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Patient Handbook

Your Rights as a Hospital Patient

As our patient you have the right to:

  • Appropriate hospital care regardless of race, creed, color, national origin, ancestry, religion, sex (sexual orientation, marital status), age (newborn status), handicap or source of payment.
  • Participate in ethical questions that arise in the course of treatment, including issues of withholding resuscitative services, conflict resolution, and participation in any form or experimental research or clinical trials.
  • Appropriate assessment and management of pain.
  • Be informed of your rights before patient care is furnished or discontinued whenever possible.
  • Be treated kindly and respectfully by all hospital personnel.
  • Receive complete and current information concerning your diagnosis, treatment and prognosis in terms you can understand. When it is not medically advisable to give such information, it should be made available to an appropriate person on your behalf.
  • An explanation of any proposed procedure or treatment. The explanation should include:
    • a description of the nature and purpose of the treatment or procedure
    • known risks or serious side effects
    • treatment alternatives
  • Know the name, identity and professional status of the person providing services to you and to know who is primarily responsible for your care.
  • Expect that a family member or representative and physician will be notified promptly of your admission to the hospital.
  • Participate in developing and implementing your plan of care.
  • Make informed decisions about your care.
  • Have an advance directive, such as a living will or a healthcare power of attorney and to have hospital staff and practitioners who provide care in the hospital comply with these directives.
  • Accept medical care or refuse treatment to the extent permitted by law and to be informed of the medical consequences of such refusal.
  • Have personal privacy concerning your own medical care program. Discussion of your care, consultation, examination and treatment are confidential and should be conducted discreetly. Those persons not directly involved in the care must have your permission to be present.
  • Expect that all communications and clinical records pertaining to your care will be treated confidentially.
  • Access information contained in your medical records within a reasonable time frame.
  • Receive evaluation, service and/or referral as indicated by the urgency of your situation. When medically permissible, you may be transferred to another facility only after having received complete information and explanation concerning the need for – and alternatives to - such a transfer. The facility to which you will be transferred must first accept the transfer.
  • Exercise cultural and spiritual beliefs that do not interfere with the wellbeing of others or the planned course of medical therapy for you.
  • Know if your care involves any experimental methods of treatment. If so, you have the right to consent or refuse to participate.
  • Be informed by the practitioner of any continuing healthcare requirements following discharge from the hospital.
  • Examine your bill and receive an explanation of the charges regardless of the source of payment for your care.
  • Be informed of the hospital rules and regulations applicable to your conduct as a patient.
  • Use the Avera Heart Hospital of South Dakota comment process for submitting a written or verbal comment or concern to your healthcare practitioners or our Administration.
  • Receive a response from Administration regarding your concern.
  • Refer quality of care concerns or premature discharge grievances to the South Dakota Foundation for Medical Care, which is the external peer review organization for South Dakota.
  • Be free from restraints or seclusion of any form that are not medically necessary or that are used as a means of coercion, discipline, convenience or retaliation by staff.
  • Receive information about rights as a Medicare beneficiary at admission.
  • Refer, at your request, beneficiary complaints to the South Dakota Foundation for Medical Care.
  • Receive care in a safe setting.
  • Be free from all forms of abuse or harassment.

Your Responsibilities as a Hospital Patient

As a patient, you have the responsibility:

  • To provide accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to your health, including advance directives and reporting whether you clearly comprehend a contemplated course of action and what is expected.
  • To follow the treatment plan recommended by the practitioner primarily responsible for your care. This may include following the instructions of nurses and other health care professionals as they implement the practitioner's orders and enforce the applicable hospital rules and regulations.
  • For your actions if you refuse treatment or if you do not follow the practitioner's instructions.
  • To assure that the financial obligations of your care are fulfilled as promptly as possible.
  • To follow hospital rules and regulations affecting patient care and conduct.
  • To be considerate of the rights of other patients and hospital personnel, and for assisting in the control of noise, smoking and number of visitors in your room.

Speak Up: Help Prevent Errors in Your Care

  • Speak Up if you have questions or concerns, and if you don't understand, ask again.
  • Every time you talk to a doctor, nurse, or pharmacist use the following Ask Me 3TM questions: 
  1. What is my main problem?
  2. What do I need to do?
  3. Why is it important for me to do this?
  • Pay attention to the care you are receiving. Make sure you're getting the right treatments and medications. Don't assume anything.
  • Educate yourself about your diagnosis, the medical tests you are undergoing and your treatment plan.
  • Ask a trusted family member or friend to be your advocate.
  • Know what medications you take and why you take them.
  • Participate in all decisions about your treatment. You are the Center of the Healthcare Team.

