Patient Rights & Responsibilities

Notice of Rights

• We will inform you of all your rights in advance of furnishing or discontinuing care.
• We will provide all Inpatient Medicare beneficiaries the Important Message from Medicare.

Exercise of Rights

• You have the right to participate in your plan of care.
• You have the right to choose your doctor and care team.
• You have the right to make informed decisions regarding your care and be informed of your health status. Including refusing a procedure or treatment to the extent permitted by law & to be informed of the medical consequences of this action.
• You have the right to receive from your doctor:
  – your diagnosis, plan of care, types of treatment with the risks, benefits, and side effects of each type.
  – information to give informed consent before the start of any procedure, treatment, or participation in any form of research or in advance of using any recordings, films, or other images for internal use other than identification, diagnosis or treatment.
• You have the right to know why your care is transferred elsewhere.
• You have the right to request a discharge plan evaluation.
• You have the right to formulate an advance directive.
• You have the right to have a family member or representative of your choice & your own physician notified promptly of admission to the hospital. (With your permission)

Privacy & Safety

• You have the right to personal privacy, to receive care, treatment and exams in a safe setting.

Confidentiality

• You have the right to confidentiality of your clinical records.
• You have the right to access your past & current medical records, upon request, in the form and format requested.
• You have the right to review your own medical record with a health care provider and have the information explained to you.
• You have the right to request amendments to & obtain information on disclosure of your health information in accordance with regulation & law in a manner tailored to your age, language, & ability to understand.

Restraint or Seclusion

• You have the right to be free from harassment, neglect, exploitation, corporal punishment, involuntary seclusion, and verbal, mental, sexual, or physical abuse.
• Restraint or seclusion may only be imposed to ensure the physical safety of patients, staff members, or others.

Visitation Rights

• You have the right to receive visitors you designate, including, but not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member, or friend, and you have the right to withdraw or deny such consent at any time.
• We will not restrict, limit, or deny visitation on the basis of age, race, gender identity or expression, color, ethnicity, culture, religion, sexual orientation, marital status, illness, disability, socioeconomic status, language or ability to pay.
• Your visitors may be restricted for reasons including but not limited to:
  – Infection control concerns
  – Interference with the care of other patients
  – Existence of court orders restricting contact
  – Visitors engaging in disruptive, threatening, unlawful and/or violent behavior
  – Your need for rest or privacy
  – Undergoing care interventions-every effort will be made to allow your support person to be present for support & comfort during care.
• Aspirus will make reasonable accommodations to allow for 24/7 visitation for our patients.

Courteous Treatment

• You will be treated with dignity. We will respect your cultural and personal values, beliefs, and preferences.
• Aspirus prohibits discrimination based on your or your support person’s age, race, gender identity or expression, color, ethnicity, culture, religion, sexual orientation, marital status, illness, disability, socioeconomic status, language or ability to pay.
• Interpreter services - both oral and written - are available free of charge as well as reasonable accommodation for hearing, speech, vision and cognition concerns.
• You may obtain information about any relationship the facility has with other health care & educational institutions concerning your care.

Understand your Medical Bill

Our staff will file claims for you, if you have questions about your bill, contact our Financial Contact Center. If you need help with understanding your insurance coverage or health plan, start with your insurance
company or health benefits manager. If you do not have health coverage, we will try to help find financial assistance or make other arrangements.

Financial Care Center
800.627.3570
Mon–Fri: 7:00 am – 4:30 pm CST

Financial Counselors
866.972.1774
Mon–Fri: 7:00 am – 4:30 pm CST

Medical Chaperone

Aspirus patients have the right to request a medical chaperone to be present during any sensitive examination or procedure. A medical chaperone is a trained Aspirus health professional who can assist or observe during an exam or procedure to enhance the comfort, safety, privacy and security of the patient and clinicians. A chaperone will be required during any sensitive examination or procedure involving minors or other vulnerable patients.

Your Responsibilities

• Provide an accurate medical history & tell your caregivers exactly how you feel about the things that are happening to you.
• If you do not understand your illness or treatment, ask your health care team to explain it to you.
• Advise your caregivers if you feel unable to follow a certain treatment plan.
• Tell your doctor about any changes in your health. Let your caregivers know if you feel your condition is not getting better.
• Know or write down the names of the medications you are taking and what they are for.
• Inform us about and provide a copy of your Advance Directive.
• Know your health insurance benefits. Please pay your bills promptly.
• Have valuables sent home or locked up until discharge. Aspirus cannot be responsible for lost items.
• Follow Aspirus’ rules & be respectful of other patients, staff & property.
• Please Note: Violence and abusive behavior against a Health Care Worker can lead to jail, fines or a Class H felony.

Complaint Concerns

If you have a complaint or concern, please ask to speak to your nurse, a manager or Patient Advocate. Whether we are able to resolve your concern or not, you may contact:

Aspirus Patient Experience
1.800.513.4101
PXTeam-AspirusInc-PatientExperience@aspirus.org

MICHIGAN PATIENTS
Department of Licensing & Regulatory Affairs
Bureau of Survey & Certification-Complaint Intake Section
PO Box 30838, Lansing, MI 48909
(p) 1.800.882.6006
LARA-Safety@michigan.gov

MINNESOTA PATIENTS
Office of Health Facility Complaints
P.O. Box 64970, St Paul, MN 55164
(p) 651.201.4200
health.fpc-web@state.mn.us
Ombudsman for Mental Health & Developmental Disabilities
651.757.1800 or 1.800.657.3506
ombudsman.mhdd@state.mn.us

WISCONSIN PATIENTS
Dept. of Quality Assurance Complaint Coordinator
201 E. Washington Ave., Room E300
Madison, WI 53703
(p) 1.800.642.6552
DHSWebmailDQA@dhs.wisconsin.gov

JOINT COMMISSION
Office of Quality and Patient Safety-Joint Commission
One Renaissance Boulevard
Oakbrook Terrace, Illinois 60181
(p) 1.800.994.6610

QUALITY IMPROVEMENT ORGANIZATION
Commence Health
(p) 1.888.524.9900 (TTY:711)

KIDNEY CARE
Midwest Kidney Network
(p) 800.973.3773