Information For Patients

Preparing for a hospital stay or procedure can be a little overwhelming. We’re here to make that process as simple as possible. If you’re coming for a surgical procedure, your surgeon will share any details about specific items or clothing you may need.

We also remind our patients to bring the following:

• Bath robe
• Comfortable day clothes (when possible)
• Current insurance card
• Night clothes
• Puzzle books
• Reading materials
• Slippers
• Toiletries (toothbrush, toothpaste, soap, shampoo, etc.)
• Valid identification, such as a driver’s license

We do encourage patients to leave all valuables (including jewelry and cash) at home.

Each of our patient rooms is designed with your comfort in mind and is equipped with all the latest technology to help you heal.

Take advantage of freshly prepared, healthy meals from room service, available from 6:30 am to 6:30 pm. Every room also includes a telephone and television.

Your spiritual health is just as important as your physical health. When you or a family member are in need a little extra spiritual support and guidance, our pastoral care team is here for you. The Ottawa Ministerial Associates provide visits to all our patients. Your nurse can help arrange for your clergy or one of our many visiting clergy members to see you.

A note from a friend or flowers from family can brighten your day and help you heal. Our volunteer staff makes daily deliveries to each of our patients. A hospital gift shop is also available for any interested family and friends who come to visit. If you happen to receive a delivery after you go home, we’ll make arrangements to forward it to you.

Sometimes it’s nice to have a loved one by your side overnight as you heal — especially for our youngest patients. AdventHealth Ottawa provides a comfortable pull-out chair in each hospital room. Talk to your loved one’s nurse or physician to make plans for staying overnight.

Accommodations / Room Service

We have all new private rooms with the latest technology. The private rooms are capable of double occupancy during very high census periods. All Medical / ICU rooms are equipped with patient lift systems. For your meals, we offer room service from 6:30 am to 6:30 pm. You are able to choose from freshly prepared foods from a restaurant-style menu delivered to your room when you want it.

What to Bring

Please remember to bring your insurance card and identification. For your personal needs, you only need a few items like toilet articles, bath robe, slippers, and night clothes. You may also want to bring some reading materials from home. Many of these items are available in the Gift Shop located in the main lobby. If you require eyeglasses, contacts or dentures, they should be kept in the drawer of your bedside table. If a denture cup is needed, a member of your nursing staff will gladly provide one.

What Not to Bring

We prefer that you leave your valuables and jewelry at home. The hospital is not responsible for loss of personal items.

Mail and Flowers

Flowers and mail are delivered to your room by members of the volunteer staff. If they arrive after your discharge, they will be forwarded to your home address.

Telephones

Telephones are provided in all patient rooms at no additional charge. All long-distance calls must be made collect or with a credit card. To make local calls, dial “9” and then the number. To place a long-distance call, please dial “0” and the switchboard operator will be happy to help you.

Television

Color television is available in all patient rooms at no extra charge. Please be considerate of other guests by keeping the volume low.

Clergy

The Ottawa Ministerial Association provides frequent visits to all patients. If you desire a visit from your clergy, either the visiting chaplain or your nurse can make that call for you.

Staying Overnight with a Patient

The hospital provides a comfortable pull out chair that makes into a bed to accommodate an overnight stay for a family member. We do encourage a parent to stay when a child is hospitalized.

Discharge Planning

AdventHealth Ottawa Social Services can help you and your family plan and arrange for the care you will need following discharge from the hospital. Your nurse can make arrangements for Social Services to visit with you.

Financial Arrangements

As a courtesy, we will bill your insurance company for you. You should be aware that hospital insurance plans do not always provide full coverage for your bill. Charges not covered by your insurance plan are your responsibility. In addition, your hospital bill does not include your physician’s fee or services of other providers such as a radiologist, anesthetist or consultant. These services will be billed to you separately.

Comments and Suggestions

We welcome any comments, criticisms, or suggestions that will help us serve you better in the future. Upon your return home, you will receive an inpatient survey in the mail. Please take a few moments to complete the survey and drop it in the mail at your convenience (we pay the postage). Immediate concerns can be taken care of by calling the administration line at Call785-229-8308. Feel free to contact us anytime with questions, comments or suggestions.