Advance Directives

Advanced directives are a set of instructions – which are written in advance – about health care decisions you would want in the future. They provide a mechanism for accepting or refusing medical care in future circumstances when you may be unable to communicate those wishes for yourself. Two types of advanced directives are:

Living Will

A living will is a written document stating the treatments you would or would not want if you should become unable to communicate your wishes. All of the decisions made by you should be included in the Living Will and also be discussed with your family and physician. This ensures that everyone involved understands what might happen if the treatments are used or withheld. Living wills do not go into effect until you are unable to communicate your wishes for yourself.

Durable Power of Attorney for Health Care (DPOA-HC)

A Durable Power of Attorney for Health Care allows you to choose another person to make health care decisions for you if you should become unable to communicate your wishes. The person you choose may or may not be a family member. It is important that your physician and the person you chose are aware of your wishes for acceptance or refusal of treatments in advance. Durable Power of Attorney for Health Care does not go into effect until you are unable to communicate your wishes for yourself.

Additional information about Advanced Directives:

  • While you remain able to communicate for yourself, your Advanced Directives will not alter any treatment decisions you make.
  • It is important that you bring any Advanced Directives with you to the hospital. A copy will be made and placed on your chart for reference in the event that they are needed. This ensures your wishes are followed by your healthcare providers at such time you become unable to communicate.
  • If you do not have any Advanced Directives and would like more information on, or assistance creating them please contact your nurse.

Avera Heart Hospital of South Dakota is a partner with Avera McKennan, a Catholic healthcare organization, and has adopted and operates in compliance with what is known as the Ethical and Religious Directives for Catholic Health Care Services. These Directives prohibit certain treatments or non-treatments as not in keeping with the Catholic doctrine. If your request or that of the individual appointed under a Durable Power of Attorney for Healthcare would violate one of these Directives, then the request would be denied and treatment alternatives discussed. An example of a prohibited treatment/non-treatment action is euthanasia.

About Your Patient Care Team

Your care will be delivered by a caring team consisting of healthcare professionals who have been trained to understand and embrace the Avera Heart Hospital of South Dakota's philosophy of "Patient-Focused Care." Our hospital uses a variety of state-of-the-art machines that can appear overwhelming. The most important part of our hospital, however, is the care provided by the members of our team. Here are a few of the people you may see and a brief description of what they do:


Every patient has a "primary" doctor who is generally in charge of the patient's care. The primary physician may ask one or more additional doctors or "consults" to provide specialized care in a certain area of practice. For example, a pulmonology consult would be asked to further assist with the lungs.


Our departments are staffed with registered nurses who have specialized training and clinical skills. The nurses use this training to provide care focused on the needs of the patient. Frequently, the nurses get to know the patients and families best because of the time they spend at the bedside.

Respiratory Therapists

The respiratory therapist's main responsibility is the management of the lungs and airways. Oxygen, breathing treatments and managing the ventilators are examples of the care they provide to patients.

Other Team Members

Taking care of you requires more than just doctors, nurses and respiratory therapists. It takes a team of healthcare workers to provide the best care possible. This team consists of the following: patient care partners, pharmacists, chaplains, dietitians, social workers, physical, occupational, and speech therapists, and unit radiology technologists and lab technologists.

Pastoral Care

We respect the beliefs and traditions of all people we serve. Whenever possible, we work in collaboration with patient's pastors and congregations. We encourage clergy of all faiths to call on members of their congregations who are patients.

We recognize that this may be a time of anxiety for you and your family. If you would like to see the Chaplain or a member of the clergy who represents your religious preference, or if you have a special request, please notify your nurse. Communion is also available upon request. The Chapel is located on the Ground Level of the hospital and is open 24 hours a day for all who wish to spend time in prayer or meditation. People of all faiths are welcome.

Infection Control

What is Infection Control?

Our hospital practices infection control to prevent the spread of infection between patient, staff and visitors. Everyone plays an active role in controlling infection in the hospital and you can help by following these guidelines.

  • Wash your hands with soap and water
  • If you see any kind of soiling, please tell our staff so that we may have it cleaned for you
  • Your visitors and family should not visit when they are sick or have an infection
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Visitor Information

The Avera Heart Hospital of South Dakota encourages visitation of family and friends because we value their assistance in your healing process. Family and friends are encouraged to spend as much time as needed with the patient; however, consideration should be given to the needs of the patient for rest and recovery.

