and beside

the toilet should be strong enough to hold your weight. ± Keep commonly used items within easy reach. ± Avoid using floor polish or wax in order to reduce slick surfaces. Keep floor surfaces dry. ± Use portable hand-held showerheads, shower seats and raised toilet seats when necessary. ± Know where your pet is to avoid tripping; pets can cause falls. ± Avoid rushing to answer the phone or doorbell. ± Keep walk areas clear of snow and ice. ±

InfectionPreventionThe number one thing you and anyone who visits you can do to stop the spread of infection is WASHYOURHANDS! Use soap and running water to adequately lather up your hands, rubbing them together, getting in between your fingers and around your nails. Proper hand washing should take at least 20 seconds – remember singing Happy Birthday or ABC’s will mean you washed long enough.It is also important for you to communicate with your health care providers about any chronic diseases, like diabetes, that may contribute to the development or severity of an infection.

Pain ManagementAs a partner in your health care, your caregivers will depend on you to tell them how you feel. Based on your comfort level, your health care providers will develop a pain management plan for you while you’re in the hospital. For this plan to be effective, you need to provide honest answers to questions about the pain you’re experiencing - its intensity, longevity and interference with your daily activities. It’s also a good idea to share with your physician what has worked to relieve your pain in the past. Here are some other things you can do to help your caregivers keep you comfortable in the hospital:

± Don’t hesitate or be afraid to tell the hospital staff if you’re in pain. ± Don’t wait to report pain. Pain is much easier to control when it first

begins than when it has become intolerable. ± Actively help your health care professionals assess your pain. Answer

their questions as completely and honestly as you can.FMCH uses a pain management scale to make your stay here as comfortable as possible. The goal is to keep your pain level low enough for you to function. Pain control can help you enjoy greater comfort so you can heal faster. As a partner in your health care, your caregivers will depend on you to tell them how you feel. Based on your comfort level, your health care providers will develop a pain management plan for you while you’re in the hospital. For this plan to be effective, you need to provide honest answers to questions about the pain you’re experiencing - its intensity, longevity and interference with your daily activities. It’s also a good idea to share with your physician what has worked to relieve your pain in the past. Here are some other things you can do to help your caregivers keep you comfortable in the hospital:

± Don’t hesitate or be afraid to tell the hospital staff if you’re in pain. ± Don’t wait to report pain. Pain is much easier to control when it first begins than when it has become intolerable. ± Actively help your health care professionals assess your pain. Answer their questions as completely and honestly

as you can.

Behavior Category

No Pain(0)

Mild(1)

Moderate(5)

Severe(10)

Facial Neutral/Smiling Frowning/Grimacing Clenched Teeth Full Cry Expression

Body Movement Calm, Relaxed Restless/FidgetingModerate Agitation

or Moderate Mobility

Thrashing, Flailing, Constant Agitation or Refuse to Move

Sleep Sleeping Quietly with Easy Breathing

Restless While Sleeping

Sleeps Intermittently (Sleep/Awake)

Unable to Sleep

Verbal/Vocal No Verbalization/Quiet

Whimpering/Moaning Softly

Crying/Moaning Loudly Screaming

Response toMovement/

TouchMoves Easily

Winces When Touched/

Repositioned

Cries Out When Touched/

Repositioned

Screams When Touched/

Repositioned

SEVEREPAIN

MODERATEPAIN

NO PAIN

SELF-ASSESSMENT BY PATIENT

PAIN ASSESSMENT TOOL

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FMCH Food ServicesPatientMealsEach morning you will receive a menu from which you will be able to select your preferred meal for the following day. If you are on a special diet prescribed by your doctor, you will receive menus tailored to your specific needs. Please mark your menu and the dietary staff will be in around 10:00 am to collect your menu order. If you need assistance making a selection, you can contact the dietary department at ext. 482 or the staff can help you when they pick up your menu.

MealTimes Breakfast .................................................7:15 a.m. Lunch........................................................11:45 a.m. Dinner ......................................................5:15 p.m.These times are approximate and your meal can be delayed if you are scheduled for a test or treatment. If at all possible you will be served after your examination or test. Visitors are required to go to the cafeteria to pick up food for themselves but they are welcome to bring it back to your room to eat. Under special circumstances a guest meal can be delivered to your room and paid for upon delivery, please make arrangements with your nurse.