AdventHealth Ottawa has a team of medical specialists to ensure your health care is excellent.

To view our Physicians, please click here.

Pre-registration

If you know ahead of time that you will be coming in for Outpatient Services or to visit one of the clinic physicians, please call Call785-229-3383 to pre-register.

Registration

When coming in for Outpatient Services or to visit one of the clinic physicians, please check in at the Information Desk. This is conveniently located just to your right when you come into the main lobby. You may be asked to wait until a Patient Registration representative is available to complete this process.

Financial Arrangements

As a courtesy, we will bill your insurance company for you. You should be aware that hospital insurance plans do not always provide full coverage for your bill. Charges not covered by your insurance plan are your responsibility. Your hospital bill does not include your physician’s fee. In addition, your physician may request the services of a radiologist or anesthesia provider. They will bill you separately. Questions concerning a patient’s bill can be directed to the Business Office at Call785-229-3379.

The Personal Touch

AdventHealth Ottawa is pleased to provide the support service of one full-time Licensed Master Social Worker and a PRN trained designee to assist patients in handling the social, emotional, and discharge planning needs that arise as a result of a hospitalization. Additionally, an AdventHealth Ottawa social worker or trained designee is available to provide education and assistance with completing Advance Medical Directives.

Planning for Your Hospital Discharge

When the discharge plan is expected to be complex, a social worker or trained designee is often involved. A discharge planner will meet with you and your family early in your stay to evaluate your needs and help determine resources available which can help you prepare and plan for your care after you leave the hospital. Factors in assessment include:

• Physical and emotional needs at the time of discharge
• Amount of assistance available from family and other informal support systems
• Resources available in the community to assist with your care
• Financial resources

As a part of the discharge plan, the discharge planner can help you obtain a variety of services such as:

• Transportation
• Durable medical equipment
• Meals-on-wheels
• Homemaker and attendant care services
• Hospice care
• Personal emergency response systems
• Nursing home and skilled nursing home placement
• Other community services for which you may qualify

Advance Directives

The AdventHealth Ottawa social services personnel have received training to provide education and assistance in completing advance medical directive forms, also known as Living Wills and Durable Power of Attorney for Health Care Decisions forms. This service is available to patients and their families upon request.

AdventHealth Ottawa recommends that everyone have a Primary Care Physician for all your on-going healthcare needs. Many illnesses and injuries may cause you to seek immediate help, however, not every case is serious enough for a visit to the ER.

HOURS:

Monday through Friday
8 am to 6 pm

Closed weekends and holidays

Express Care hours are applicable to change in the event of inclement weather. Call Call785-229-8888 or check AdventHealth Ottawa social media for updates.

You have the right to:

1) Impartial access to medically indicated treatment and available accommodations, regardless of age, race, color, ethnicity, religion, culture, language, disability, socioeconomic status, sexual
orientation, gender identity or expression, creed, national origin, or source of payment for care.

2) Respect, dignity, and personal safety including:

• Requesting protective services considered necessary;
• Freedom and protection from neglect, exploitation, and abuse that could occur while receiving care, treatment, and services, or from restraint or seclusion unless medically indicated to prevent harm to yourself or others.

3) Privacy and confidentiality for you, your medical record, and your hospital account including:

• Audio-visual privacy during interviews and examinations;
• Knowing the identity and professional status of those who provide your care and services;
• Expecting discussions involving your case or account to be conducted with only those who are directly involved.

4) Information, both medical and financial, communicated in a manner understandable to you, regardless of language or hearing barriers, including:

• Your health status, and medical record as outlined by Hospital policy;
• At your own expense, the right to consult with another physician or specialist;
• The existence of any professional relationship to any other healthcare or educational institution involved;
• Requesting an itemized and detailed explanation of your Hospital statement;
• Timely notice prior to termination of your eligibility for reimbursement by any third party payor for the cost of your care.