  • An area in the patient's room has been designed to accommodate one family member who wishes to spend the night with the patient.
  • Please do not touch equipment in the patient rooms. If you think there is a problem with one of the machines, ask for assistance from the nursing staff.
  • Our nurses and/or physicians may issue a "no visitor" order or limit the number of visitors if the patient is not resting or is in need of minimal disturbance.
  • In the best interest of the health of our patients, we ask that visitors who have fever, symptoms of cold or flu, or any type of communicable disease not come to the hospital.
  • We believe it is important for you and your family to be comfortable communicating with your caregivers, so please do not hesitate to ask questions or seek assistance from our staff.

Pagers for Family

If family members/significant others wish to leave the hospital for any period of time while a patient is undergoing a procedure or is in recovery, pagers are available so that they may stay in communication with the Avera Heart Hospital of South Dakota regarding the patient's progress. If you would like to borrow a pager, contact the Concierge in the hospital lobby. After hours, please contact your nurse.

Ending Your Hospital Stay

We understand your desire to be discharged from the hospital as soon as your condition warrants. Therefore, your nursing staff and case manager will begin the coordination of your discharge plan at the time of admission. This includes your need for community resources.

After discussion with you and/or your family, your physician will determine if you are ready to be discharged and will advise your nurse, who will assist you with the discharge process. The Business Office may contact you prior to your discharge if additional information is needed. Any valuables placed in the safe should be reclaimed upon discharge. You are responsible for your transportation arrangements. Final instructions will be completed in your room prior to discharge. A patient caregiver will transport you from your room to your vehicle at the time of your discharge.

Understanding Your Hospital Bill

Billing and Credit Policy

All patient accounts are considered due upon receipt of your itemized bill. This would include any deductibles or co-insurance amounts for which you are responsible. As a courtesy to our patients, Avera Heart Hospital of South Dakota files all the necessary hospital claims to insurance companies if proper information is provided. The patient will be billed the current account balance regardless of insurance claim status. Accounts over 90 days old may be referred to a collection agency.

The Avera Heart Hospital of South Dakota is aware that hospital bills are sometimes difficult to understand. If you wish to have your statement of accounts clarified, you can call the Business Office at (605) 977-7000.

Insurance Benefits

Benefits are payable directly to the hospital. You are responsible for non-covered charges, which may include deductible and co-insurance amounts, sales tax, take-home medications, etc. Other commercial insurance policies will allow you to assign your benefits directly to the hospital. If benefits are not assigned, you will be expected to pay your bill in full at the time of discharge or when you receive your itemized statement. If you choose to assign your insurance benefits to the hospital, you will be expected to pay only charges not covered by your insurance when you receive your itemized statement.

When payment is received from the insurance company, you will be billed for the remaining balance. You may make an appointment with our Business Office during your stay to answer any questions regarding payment of your account.


The dining area is located on the first floor. Vending machines are located in the dining area.
The hours for the cafeteria are:

Mondays - Fridays
Breakfast 7:00 a.m. - 9:30 a.m.
Lunch 11:00 a.m. - 1:30 p.m.
Dinner 5:30 p.m. - 6:30 p.m.

Saturdays - Sundays
Breakfast 8 a.m. - 9:00 a.m.
Lunch 12:00 p.m. - 1:00 p.m.
Dinner Room Service Available

Emergency Department

The Avera Heart Hospital of South Dakota provides a full service and comprehensive Emergency Department. All emergencies are evaluated and treated. If the emergency is non-cardiac and hospital admission is required, the patient may be transferred to another facility after being stabilized.

Organ and Tissue Donation

Donations of organs and tissues is a gift of life and health for many people with serious or life-threatening disease. Avera Heart Hospital of South Dakota is committed to following the wishes of patients and their families who may wish to request to donate. Organs that can be donated include kidneys, liver, heart and lungs. Tissues for donation include corneas, bone, skin and heart valves. The Avera Heart Hospital of South Dakota works with LifeSource and the South Dakota Lions Eye Bank to facilitate donation.

Patient Satisfaction

At the Avera Heart Hospital of South Dakota, your satisfaction with all services is important to us. We encourage you to voice your opinion regarding the care you have received and we welcome your comments. Please contact a staff member, fill out a Patient Comment Card, or give us feedback on the Patient Satisfaction Survey. If you would like to visit in person with a Patient Care Representative, dial 7020.

