Patient Rights & Responsibilities

Dallas County Medical Center is committed to providing quality medical care to every patient. We support your right
to know about your medical condition and your right to participate in the decisions that affect your well-being. When
you are treated as a patient at Dallas County Medical Center, you or your representative have the following rights and
responsibilities:

I. Patient Rights

A. To be treated with dignity and receive considerate care that is respectful of your personal beliefs and cultural
and spiritual values.
B. To have a family member or other person of your choosing to be notified promptly upon your admission to
DCMC.
C. To know the name of the physician who has primary responsibility for coordinating your care and the names
of other health care providers who will be caring for you.
D. To be informed of your health status, diagnosis, and treatment options, including risks, benefits and
alternatives, and prospects for recovery and outcomes of care in terms you understand.
E. To make decisions regarding your medical care, including the right to refuse treatment and participate in the
development and implementation of your plan of care;
F. To appropriate assessment and management of your symptoms, including pain.
G. To impartial medical care, regardless of race, color, national origin, religion, cultural beliefs, sex, gender
identity, gender expression, sexual orientation, disability or financial status.
H. To an interpreter as necessary to understand all pertinent communications;
I. To have any restrictions on communications discussed with you;
J. To leave DCMC against the advice of your health care providers, to the extent permitted by law.
K. To be advised if your health care providers propose to engage in or perform research affecting your care or
treatment, including the right to refuse to participate in such research proposals, and any such refusal will
not jeopardize your access to treatment or services.
L. To receive care in a safe setting, free from all forms of abuse, neglect, harassment and/or exploitation.
M. To be free from restraints and seclusion of any form that are used for the purpose of coercion, discipline,
convenience, or retaliation by staff.
N. To have your personal privacy respected. You have the right to restrict non-DCMC visitors and to have non-
healthcare provider visitors leave prior to an examination and when treatment issues are being discussed.
O. To confidential treatment of all communications and records pertaining to your care and stay in the hospital
to the extent required by law. You will receive a separate Notice of Privacy Practices that explains your
privacy rights in detail.
P. To access your medical records within a reasonable time frame and have them explained unless restricted
by law;
Q. To be informed of continuing health care requirements following discharge from the hospital and to be
involved in the development and implementation of your discharge plan.
R. To have your family and other guests present while receiving care at DCMC.
S. To obtain an explanation of the bills related to your health care services.
T. To access state and community protective services.
U. To include or exclude any or all family members or support persons from participating in your care decisions.
V. To formulate an advance directive and have it followed as allowed by law.
W. To express any concerns or grievances you have with DCMC orally or in writing by contacting any member
of your health care team or by contacting the Administration Department at 870-352-6363 or Risk
Management at 870-352-6324 and to be informed of the outcome or response to your concerns or grievance
within a reasonable time and without affecting the quality of your care.

II. Patient Responsibilities

A. To be respectful and considerate of members of your health care team and to refrain from discrimination,
threats, verbal abuse, harassment, or aggressive behavior directed at members of the health care team.
B. To follow DCMC rules, regulations and policies affecting patient care and conduct.
C. To respect the rights and property of other patients and Dallas County Medical Center employees. You have
the responsibility to comply with DCMC policies prohibiting smoking, the use of illegal substances or alcohol,
and the presence of weapons.
D. To provide, to the best of your knowledge, accurate and complete information about your present illness and
past medical history, including medications, to your physicians and other members of your health care team.
E. To ask questions when you do not understand information or instructions.
F. To participate as best you can in making decisions about your medical treatment and carry out the plan of
care agreed upon by you and your health care team.
G. To cooperate with members of the health care team who provide care for you.
H. To be reasonable in requests for medical treatment and other services.
I. To pay bills promptly to ensure that your financial obligations for your health care are fulfilled and to request
financial assistance if needed.
J. To understand how to continue your care after you leave Dallas County Medical Center, including when and
where to get further treatment if needed, and to cooperate with members of the health care team who are
assisting you with any follow up care needs.
K. To accept responsibility for your own decision and actions if you choose to refuse treatment or not to comply
with instructions given by your health care providers.
L. To provide DCMC with a copy of your advance directive if you have one.

III. Expressing Concerns

A. To express any concerns about the service you are receiving, you may speak to any staff member or to file a formal grievance regarding your care you may be directed to Administration by calling (870)-352-6363 or Risk Management at (870)-352-6324. If you wish to submit a written grievance, you may address it to:

Hospital Administration
Dallas County Medical Center
201 North Clifton St.
Fordyce, AR 71742

We are committed to addressing your concerns in a timely manner without affecting the quality of your care to inform you of the outcome or response to your concerns.

B. We appreciate and ask for the opportunity to be able to personally address any concerns you may have, but you may also contact the following outside agencies regarding your concerns regardless of whether you have first used Dallas County Medical Center’s grievance process:

Arkansas Department of Health
Healthcare Facility Services
5800 West 10th St. – Suite 400
Little Rock, Arkansas 72204
Phone: (501) 661-2201
Toll Free: 1-800-224-0340
Fax: (501)-661-2165
Online: Healthy Arkansas

Quality Improvement Organization (Medicare)
Acentra Health BFCC-QIO
1650 Summit Lake Dr. – Suite 102
Tallahassee, FL 32317
Toll Free Phone: 1-(888)-315-0636
Toll Free Fax: (844)-878-7921
Online: Acentra Health

DCMC Patient Rights & Responsibilities (PDF)