Patient rights & responsibilities

Review draft — not an adopted public notice. Facility approval and completion are required before publication.

OrthoSurg ASC LLC • Effective: pending approval • Last reviewed: pending approval

Respect, dignity and participation

You have the right to respectful care, personal privacy and confidentiality; to receive care in a safe setting; and to be free from abuse, neglect, harassment, discrimination and retaliation.

You may participate in decisions about your care, receive information in a way you understand, and exercise your rights personally or through a legally authorized representative when applicable. You may express a complaint or grievance without compromising your care.

Information and choices about your care

You have the right to:

• Receive information about your diagnosis, evaluation, treatment, expected outcomes, risks and alternatives, to the extent known, and know the identity and professional status of those providing care.
• Accept or refuse treatment to the extent permitted by law, and be informed of the consequences of refusal. You may choose whether to participate in research or experimental treatment.
• Request a change in your provider when another qualified provider is available, and receive prompt, reasonable responses to questions and requests.
• Receive appropriate language assistance, communication aids and support for understanding care and exercising your rights.
• Obtain information about charges, payment expectations, itemized billing and, upon request, whether the facility accepts Medicare assignment.
• Be informed about advance directives and the center's policy on resuscitation and transfer before your procedure.
• Know about physician financial interests in the center through the ownership disclosure.
• Exercise privacy and medical-record rights described in the Notice of Privacy Practices.

Your responsibilities

Please provide accurate and complete information about your health, medicines, over-the-counter products, supplements and allergies; report changes in your condition; ask when you do not understand; and follow the agreed care plan or discuss your decision not to do so.

Please respect other patients, staff and property; keep appointments or notify the center when you cannot; make arrangements for your financial responsibilities; and provide any advance directive or health care representative documents relevant to your care.

Arrange a responsible adult to transport you home and remain with you for 24 hours unless your provider specifically exempts you. Understand the consequences of not following your treatment or discharge instructions, and contact your care team with questions.

Complaints and grievances

Contact the center

You, your representative or surrogate may make a verbal or written complaint or grievance. Ask for the Administrator at 812-401-9171, or write to OrthoSurg ASC LLC, Attention: Administrator, 300 Circle Front Dr., Evansville, IN 47715. Staff can help you put your concern in writing. You do not have to use the website form.

The center's grievance process provides for review, investigation, documentation and a written response describing the decision and steps taken, as applicable. Ask the Administrator about the process and expected timing. You may contact an outside agency without first complaining to the center.

For privacy complaints, see the privacy notice. For civil rights concerns, see the nondiscrimination notice. For surprise billing concerns, see billing protections.