Use of Electronic Devices

All electronic equipment brought from home, such as radios or notebook computers, must be approved prior to use. The Biomedical Engineering department must certify any home medical equipment (home ventilators, CPAP, etc.) brought to the hospital. Please notify your nurse if you have brought such equipment.

Telephone and Cellular Phone Use

To make a local call from your room, dial "9" and the number. Local calls are at no cost to you. To make other calls such as long distance, dial "9" to get an outside line. If making long distance calls you will need to use a credit card, call collect or have the call billed to your home.

Anyone entering the hospital must have his or her cellular phone turned off as it may interfere with the operation of clinical and other electronic equipment. Please use cellular phones outside the facility to help us avoid the risk of interrupting patient care.

Valuable and Personal Belongings

Please do not bring valuables such as money, jewelry, documents or other articles of unusual value to the hospital. You should make arrangements with a family member or friend to take these items home for you. A safe is available should you be unable to make appropriate plans. The hospital is not responsible for the loss or damage of items unless they have been placed with the hospital for safekeeping.

Special Needs

Translator/Interpreter Services

Foreign language translation services are available through the AT&T Language Line to assist in communicating with patients regarding their medical care. There is no cost to you for these services. To arrange for these services, please contact your nurse.


If you have any other special requirements or needs, please discuss them with your nurse or a staff member. Also, if you encounter any concerns of an ethical nature (death or dying issues, family conflicts, etc.), please feel free to talk with your physician or nurse. At any time, if you feel uncomfortable in discussing issues of an ethical nature, with your physician or nurse, you have the right to request a meeting of the Ethics Committee of the Avera Heart Hospital of South Dakota. The Ethics Committee members provide guidance to patients, physicians, and hospital personnel when ethical considerations or personal dilemmas arise regarding conflicts due to the extent or direction of treatment planned for your. The Ethics Committee will meet with you and/or family to discuss your concerns. If you wish to request a meeting with the Ethics Committee, please contact the Resource Nurse at Extension #7171 or dial 0 to get the switchboard operator and they will direct your request to the appropriate individual(s).

At any time, you or your representative may contact the SD Dept. of Health for any problems or concerns related to your hospitalization.

South Dakota Department of Health Licensure and Certifications 615 E. 4th Street, Pierre, SD 57501 (605) 773-3356

Sign Language

Sign language services are available if needed. Your nurse can make the necessary arrangements.

Telecommunications Device for Deaf (TDD)

TDD is available upon your request. Your nurse can make the necessary arrangements for your use of the TDD.

Smoking Policy

The Avera Heart Hospital of South Dakota is a smoke and drug-free facility. The hospital recognizes the hazards of smoking and enforces a "no smoking policy" throughout the institution.

Fire Drills

The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to routinely participate in fire drills. Do not be alarmed. Your door will shut automatically. In the event of a true emergency, the hospital staff will guide and assist you to a safe area.

Helpful Tips

Time Out It is important for the family to take time to care for themselves, along with allowing time for the patient to rest. We provide family pagers to ensure accessibility while families are away from the unit.

Information We encourage open communication between patients, family members and the healthcare providers. Ensuring that the patient and family understand the condition and treatment plan is important to us.

Preparedness In the event of a critical illness, you may not be able to communicate your wishes regarding treatment to your physician. Advance Directives are specific instructions, prepared in advance, intended to direct medical care if a person becomes unable to do so. If you have advanced directives prepared, you should bring a copy with you to the hospital.

Sleep and Eat Caring for a loved one who is hospitalized can be a difficult and stressful time. In addition to caring for your loved one, you must also take care of yourself. It is essential for you to remember to eat regular, nutritious meals and to get adequate rest.

Medicare Patient Information

For Admission to PPS Hospitals

You have the right to receive all the hospital care that is necessary for the proper diagnosis and treatment of your illness or injury. According to Federal law, your discharge date must be determined solely by your medical needs, not by Diagnosis Related Groups (DRGs) or Medicare payments.