CafeteriaThe hospital cafeteria is open offering snack items and sandwiches during the following hours: Monday - Friday .......................................6:30 a.m. to 6:30 p.m. Saturday, Sundays, & Holidays .................6:30 a.m. to 2:30 p.m.Full Menu with daily specials is Served during the following hours: Breakfast ..................................................6:30 a.m. to 9:45 a.m. Lunch........................................................10:30 a.m. to 1:00 p.m. Dinner (Monday -Friday Only) .................4:45 p.m. to 6:30 p.m.Hospital employees and visitors are welcome to use the cafeteria at any time. Patients should obtain permission from their physicians or nurse before eating in the cafeteria as some foods may be restricted due to diet or medication needs.

Vending MachinesVending machines for snacks and beverages are located throughout the hospital complex. The vending machine area located in the hallway off of the cafeteria is closest to the patient rooms and a microwave is available for use.

VisitorsVisitingHoursFMCH welcomes all visitors, however, we encourage visits between 10 a.m. and 9 p.m. FMCH requests that only siblings of the newborn visit patients in the BirthPlace. This reduces the spread of germs. Please check in a the Information Desk.As a patient, you have the right to receive the hospital visitors whom you designate, including, but not limited to, your spouse, a domestic partner (including a same sex domestic partner), another family member, or a friend. You also have the right to withdraw or deny your consent to visitation at any time. In the event you are unable to designate who can visit you in the hospital, any person you have designated as your “support person” can make that designation. Hospital visitation will not be limited or denied based on race, color, national origin, disability, religion, sex, sexual orientation, gender identity or expression. However, hospital visitation may be limited or denied if it becomes clinically or otherwise reasonably necessary for a patient’s care, safety or well-being to impose restrictions. Reasons to limit hospital visitation, if deemed necessary, may include but are not limited to:

Visitationmayinterferewithyourcareinterventions ± Infection control issues ± Visitation may interfere with the care of other patients ± Existence of court orders restrict visitation or other contact ± Disruptive, threatening, or violent behavior by a visitor of any kind ± Need for limitation on the number of visitors in particular space or during specific time period

Foryourhealthandrecovery,weaskvisitorstoobservetheseguidelines: ± People with colds, sore throats, or any contagious diseases should not visit patients. ± Visitors are encouraged to wash their hands before and after visiting a patient. ± Please leave the room when the patient receives a treatment. ± Please do not smoke on hospital property. FMCH is a smoke-free facility inside and out.

BringingGiftsforPatientsVisitors should check with the nurse before bringing gifts of food or drink to patients. If you are unsure of the appropriateness of the gift, please ask the nurse for guidance. All gifts for the special care unit should be approved by the nursing staff.

ParkingFree parking is available at FMCH 24 hours a day. However, parking in reserved areas, the circle drive, or emergency vehicle areas is prohibited. Be sure to lock your car at all times. If you experience a problem in the parking area or you need assistance, please call Facilities Management at ext. 459.

AccommodationsforVisitorsAccommodations for out-of-town visitors are available at a number of area hotels, inns, and bed and breakfast establishments. Comfort Inn ..............................................372-6800 Rivers Inn ................................................372-5123 Knights (Madison) Inn ..............................372-7740 Super 8 .....................................................372-8500 Kingsley Inn ..............................................372-7074

WaitingAreasSpecific waiting areas have been designated for families of patients in the emergency department and surgery. All other visitors are welcome to utilize the various lounge areas located throughout the main lobby and near room 124. The small interior courtyard is also available and is accessible from the main lobby.

