Patient Bill of Rights

In recognition of the responsibility of this Center in the rendering of patient care and our commitment to high standards of quality professional care, these rights are affirmed as the policies and practices of The Surgery Center.

As a patient and guest in this Ambulatory Surgery Center, you have:

1. The right to be informed of your rights as a patient in advance of receiving care. The patient may appoint a representative to receive this information should they so desire.

2. The right to exercise these rights without regard to sex, cultural, economic, educational, or religious background or the source of payment for care.

3. The right to considerate, respectful and dignified care, provided in a safe environment, free from all forms of abuse, neglect, harassment and/or exploitation.

4. The right to access protective and advocacy services or have these services accessed on your behalf.

5. The right to courtesy, consideration, respect, privacy, dignity, responsiveness and timely attention to your medical and personal care needs. We adhere to the principle that patients come first.

6. The right to appropriate assessment and management of pain.

7. The right to receive complete information from your physician about your diagnosis, illness, course of treatment, risks, benefits, alternative treatments, outcomes of care (including unanticipated outcomes), and your prospects for recovery in terms that you can understand. Your physician should discuss these with you prior to the procedure and give you the opportunity to ask any questions you may have.

8. The right to participate in decisions regarding your medical treatment. Health care decisions should be a shared process between patients, their families and health care professionals. You are free to accept or refuse health care that is recommended by your physician(s) and to know the consequences of such action.

9. The right to be advised if your physician has a financial interest in The Surgery Center.

10. The right to have discussions, consultations, examinations and treatment conducted discreetly and held in confidence.

11. The right to be informed by your physician or a delegate of your physician of the continuing healthcare requirements following your discharge.

12. The right to be informed of the facilitys policy and state regulations regarding advance directives and be provided advance directive forms if requested.

13. The right to confidentiality and to expect that communications and records pertaining to your care should be treated by the Center as confidential and, except where required by law, should not be released without your express consent.

14. The right to receive information in a manner that you understand and a right and a responsibility to take an active role in your care and treatment.

15. The right to be advised if the Center proposes to engage in or perform experimental research affecting your care or treatment. You also have the right to refuse to participate in any such research projects.

16. The right to be informed about fees for services, payment policies, and to examine and receive an explanation of your bill regardless of the source of payment.

17. The right to treatment without regard to race, color, national origin, sex, handicap or age.

18. The right not to be deprived of any rights, benefits or privileges guaranteed by law based solely on your status as a patient in this Center.

19. The right to unimpeded, private and uncensored communication of your choice by telephone. We shall ensure that you have reasonable access to a telephone.

20. The right to have your representative notified of any surgical complication, illness or accident.

21. The right to change Physicians.

22. The right to translator services. (within reason)

23. The right to designate advance directives such as a Living Will or a Durable Healthcare Power of Attorney which would authorize your designated agent to make health care decisions for you when you might be unable to do so. You are responsible for providing The Surgery Center with a copy of any advanced directive.

24. The right to express grievances and complaints regarding the care and services provided or to make suggestions to the facilitys CEO or Director of Clinical Services at 732-7700 or to the Michigan Department of Consumer and Industry Services, Bureau of Health Systems at 1-800-882-6006 or to the Health Care Financial Administration. If you file a grievance with The Surgery Center, you will be provided with a written notification of the grievance determination that contains the name of the facilitys contact person, the steps taken on your behalf to investigate the grievance, the results of the grievance and the grievance completion date.

25 The right to be advised of contact information for the state agency to whom complaints can be reported, as well as contact information for the Office of the Medicare Beneficiary Ombudsman. www.cms.hhs.gov/center/ombudsman.asp

26. The right to have all patient rights apply to the person who may have legal responsibility to make decisions regarding medical care on your behalf.