Ambulatory Surgery Patient Rights and Responsibilities

Our Commitment to You, Our Patient

At Providence St. Joseph Health and its Affiliates (collectively “PSJH”), we believe health is a human right. Every person deserves to live their healthiest life. Our mission calls for us to care for all by honoring the dignity and diversity of each person. We welcome you, at every stage of life, and we are committed to providing care that recognizes and affirms you as a whole person. You, your representative, or surrogate, if applicable, have the right to be informed of your rights and responsibilities prior to receiving care at our center. This will be in a conspicuous or noticeable location for your access.

We strive to create a welcoming, safe, and respectful environment for you to celebrate life’s most sacred moments and for us to stand by you when times are tough. You can count on us to hear you, understand you and work with you to meet your health goals.

More than a place of healing and health, we are committed to eliminating health inequities, including giving everyone equitable access to safe, high-quality, effective care. We will not discriminate, and you can expect care that is free of prejudice.

This freestanding ambulatory surgery center is wholly owned by Providence St. Joseph Health and its Affiliates (collectively “PSJH”)and does not have physician owners. We thank you for entrusting us with your care – it is our greatest responsibility and honor.

As Our Patient, You Have These Rights:

To respect, dignity, and justice

You have the right to receive considerate, compassionate, confidential, and respectful care. You will be treated with dignity, and therefore be free from neglect, exploitation, abuse, harassment, racism, discrimination, and/or reprisal. All patients have the right to be free from physical or mental abuse, and corporal punishment. Providence St. Joseph Health and its Affiliates (collectively “PSJH”)will provide high-quality, inclusive care to all that visit us. We see you as the unique person you are, and we will provide your care in a culturally responsive manner.

We are committed to removing the causes of oppression. We respect and diligently care for all individuals accessing services. We welcome people of all races, ages, creeds, ethnicities, cultures, national origins, citizenship, languages and/or immigration statuses, economic statuses, the source of payment for care, religious beliefs, moral convictions, traditions, practices, and ancestries. We honor and respect all marital, domestic partnership, or civil unions, appearances and body sizes, sexes, sexual orientations and gender identities or expressions. We welcome and provide equitable care for all physical or psychiatric or intellectual disabilities, handicaps or abilities, medical conditions (including HIV/AIDS status, cancer, genetic, substance use and eating disorders), family medical histories, veteran or military statuses, and any characteristic protected by federal, state, or local law.

To a safe environment

You have the right to security and to receive care in a safe setting, to access protective and advocacy services, and to be free from all forms of abuse and harassment.

To be free of restraint or seclusion

You have the right to be free from restraint or seclusion. The use of restraint or seclusion for the following reasons is prohibited: based on the patient’s race, color, national origin, age, disability (recognized by anti-discrimination laws), or sex (including pregnancy, sexual orientation, gender identity and expression), and all other categories protected under the law. The center’s professional staff members receive education and training (in accordance with statutory and regulatory requirements) on assessment of patients who exhibit behaviors that may inhibit the patient's ability to protect themselves and others from harm or injury.

To your chosen visitors

In accordance with applicable policies, you have the right to receive visitors of your choice based on allowable space. These visitors include, but are not limited to, a spouse, a domestic partner (including a same-sex domestic partner), another family member, or a friend. These visitors will not be restricted or otherwise denied visitations privileges because of race, color, national origin, sex, sexual orientation, gender identity or expression, age, or disability. You hold the right to withdraw or deny such consent at any time.

To access medical care responsive to your unique needs

You have the right to access services, treatment or accommodation that are available at our facilities and that are medically necessary. Our goal is to align with your personal health and life goals and take into account all of who you are.

To discuss and participate in your health care decisions

You have the right to discuss, ask questions about, and make decisions regarding your care. You know yourself best, which is why we listen to your health goals and partner with you to achieve them. You will have your personal, cultural, and spiritual Values, preferences and beliefs honored when deciding about treatment. If you desire, your trusted decision maker or others of your choosing may participate in decisions about your care. You also have the right to request the consultation of a specialist, ethicist, and/or chaplain. And, to help ensure you understand the care being given or proposed, interpreter services are available at no cost to you. You have the right to spiritual care in accordance with your values.

To have your wishes honored

You have the right to make an Advance Directive and/or to execute a Power of Attorney authorizing others to make decisions on their behalf when unable to make or communicate decisions for themselves. Such documentation will be discussed with the provider, and documentation will be placed in the patient record. Due to the extensive screening to minimize patient risk for complications and the low-risk nature of surgeries and procedures done in this facility, it is our policy to initiate resuscitative or other stabilizing measures if an adverse event occurs during treatment in this facility. Following resuscitation/stabilization, you will be transferred to a hospital where further treatment or withdrawal of treatment will be carried out in accordance with your, surrogate’s or Power of Attorney’s wishes.

To informed consent and declination of care

You, your legal representative, or surrogate as applicable have the right to be informed by your doctor of your diagnosis, treatment, and prognosis in a way that you understand, so that you can make informed decisions regarding your care or refusal of care as required by prevailing laws and regulations. To the degree possible, this should be based on an explanation of your condition and all proposed procedures and treatments, including the possibility of any serious risks or side effects, problems related to recovery and the probability of success prior to the treatment or procedure. You have the right to family input in care decisions, in compliance with existing legal directives of the patient or existing court-issued legal orders. In addition, you have the right to understand the risks and benefits of not having the proposed procedures and treatment. You have the right, to the greatest extent possible, to participate in decisions concerning your medical care. You have the right to resolve any problems with care decisions. This includes your participation in any research projects or ethical issues that may arise. You have the right to refuse participation in research without hindering your access to care. This includes the right to decline treatment or leave the center, even if advised not to do so by your provider for medical reasons. 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.