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For Your Reference AbbreviationsWhile at FMCH you may encounter staff from many different departments, below are the abbreviations you might see:

CDE ................................................... Certified Diabetes Educator CNA .................................................... Certified Nursing Assistant CRNA .................................................. Certified Registered Nurse Anesthetist CRNP ................................................. Certified Registered Nurse Practitioner CRTT ................................................... Certified Respiratory Therapy Technician LPN .................................................... Licensed Practical Nurse MLT ................................................... Medical Laboratory Technologist NMT ................................................... Nuclear Medicine Technologist PT ...................................................... Physical Therapist RD ...................................................... Registered Dietician RT ....................................................... Radiology Technician RRT..................................................... Registered Respiratory Therapist RN ...................................................... Registered Nurse SLP ..................................................... Speech and Language Pathologist OCN ................................................... Oncology Certified Nurse OTR ................................................... Occupational Therapist

Operator .................................................................0Department EXTAdministrative Offices .................................................271The Annex .................................................................266The Birthplace Unit......................................................288Business Center ...........................................................314 Cafeteria (Dining Area) ................................................469Cardiac Rehabilitation .................................................583Case Management .......................................................291Community Relations ..................................................593Courtesy Van ...............................................................222Dietitian .................................................................572Discharge Planner ........................................................291Education .................................................................277Emergency Department ..............................................237Facilities Management/Housekeeping ........................459Financial Counselor .....................................................310Food Service ................................................................482FMCH Foundation........................................................2038Fort Madison Physicians &Surgeons Clinic ...............536Gift Shop .................................................................298

Health Information (Medical Records) ........................359Home Health Care .......................................................565Hostess Desk/Information ...........................................222Infection Control ..........................................................213Laboratory .................................................................248Materials (Supplies) Management ..............................265Medical/Surgical Unit ..................................................280Nursing Services Director ............................................263Occupational Therapy .................................................246Patient Accounts ..........................................................314Pharmacy .................................................................440Physical Therapy ..........................................................480Radiology .................................................................368Respiratory Therapy ....................................................453Special Care Unit .........................................................280Specialty Clinics ...........................................................590Speech Therapy ..........................................................433Surgery/SCU Waiting Room .........................................215Surgi-Center/Ambulatory Surgery ...............................209Social Services .............................................................291Wound Healing Center ................................................1203

Hospital Phone Extension Directory

TV Channel Listing

Channel Listing Channel Listing2 FOX QUINCY 53-23 TRU TV3 ABC KIRKSVILLE 54-1 FOOD NETWORK5 TBN QUINCY 54-3 HGTV6 NBC DAVENPORT 54-7 DISNEY CHANNEL7 CBS HANNIBAL 54-9 TLEMUNDO8 ABC MOLINE 54-11 A&E

10 NBC QUINCY 54-13 HISTORY11 QVC 54-15 VH112 IPTV IOWA CITY 54-17 LIFETIME16 C-SPAN 54-21 SYFY17 ION 54-23 AMC19 CW QUINCY 55-2 BIG TEN NETWORK20 CW BURLINGTON 55-5 ESPN21 WGN AMERICA 55-13 EXPN 222 MEDIACOM CONN. 55-15 COMCAST SPORTSNET

51-1 HALLMARK CHANNEL 55-17 THE WEATHER CHANNEL51-3 LMN 56-1 NATIONAL GEOGRAPHIC51-5 ABC FAMILY 56-3 DISCOVERY FIT & HEALTH51-7 COMEDY CENTRAL 90-2 FOX QUINCY

51-11 DISCOVERY CHANNEL 90-4 ION51-13 FOX NEWS 90-6 CW BURLINGTON51-17 RFD TV 90-8 CBS HANNIBAL51-19 TLC 90-10 IPTV IOWA CITY51-21 WE 90-12 ABC KIRKSVILLE52-1 FX 90-14 NBC DAVENPORT52-5 E! 90-16 NBC QUINCY52-7 NBC SPORTS NET. 91-2 CW QUINCY52-9 SPEED 91-4 TBN QUINCY

52-11 UNIVISION 91-6 QVC52-13 BET 91-8 ABC MOLINE52-15 BRAVO 91-10 BYU52-17 CNBC 91-25 MEDIACOM CONN.52-19 ANIMAL PLANET 94-3 C-SPAN52-21 USA 94-5 TBN52-23 TRAVEL CHANNEL 94-7 WGN AMERICA53-1 CNN 94-11 CHURCH CHANNEL52-3 HLN 94-13 C-SPAN 353-5 CARTOON NETWORK 94-15 INSPIRATION NETWORK53-7 TBS 94-17 EWTN53-9 TNT 94-19 3ABN

53-11 SPIKE 94-21 C-SPAN 253-13 TV LAND 94-23 HSN53-15 CMT 118 IPTV LEARNS53-17 MTV 119 IPTV WORLD53-19 NICKELODEON53-21 MSNBC

Page 31Page 30

DischargeCase Management & Discharge Planning A member of the Case Management Department at Fort Madison Community Hospital will meet with you prior to your discharge. Their role is to help you with planning for your release from the hospital and arranging any services that you might need after your release. Your Case Manager, will talk with you about your health care needs after you leave the hospital. These needs include: family support, equipment, community services, medications, follow-up care, transportation and other needs that are important to you.