For both PPS Hospitals and Non-PPS Hospitals and Non-PPS Hospital Units

  • You have the right to be fully informed about decisions affecting your Medicare coverage and payment of your hospital stay and any posthospital services.
    • You have the right to request a review by a Peer Review Organization (PRO) of any written Notice of Noncoverage that you may receive from the hospital stating that Medicare will no longer pay for your hospital care. PROs are groups of doctors who are paid by the Federal government to review medical necessity, appropriateness and quality of hospital treatment furnished to Medicare patients. The address of the PRO for your area is: South Dakota Foundation for Medical Care 1323 S. Minnesota Avenue Sioux Falls, SD 57105.
  • You and your doctor know more about your condition and your health needs than anyone else. Decisions about your medical treatment should be made between you and your doctor. If you have any questions about your medical treatment, your need for continued hospital care, your discharge, or your need for possible post-hospital care, don't hesitate to ask your doctor. The hospital's patient representative or social worker will also help you with your questions and concerns about hospital services.
  • If you think you are being asked to leave the hospital too soon, ask a hospital representative for a written notice of explanation immediately, if you have not already received one. This notice is called a "Notice of Noncoverage." You must have this notice if you wish to exercise your right to request a review by the PRO.
  • The Notice of Noncoverage will state either your doctor or the PRO agrees with the hospital's decision that Medicare will no longer pay for your hospital care.

If the hospital and your doctor agree, the PRO does not review your case before a Notice of Noncoverage is issued. But the PRO will respond to your request for a review of your Notice of Noncoverage and seek your opinion. You cannot be made to pay for your hospital care until the PRO makes its decision, if you request the review by noon of the first work day after you receive the Notice of Noncoverage.

If the hospital and your doctor disagree, the hospital may request the PRO to review your case. If it does make such a request, the hospital is required to send a notice to that effect. In this situation, the PRO must agree with the hospital or the hospital cannot issue a Notice of Noncoverage. You may request that the PRO reconsider your case after you receive a Notice of Noncoverage but since the PRO has already reviewed your case once, you may have to pay for at least one day of hospital care before the PRO completes this reconsideration.

  • If you do not request a review, the hospital may bill you for all the costs of your stay beginning with the third day after your receive the Notice of Noncoverage. The hospital, however, cannot charge you for care unless it provides you with a Notice of Noncoverage.
  • If the Notice of Noncoverage states that your physician agrees with the hospital's decision:

You must make your request for review to the PRO by noon of the first work day after you receive the Notice of Noncoverage by contacting the PRO by phone or in writing.

The PRO must ask for your views about your case before making its decision. The PRO will inform you by phone and in writing of its decision on the review.

If the PRO agrees with the Notice of Noncoverage, you may be billed for all costs of your stay beginning at noon of the day after you receive the PRO's decision.

Thus, you will not be responsible for the cost of hospital care before you receive the PRO's decision.

If the Notice of Noncoverage states that the PRO agrees with the hospital's decision:

You should make your request for reconsideration to the PRO immediately upon receipt of the Notice of Noncoverage by contacting the PRO by phone or in writing.

The PRO can take up to three working days from receipt of your request to complete the review. The PRO will inform you in writing of its decision on the review.

Since the PRO has already reviewed your case once, prior to the issuance of the Notice of Noncoverage, the hospital is permitted to begin billing you for the cost of your stay beginning with the third calendar day after you receive your Notice of Noncoverage, even if the PRO has not completed its review.

This, if the PRO continues to agree with the Notice of Noncoverage, you may have to pay for at least one day of hospital care.

Note: The process described above is called "immediate review." If you miss the deadline for this immediate review while you are in the hospital, you may still request a review of Medicare's decision to no longer pay for your care at any point during your hospital stay or after you have left the hospital. The Notice of Noncoverage will tell you how to request this review.

  • When you doctor determines that you no longer need all the specialized services provided in a hospital, but you still require medical care, he or she may discharge you to a skilled nursing facility or home care. The discharge planner at the hospital will help arrange for the services you may need after your discharge. Medicare and supplemental insurance policies have limited coverage for skilled nursing facility care and home health care. Therefore, you should find out which services will or will not be covered and how payment will be made. Consult with your doctor, hospital discharge planner, patient representative and your family in making preparations for care after you leave the hospital. Don't hesitate to ask questions.

Notice of Privacy Practices

The Avera Heart Hospital:
Your Best Choice

You want the best for your heart, and so do we. Cutting edge technology. A national leader in cardiovascular care. Because it's about advanced technology for better outcomes. But it's also about advanced care.

A Strong Partnership

The Avera Heart Hospital is a cooperative venture between Avera McKennan and North Central Heart.

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