To continuity of care

You have a right to receive information that allows you to understand the choices that you have as we assist you in planning for continued health care needs that may exist when you leave our care and facilities. This includes coordinating treatment, evaluations, and if necessary, transferring to another facility or to another qualified care provider as available.

To adequate pain control

You have the right to have your pain managed while receiving care and services.

To choose a pharmacy

You are not required to use a pharmacy owned or operated by the organization. Your prescription may be sent to the pharmacy of your choice participating in e-prescribing standards in accordance with state and federal law.

To communicate about your care

You are encouraged to learn and ask questions about the treatment you are receiving. If necessary, our staff will obtain an interpreter at no cost to you or provide other means for you to fully understand the care being given to you or proposed. Unless you tell us not to, we retain the right to notify your established primary care practitioner, primary care practice group/entity, or other practitioner group/entity, as well as all applicable post–acute care services providers and suppliers of your admission, discharge, or transfer from the center.

To your medical records

You have the right to receive information about your health status, diagnosis, prognosis, course of treatment, prospects for recovery and both anticipated and unanticipated outcomes of care in terms you can understand in accordance with state law. You have the right to access your medical records. You will receive a separate Notice of Privacy Practices that explains your rights to access your records. You have the right to effective communication and to participate in the development and implementation of your plan of care. You have the right to participate in ethical questions that arise during your care, including issues of conflict resolution. In addition, you have the right to sign up for the MyChart patient portal. MyChart provides up-to-date information on appointments, medications, health conditions, labs, studies, after-visit summaries, clinical notes, and other information in real time with no unique access request. Please visit Providence.org for more information. Any restrictions necessary for patient care and safety will be documented and explanations will be provided to the patient and family in accordance with state law.

To privacy and confidentiality

You have the right to confidential treatment of all communications and records pertaining to your care and stay, including at check-in. You will receive a separate Notice of Privacy Practices that explains your privacy rights in detail and how we may use and disclose your medical information. You have the right to have personal privacy respected. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly. You have the right to know the name of the licensed healthcare practitioner acting within the scope of his or her professional licensure who has primary responsibility for coordinating the care, the names, and professional relationships of physicians and nonphysicians who will see the patient and to be told the reason for the presence of any individual.

To voice complaints about your care and receive a response from us

You have the right to voice concerns, complaints, or grievances about your care and to receive a response from us, without fear of retribution, denial or impacting the quality or delivery of your care. This may also include care that you believe was failed to be delivered. You may report or contact any of the listed leadership agencies below. Further contact information for complaint and grievance reporting is available and posted at the center. We encourage you, your representative, or surrogate to voice your concerns immediately to the manager or person in authority at the center to expedite a response. Efforts are made to quickly resolve grievances within 14 days. For grievances requiring further investigation, you or will be notified of the status and a stated timeframe for follow-up.

To understand your financial responsibility and options for assistance

As our patient, you can request a cost estimate and you have the right to receive a copy of a clear, understandable estimate of uncovered charges for the planned procedure. Upon request, you can also have charges explained. If you are experiencing financial hardship, please contact our customer service center at 1-866-747-2455. You can find out about payment options or whether you qualify for financial assistance, regardless of insurance coverage. We are committed to working with any of our patients who ask for assistance to pay a medical bill.

To information on care facility policies

If requested, you will receive information about our policies, rules, or regulations applicable to your care, including the use of service animals in public spaces within care facilities, based on federal law.

As a Patient, Family Member, or Visitor You Have Responsibilities

Providence St. Joseph Health and its Affiliates (collectively “PSJH”) is a place of healing, where caregivers, patients, family members and visitors alike should feel welcome, safe, and respected. We ask and expect all people who come through our doors or seek care with us to behave in a manner that honors everyone’s dignity, and helps us to provide high-quality, compassionate care. Our staff members are chosen for their skill and expertise and their safety is paramount. Harassment or mistreatment of our staff will not be tolerated.

In accordance with facility policy, we require you, as the patient, to ensure transportation by a responsible adult home and who will remain with you as directed by the provider or as indicated on discharge instructions.

While in our care or while visiting our facilities, responsibilities will include:

• Be considerate and respectful of those around you, including those providing care or receiving it.
• Understand that caregivers will not be reassigned for reasons unrelated to their professional role.
• Refrain from using discriminatory and/or derogatory language or behavior of any kind. It will not be tolerated and may result in your exclusion or removal from the facility.
• Inform your provider about your health priorities, so you can create a plan together.
• Provide your medical history and treatment information accurately and completely. This includes current medication, over-the-counter products and dietary supplements, and any allergies or sensitivities.
• Report unexpected changes in your condition, take part in decisions, and ask providers questions about your care.
• Consider your providers’ advice and follow the treatment plan that is agreed upon. This includes notifying your providers if you are unable to keep an appointment or follow medical guidance.
• Provide us with a copy of your medical advance directive, living will and/or the identity and contact information of your designated trusted decision maker, if you have one.
• Work with your caregiver to complete a medical advance directive if you do not have one.
• Understand your financial responsibilities and options for financial assistance.
• Follow care facility policies.
• Leave all personal belongings at home.

Filing a Grievance

If you wish to file a grievance you may contact the health facility, U.S. Department of Health and Human Services, the accrediting organization for the health care facility and/or the state health department.

See contact information for filing a grievance or complaint regarding care at an Ambulatory Surgery Center (ASC)