ReferralServicesProvided: ± Home Health Care Services ± Durable Medical Equipment (Oxygen, walkers, hospital beds) ± Intravenous Therapy ± Referrals to Public Assistance Programs ± Referrals to Community Agencies such as:

± Meals on Wheels ± American Cancer Society ± Support Groups/Self Help Groups

± Transfer to Skilled Nursing Facilities ± Ambulance Transfers When Medically Necessary ± Completion of an Advance Directive ± Monitoring of Insurance Coverage/Communication with Insurance Company ± Nursing Home Placement ± Rehabilitation Needs ± Medicaid Application Process ± Referrals to Counseling Services ± Assisted Living ± Funeral Arrangement ± Other Requests

QuestionsIf you have any questions feel free to contact one of our Case Managers:

MarciaKruse,RN,DirectorofCaseManagement319-376-2048

JillHouston,RN319-376-2162

Leaving The Hospital When your doctor decides you are ready to leave the hospital, a discharge order will be written and you will be notified. It may be helpful to make arrangements with a family member or friend to help you when it is time to leave.

CheckOutTimeThere is no regular check out time. You may leave anytime during the day that you are discharged. Hospital days run from midnight to midnight so you would not be billed for extra time unless you stay past midnight on your discharge day. A good rule of thumb is to plan a late morning or early afternoon departure after you know the date of discharge.One exception to this rule is if you are admitted for “observation.” Observation runs on a hourly basis, so patients will want to leave shortly after discharge to avoid any extra charges. If this is not possible, notify your nurse to make other arrangements.

PersonalBelongingsPlease collect all of your belongings and double-check your closets and drawers. If you have given the staff any valuables remember to ask a nurse to get them for you before you leave. If something has been left behind you can contact lost and found at ext. 459.

Escorted DepartureWhen you are ready to leave, please let a staff member know. They will escort you to the front entrance and help you into your car if needed.

Financial ArrangementsBilling ProceduresAt Fort Madison Community Hospital the medical charges are based on the services that the physician felt necessary to treat your condition and the procedures that were performed. We adhere to the following billing procedures:

± Your bill will be submitted to your insurance company for payment shortly after your visit; please remember to bring your insurance, Medicaid, or Medicare card with you at time of service.

± An explanation of benefits (EOB) from your insurance company will be sent to you. This explains the amount your insurance company will be paying FMCH.

± If you have a secondary insurance provider, FMCH will submit your bill to them at this time. ± About six weeks after services were provided, FMCH will send a billing statement to your home with the balance

of your account. This is the amount that you are responsible for paying.Separate statements will be sent to you for Radiology and Anesthesia services. Contact information is listed below: Davis Radiology, PC ..................................1-877-986-2323 Midwest Anesthesiology ..........................1-800-433-1439

PaymentOptionsFor your convenience these include:

± Cash Payments ± Personal Check ± Credit Card (Visa, MC, Discover, American Express) ± Extended Payments/Special Arrangements (please call one of our Financial Counselors at either 319-376-2110 or

319-376-2069). You may also contact the Business Office Manager at 319-376-2155. ± Online Bill Pay (www.fmchosp.com)

BusinessOfficeHours8:00 am to 4:30 p.m. • Monday through FridayEmail: business@fmchosp.com

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Patient Support ServicesFMCH Anticoagulation ClinicThe Anticoagulation Clinic is offered by appointment and will be managed by FMCH Clinical Pharmacist Audrey Housel. Pharmacy-managed anticoagulant therapy improves the quality and safety of such therapy in the inpatient and outpatient setting. No appointment is necessary for the FMCH Anticoagulation Clinic. Patients will need a referral from their FMCH healthcare provider. To find out more about the Anticoagulation Clinic contact Audrey Housel at the FMCH Pharmacy at 319-376-2052.

