Patient Rights and Responsibilities

The patient has the right to exercise his or her rights without being subjected to discrimination or reprisal.

As a patient, the patient representative, or surrogate, you have the right to:

1. Patients are treated with respect, consideration and dignity for both property and person.
2. Patients are provided appropriate personal privacy.
3. Receive care in a safe setting.
4. Be free from all forms of abuse, harassment, any act of discrimination or reprisal.
5. Patient disclosures and records are treated confidentially, and patients are given the opportunity to approve or refuse their release, except when release is required by law.

As a patient, patient representative, or surrogate, you have the right to the following information:

1. Patients are provided and informed, to the degree known, complete information concerning their diagnosis,
2. evaluation, treatment, prognosis, and expected outcome before the treatment or procedure is performed to make informed decisions. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person.
3. Patient conduct and responsibilities.
4. Disclose for review in writing, physician financial interests or ownership in the Center. Northwest Health
5. Lakeshore Surgicare majority owned and operated by- Northwest Health La Porte Hospital, with financial interests from Lakeshore Bone and Joint Institute Physicians.
6. Services available at the organization.
7. When the need arises, reasonable attempts are made for health care professionals and other staff to communicate in the language or manner primarily used by patients.
8. Provisions for after-hours and emergency care.
9. Fees for services.
10. Payment policies.
11. Patient or, as appropriate, the patient's representative will be provided for review in writing information concerning the Center's policy on advance directives, as required by state or federal law and regulations, including a description of applicable State health and safety laws and, if requested, official State advance directive forms.
12. The credentials of health care professionals.
13. The patient, patient's representative, or patient surrogate will be provided for review his/her rights prior to the procedure. The Center will protect and promote the exercise of such rights.
14. Marketing or advertising regarding the competence and capabilities of the organization is not misleading to patients.
15. Patients are provided with appropriate information regarding the absence of malpractice insurance coverage.
16. These rights must be provided for review in writing to the patient or the patient's representative in a language and manner in which the patient or the patient's representative understands prior to the procedure.
17. Patients are informed about procedures for expressing suggestions, complaints and grievances regarding treatment or care that is (or fails to be) furnished, including those required by state and federal regulations.
18. Complaints should be registered by contacting the center and/or patient advocate through the State Department of Health or Medicare. The center will respond in writing with notice of how the grievance has been addressed.
19. Patients are given the opportunity to participate in decisions involving your health care, unless contraindicated by concerns for your health.
20. If a patient is adjudged incompetent under applicable state laws by a court with proper jurisdiction, the rights of the patient are exercised by the person appointed under state law on the patient's behalf.
21. If a State court has not adjudged a patient incompetent, any legal representative designated by the patient in accordance with State law may exercise the patient's rights to the extent allowed by State law.
22. The role of the Medicare Beneficiary Ombudsman is to ensure the Medicare beneficiaries receive information and help the protection and the need to understand their Medicare options, and to apply their Medicare right.

Participation in Care

1. Patient's right to refuse to participate in experimental research.
2. The patient has the right to actively participate in decisions about his/her care.
3. Patients are informed of their right to change their provider if other qualified providers are available.
4. Patients are given the opportunity to participate in decisions involving their care, except when such
5. participation is contraindicated for medical reasons.

The patient has the responsibility to do the following:

1. Follow the treatment plan prescribed by his/her provider, and participate in his/her care.
The patient is encouraged to ask any and all questions of the physician and staff in order that he/she may have a full knowledge of the procedure and aftercare.
2. Provide complete and accurate information to the best of his/her ability about his/her health, any medications, including over-the-counter products and dietary supplements and any allergies or sensitivities.
3. Provide a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider.
4. Inform his/her provider about any living will, medical power of attorney, or other directive that could affect his/her care.
5. Accept personal financial responsibility for any charges not covered by his/her insurance.
6. Behave respectfully toward all the health care providers and staff, as well as the other patients.

These rights and responsibilities are prominently displayed in the waiting area of the Center, and are also available, upon request.

Complaint/grievance process:

If you, your representative or surrogate have a problem or complaint, please speak to the receptionist, nurse, physician or your caregiver; we will address your concern(s). You may also contact the Facility Administrator. If your concern cannot be immediately resolved the facility will investigate the complaint/grievance and notify you, in writing, the outcome of the investigation.

If you are not satisfied with the response of the Surgery Center you may contact the State of Indiana via:

Administrator
3111 Village Point
Chesterton, IN 46304
Phone: 1-219-983-1401

Indiana State Department of Health Division of Acute Care - John Lee
2 North Meridian St
Indianapolis, IN 46204
Phone: 1-317-233-1325

Medicare Beneficiary Ombudsman
1-800-MEDICARE
1-800-633-4227
https://www.cms.gov/Center/Special-Topic/Ombudsman/Medicare-Beneficiary-Ombudsman-Home

NOTE: Role of Medicare Ombudsman is to ensure that Medicare Beneficiaries receive the information and help them need to understand their Medicare options and to apply their Medicare rights and protections.

You may also contact AAAHC via:

Mail: Accreditation Association for Ambulatory Health Care, Inc.
3 Parkway North, STE 201
Deerfield, IL 60015
Phone: 1-847-853-6060