5) Involvement in and voluntary consent to all aspects of your care including:

• Having your own physician and a person of your choice notified promptly of your admission to the Hospital;
• Expecting timely assessment and effective relief of pain;
• At your request, your family member, spouse, domestic partner, friend, or other individual may participate in your healthcare decisions and may be present for emotional support during the course of your stay, as long as it does not interfere with others rights, safety or is medically or therapeutically contraindicated;
• Preparing Advanced Directives or Durable Power of Attorneys and expecting Hospital compliance;
• Accessing Hospital resources for ethical issues;
• Voluntary participation in clinical training or research programs;
• Transferring to another facility with explanation of need and the alternatives and risks;
• Your request for or refusal of treatment.

You are responsible for:

1. Providing, to the best of your knowledge, accurate and complete information about present health complaints and past health history;
2. Following and understanding your plan of treatment;
3. Asking questions and expressing concerns when you do not understand or cannot comply with a contemplated plan of treatment and what is expected of you;
4. The outcome when you refuse treatment or do not follow your plan of treatment;
5. Being considerate of the rights and property of patients, staff, and the rules of AdventHealth Ottawa;
6. Providing accurate financial information and fulfilling your financial obligation.

We would like to resolve any concern you might have as soon as possible. Please first discuss it with the staff on the unit; you may also request to speak to the nurse in charge. If you are not satisfied with the results, you may contact the Quality and Patient Safety Director by calling extension 8317 from within the building or Call785-229-8317 from outside of the building.

If you would like to provide feedback or have a complaint or grievance that is not urgent, you may write to the following address; there is no special form – a letter or note is welcomed.

Quality and Patient Safety Director, AdventHealth Ottawa, 1301 S. Main, Ottawa, Kansas 66067

If you file a grievance, please be assured that it is taken seriously. AdventHealth Ottawa investigates all grievances received from patients or an acceptable patient designee.

You may also choose to contact one of the following agencies:

QIO: Call1-888-755-5580, TTY Call1-888-895-9295

Kansas Department for Aging and Disability Services: Complaint Hotline Call1-800-842-0078

The Joint Commission Phone: Call1-630-792-5800
Email: [email protected]
Website: www.jointcommission.org

Please be assured, under no circumstance does the presentation of a complaint or grievance affect the patient or family member’s current or future care at AdventHealth Ottawa.

Patient Registration
Audiology Adult Patient History Form
Audiology Pediatric Patient History Form
Authorization to Treat a Child
Financial Policy

To Request an Appointment, call Call785-248-2932. We can also be reached at Call785-229-8438.

Cardiology forms will be provided to you directly from AdventHealth Ottawa Cardiology Care.

Patient Registration
Authorization to Treat a Child
Financial Policy

Patient Registration
Adult Patient History Form
Pediatric Patient History Form
Authorization to Treat a Child
Financial Policy

Rehabilitation Patient Intake Form
Authorization to Treat a Child

Patient Registration
Internal Medicine Patient History Form
Financial Policy

Patient Registration
Financial Policy

Patient Registration
Patient Medical Questionnaire

Patient Registration
Neurology Patient History Form
Authorization to Treat a Child
Financial Policy

Patient Registration
Financial Policy
Accident Injury Form
Company Data Form
Occupational Medicine Brochure
Authorization for Initial Treatment

Patient Registration
Authorization to Treat a Child
Financial Policy

Patient Registration Form
Authorization to Treat a Child
Authorization for Release of Confidential Health Information
Financial Policy
2018 PPE Physical Form

Patient Registration
Patient History Form
Authorization to Treat a Child

Patient Registration
Dr. Jacob Goldstein Podiatry Services Form
Dr. Jacob Goldstein Patient History Form
Dr. Jacob Goldstein HIPAA Policy
Dr. Jacob Goldstein Podiatry Financial Policy
Dr. Brooks Young Patient Form

Patient Registration
Patient History Form
Authorization to Treat a Child

Surgery Pre-Admission Patient Registration Form
Patient Registration
Surgical Care Patient History Form
Authorization to Treat a Child
Financial Policy
Prep Instructions and Info for Colonoscopy

Patient Registration
Medication Sheet
Urology Patient Intake Form
Authorization to Treat a Child
Financial Policy

Patient Registration
Gynecology Patient History Form
Authorization to Treat a Child
Financial Policy

Patient Registration
Wound Care Intake Form
Authorization to Treat a Child
Financial Policy