FMCH Diabetes Self-Management ProgramThe FMCH Diabetes Self-Management Program is designed to help diabetic individuals enhance their health by learning to effectively manage Diabetes. The topics covered are; coping strategies, nutrition, exercise, medication, blood sugar monitoring, managing low and high blood sugars, personal health habits, benefits of blood sugar control, and improving long term health. Contact your physician for a referral or contact a diabetes educator by calling 319-376-2223 or emailing education@fmchosp.com.

FMCH Home Health ServicesFMCH Home Health Care professional nursing staff offers services to residents of Lee, Des Moines, Van Buren and Henry counties. Their services cover: new mothers; patients recently discharged from the hospital; patients recovering from surgery; heart attack or stroke; disabled individuals; and Alzheimer patients. Services are provided by Registered Nurses, Professional Therapists, Home Health Aides, Companions, and Social Workers. FMCH Home Health Care also has a Registered Nurse on call 24 hours a day for those unexpected incidents. For more information, call 319-376-2166 or 1-877-248-3069 (toll free).

FMCH Sleep Studies CenterIndividuals who have trouble sleeping often have health-related problems as the cause. The FMCH Sleep Studies Center provides diagnostic testing in a comfortable, homelike sleep laboratory. Talk to your family physician about whether a referral to the Sleep Studies Center would be appropriate for you.

FMCH Wound Healing & Hyperbaric CenterEvery wound has its unique set of circumstances. Our Wound Healing & Hyperbaric Center is equipped and staffed to address them all. With state-of-the-art hyperbaric oxygen chambers, and a multi-disciplinary medical team, the FMCH Wound Healing and Hyperbaric Center stands ready to provide the treatments you need. Most treatments are covered by Medicare, Medicaid, HMOs and other private insurance plans. We are experts at caring for people whose open sores have resisted traditional treatment for over 30 days. Our success rate shows that 80% of chronic wounds are healed within 12-16 weeks. Our Center is staffed with a unique team of doctors, nurses, and therapists, all dedicated to healing chronic wounds. For more information about Fort Madison Community Hospital’s Wound Healing and Hyperbaric Center, please call 319-376-2403.

Community & WellnessEducational ServicesThe mission of Fort Madison Community Hospital states one of the goals of the organization is “to promote and encourage healthy lifestyles by providing programs and services aimed at health and safety education, illness and injury prevention and overall health and wellness.” Fort Madison Community Hospital strives to meet this goal by providing a wide range of programs on a regular basis.

Tours&EducationalSpeakersTours of the hospital are available to the public and can be tailored for different ages and groups. FMCH can also provide educational speakers for different group meetings, classes or gatherings. For more information or to set up either a tour or speaker, please call FMCH Community Relations at 319-376-2244.

CPRTrainingFMCH has several American Heart Association certified instructors for CPR training. CPR classes are scheduled monthly for both health care providers and the public-at-large. For more information on CPR training, please call FMCH Education at 319-376-2223.

ExpectantParentClassesThe Birthplace offers several educational classes. Classes are available for those thinking about becoming parents to Baby Weigh-Ins after your child is born. All classes are free to the mother and her support person. Go to our website at www.fmchosp.com for dates, times, and more information on the classes or you can also call the BirthPlace at 319-376-BABY. We ask that you pre-register for all classes, except for Baby Weigh-In which is held every Tuesday morning from 9:30 to 11:00 a.m. in the Suite 108. You can pre-register online by going to www.fmchosp.com. Click on the “Community & Wellness” tab and then select “Prenatal Education”. You may also call 319-376-2223 to pre-register.

Health Fairs The hospital is a regular participant in area activities, setting up health fairs and exhibits to provide both service-based and educational health information for the general public. We hope you use the opportunity to visit our display areas and take home helpful information available to guide you in staying healthy. For more information on these fairs please contact the Community Relations Department at 319-376-2244.

