PATIENT RIGHTS INCLUDE THE RIGHT TO:
- Be informed about Patient Rights before the surgical procedure begins. The patient may appoint a representative to receive this information.
- Exercise Patient Rights without regard to age, race, gender, national origin, religion, culture, disability, economic status, or source of payment for care.
- Considerate, respectful, and dignified care, provided in a safe environment, free from all forms of abuse, neglect, harassment, or reprisal.
- Access protective and advocacy services or have these services accessed on the patient’s behalf.
- Assessment and management of pain.
- Know the name of the physician with primary responsibility for coordinating the patient’s care, and the names and professional relationships of other physicians and healthcare providers who will provide care.
- Change providers if other qualified providers are available.
- Know whether physicians hold financial interest in the surgery center.
- Know whether the physician(s) providing care does not carry malpractice coverage.
- Receive sufficient information about proposed treatment(s) and procedure(s) to give informed consent for treatment(s) or refuse treatment(s) and procedures. Excluding emergency situations, information includes: a description of the treatment(s) and procedure(s), the clinically significant associated risks, alternate courses of treatment or non-treatment, the risks associated with each, the name of the person who will provide treatment(s) and/or perform the procedure(s).
- Participate in the development and implementation of the clinical plan of care and actively participate in decisions regarding clinical care. As permitted by law, this includes the right to request and/or refuse treatments and procedures.
- Know the surgery center’s policy and state regulations about Advance Directives and request Advance Directive forms in keeping with State regulatory agency requirements.
- Privacy about clinical care, treatment(s) and procedure(s). Case discussion, consultation, examination, and treatment are confidential. Patients have the right to know the reason for the presence and authorize the presence of all individuals participating in or delivering care.
- Confidential treatment of all communications and records pertaining to care at the surgery center. The patient gives written permission to release clinical information to those not directly providing care.
- Receive information as best understood by the patient. Communication with the patient is effective and provided to facilitate the patient’s understanding. Written information is appropriate to the age, understanding, and language of the patient. Communications are specific to the patient’s vision, speech, hearing, and cognitive status.
- Access clinical record information within a reasonable time.
- Know the surgery center’s grievance process, should there be concern regarding care received. Information about the grievance process includes: surgery center contact information, regulatory agency contact information, written notice of the grievance determination or outcome that contains steps taken to investigate the grievance, the results of the findings, and investigation completion date.
- Know surgery center contact information, the State or Federal agency to whom complaints can be reported, and contact information for the Office of the Medicare Beneficiary Ombudsman
- Know whether surgery center physicians propose or perform experiments, research, clinical trials, or medical education affecting or involving care or treatment. The patient has the right to refuse participation or discontinue participation without compromising access to care, treatment, or services.
- Full support and respect of all patient rights if the patient participates in research projects. This includes the patient’s right to grant informed consent as related to the research project. Information given to participants is recorded in the clinical record or research file.
- Receive instructions from the physician(s) or delegate about care after discharge from the surgery center.
- Examine and receive an explanation of charges and costs, regardless of payment source.
- Have all Patient Rights apply to the person delegated legal responsibility to make clinical care decisions on behalf of the patient.
- Be advised of the facility’s grievance process, should he or she wish to communicate a concern regarding the care he or she receives. All alleged violations/grievances relating but not limited to mistreatment, neglect, verbal, mental, sexual, or physical abuse will be fully documented. This center files a report about any substantiated allegations to the appropriate local and/or State authority. Notification of the grievance process includes: whom to contact to file a grievance and that he or she will be provided a written notice of the grievance determination that contains the name of the facility’s contact person, the steps taken on his or her behalf to investigate the grievance, the results of the grievance, the grievance completion date.
PATIENT RESPONSIBILITIES INCLUDE THE RESPONSIBILITY TO:
- Provide accurate and complete information concerning current and past states of health, present complaints, hospitalizations, medications (including over the counter products and dietary supplements), allergies and sensitivities, and any other pertinent health information.
- Understand and/or ask questions about care and services delivered, and about instructions following care and treatment.
- Follow the treatment plan and care instructions or accept accountability if the treatment plan and care instructions are not followed.
- Keep appointments or notify the surgery center if unable to keep an appointment.
- Leave valuables with a family member/representative.
- Be accompanied at discharge by a responsible adult.
- Inform the surgery center staff of a living will, medical power of attorney, or other directive that could affect care.
- Accept personal financial responsibility for any charges not covered by insurance.
- Show respect for other patients and surgery center staff.
- Tell us if there is a problem with care.
* It is the responsibility of a parent or guardian to remain at the surgery center for the duration of a pediatric patient’s stay.
Feedback on Our Service
You may contact any of the following:
- Valley Surgery Center at 1-812-435-1600
- Indiana State Department of Health at (317) 233-7474 for Acute Care Receptionist or (317) 233-1325 (Main Switchboard) or by mail at: 2 North Meridian Street, 4A, Indianapolis, IN 46204
- Medicare at 1-800-633-4227 or by visiting http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html
- Office of Civil Rights at 1-800-368-1019, 1-800-527-7697 (TDD) or by visiting https://ocrportal.hhs.gov/ocr/portal/lobby.jsf or by mail at U.S. Department of Health and Human Services, 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
- Covenant Surgical Partners Compliance Help Line at 855-315-0528 or by visiting www.covenantsurgicalcompliance.com
- AAAHC at 1-847-852-6060 or in writing to Accreditation Association for Ambulatory Health Care, 5250 Old Orchard Road, Suite 200, Skokie, IL 60077 or via email at www.AAAHC.org