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Advanced Directives Policy


Horn Memorial Hospital (HMH) respects the right of a patient to make decisions regarding their own health care, including the right to accept or reject certain recommended care. HMH recognizes a person's right under Iowa law to execute a Living Will or a Durable Power of Attorney (DPOA) for health care decisions in accordance with the requirements of the law.

Scope of Policy

This policy applies to all HMH staff.

Policy Statement

It is the policy of HMH to distribute a copy of our Advance Directives brochure (created by the Iowa State Bar Association, The Iowa Hospital Association, and the Iowa Medical Society) to all patients admitted to Inpatient, Skilled, Outpatient Observation, or Inn Care levels of care.


Every patient will be asked to sign a Consent to Treat Form on admission. This form states that the patient has been informed and offered a copy of his/her patient rights, including his/her right to formulate Advance Directives for physical or mental healthcare, and a copy of HMH's Advance Directives policy and brochure.

In addition, every patient admitted to Inpatient, Skilled, Outpatient Observation, Inn Care, Home Health or Hospice levels of care will be provided with the HMH folder containing an informational insert titled, "Advance Directives for Healthcare." This insert explains what an Advance Directive is, the different kinds of Advance Directives available to patients, and lists several additional resources to assist the patient in creating their own Advance Directives.

The admitting nurse will also ask every patient admitted to Med/Surg/Peds to HMH whether they currently have an Advance Directive and whether HMH has a current copy. If a patient is admitted to HMH as an Inpatient and then transferred to Skilled Care at HMH, the patient will not be asked these questions again as they were already addressed on the initial admission.

A member of the Case Management or Community Health staff will review Advance Directives with all Inpatient, Skilled, Home Health and Hospice patients prior to discharge. Case Management or Community Health staff will verify if the patient has an Advance Directive, if the hospital has a copy on the chart, and whether the patient has any questions regarding creating or updating their current Advance Directive. A summary of this discussion will be documented in the patient's medical record. Patients who desire more detailed information then what HMH can provide, should consult a lawyer or qualified person of their choice to assist them.

· It is our desire to protect and promote the rights of our patients. If you think that your rights may have been violated, or if you feel that a problem has not been settled at the time by the staff present, you may initiate a formal complaint by notifying the CEO, Compliance Officer, or CNO. The complaint may be submitted in person, by telephone, or in writing to:

Horn Memorial Hospital
701 East Second Street
Ida Grove, Iowa 51445

Your complaint will be investigated and you will receive a response within 7 working days.

You also have the right to file a complaint with the State Survey Agency. You may write or call: Iowa Department of Inspections and Appeals, Division of Health Facilities, Lucas State Office Building, Des Moines, Iowa 50319-0083; telephone 515.281.4115.

If you would like more information regarding Advance Directives, contact the Horn Memorial Business Office for a copy of the brochure, "ADVANCE DIRECTIVES for health care."

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1. Mapleton

412 Main Street
Mapleton, IA 51034

2. Ida Grove

701 East Second Street
Ida Grove, IA 51445

3. Odebolt

300 South Maple
Odebolt, IA 51458