Support GroupsFMCHBabyWeigh-InMoms and their newborns are invited to attend “Weigh In” every Tuesday morning in the FMCH Conference Rooms from 9:30 to 11:00 a.m in Suite 108. The program allows new moms to bring their babies to the hospital to be weighed. It will also provide the moms a chance to socialize with one another and have questions answered by a Registered Nurse. Breastfeeding advice and support will also be offered. There is no charge for the program and reservations are not required.

Children in the MiddleThis program is designed for parents who are concerned for children of divorce. The first session meets the second Wednesday of every other month 8:30 - 11:00 am in the FMCH Conference Rooms (located in the lower level of the east addition). The second session meets from 6:00 - 9:30 p.m. once every three months. For dates and a registration form, please call 319-754-8035.

FMCH Diabetes Support GroupThis group meets on a rotating every other month basis. At each meeting a guest speaker will focus on a topic related to diabetes education. Please contact the Education Department at 319-376-2223 to verify the dates or if you have any questions. New members are always welcome.

Medicare & Insurance CounselingS.H.I.I.P.FMCH sponsors the Senior Health Insurance Information Program. This program helps seniors and their families understand Medicare, supplemental insurance, long-term care insurance, other health insurance issues and Medicare prescription drug coverage. A S.H.I.I.P. volunteer can help you make important decisions by offering unbiased information. To make an appointment with one of our trained S.H.I.I.P. volunteers call 319-376-2249 or email aalexander@fmchosp.com.

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VolunteersFortMadisonCommunityHospitalAuxiliaryThe Fort Madison Community Hospital Auxiliary was created to promote the welfare of Fort Madison Community Hospital, to create interest in its goals and objectives, to assist in services of the hospital and to provide scholarships. Each year, the Auxiliary awards scholarships to high school seniors who are pursuing a health-related education. The Auxiliary often purchases equipment and supplies for the hospital to fill a special need. Membership in the Auxiliary is open to all. If you are interested in becoming a member of the Auxiliary, please contact FMCH Human Resources at 319-376-2126 or HR@fmchosp.com.

VolunteersVolunteers donate approximately 3,000 hours of their time each year to FMCH. They participate in running the gift shop, rehabilitation services, delivering flower and cards, and other duties that may arise in the hospital. Volunteers must be 16 years of age and take a TB skin test. If you would like more information or to donate your time please contact Human Resources at 319-376-2126.

FMCH FoundationThe FMCH Foundation was established, with full authority from the Hospital’s Board of Directors, in the summer of 1995. The purpose of the Foundation is to raise private funds to support the Hospital, and to conduct charitable, educational, and scientific activities that will benefit both the Hospital and its patrons. Hence, every contribution to the Foundation in some way extends gifts of health and healing to others. These are among life’s most precious, and sometimes fleeting, gifts.That’s why the FMCH Foundation is a rewarding choice for charitable contributions. Monies aimed at providing health and healing can impact thousand of lives - including those of friends, neighbors, and family members - both now, and for generations to come.

Arranging ContributionsBecause the FMCH Foundation is a nonprofit corporation, contributions by donors may be deductible for Federal Income, Estate, or Gift Tax purposes. For many donors, this could provide a considerable tax advantage. Our Foundation Director will be happy to meet with potential donors, or their designees, to discuss ways in which both the donor and the Foundation may realize benefits. Consultations may be arranged with an attorney, accountant, bank trust officer, or life insurance representative as well, to ensure the most productive use of a donor’s assets. For more information, please contact our Foundation Director at 319-376-2747 to set up an appointment.

Guardian Angel ProgramThe Guardian Angel Program allows patients and their families to recognize a staff member, physician or volunteer who made a difference during their Hospital experience or who went above and beyond to help someone. The program invites individuals to make a donation to the Foundation along with a nomination explaining why an individual is being recognized.We often have many patients ask how they can express their gratitude after they’ve received quality care at Fort Madison Community Hospital. When a Grateful Patient indicates the name of a caregiver or staff member on the gift reply card that accompanies their donation, the honored caregiver will receive a letter from the Foundation Board President and/or the CEO recognizing them as a Guardian Angel and will be presented with a Guardian Angel pin by the CEO and/or Foundation. Guardian Angels will be listed in the spotlight and be formally recognized. An employee can receive multiple Guardian Angel pins. Brochures outlining the program and containing a nomination form can be found throughout the hospital.

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