It is recognized that a personal relationship between the physician and the patient is essential for the provision of proper medical care. The traditional physician-patient relationship takes a new dimension when care is rendered within an organizational structure. Legal precedent has established that the facility itself also has a responsibility to the patient. It is in recognition of these factors that these rights are affirmed.

PATIENT RIGHTS:

1. The patient has the right to considerate and respectful care.

2. The patient has the right to obtain from his/her physician complete current information concerning his/her diagnosis, treatment and prognosis in terms the patient can be reasonable expected to understand. When it is not medically advisable to give such information to the patient, the information should be made available to an appropriate person in his/her behalf. He/she has the right to know, by name the physician responsible forcoordinating his/her care

3. The patient has the right to participate in decisions involved in his/her care and to receive from his/her physician information necessary to giveinformed consent prior to the start of any procedure and/or treatment. Except in emergencies, such information for informed consent should includebut not necessarily be limited to the specific procedure and/or treatment, the medically significant risks involved, and the probable duration ofincapacitation. Where medically significant alternatives for care or treatment exist, or when the patient requests information concerning medical alternatives, the patient has the right to know the name of the person responsible for the procedure and/or treatment.

4. The patient has the right to refuse treatment to the extent permitted by law and to be informed of the medical consequences of his/her action.

5. The patient has the right to every consideration of his/her privacy concerning his/her medical care program. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly. Those not directly involved in his/her care must have permission of the patient to be present.

6. The patient has the right to expect that all communications and records pertaining to his/her care, including financial records, should be treated as confidential and not released without written authorization by the patient.

7. The patient has the right to expect that within its capacity, this ambulatory surgical facility must provide evaluation, and/or referral as indicated by the urgency of the case. When medically permissible, a patient may be transferred to another facility only after he/she has received complete information and explanation concerning the needs for and alternatives for such a transfer. The institution to which the patient is to be transferred must first have accepted the patient for transfer.

8. The patient has the right to obtain information as to any relationship of this facility to other health care and educational institutions insofar as his/her care is concerned. The patient has the right to obtain information as to the existence of any professional relationships among individuals, by names, which are treating him/her.

9. The patient has the right to be advised if this ambulatory surgical facility proposes to engage in or perform human experimentation affecting his/her care or treatment. The patient has the right to refuse to participate in such research projects.

10. The patient has the right to expect reasonable continuity of care. The patient has the right to expect that this facility will provide a mechanism whereby he/she is informed by his/her physician of the patient’s continuing health care requirements following discharge.

11. The patient has the right to examine and receive an explanation of his/her bill regardless of the source of payment and to be informed regarding the fees for procedures performed in the center. The patient has a right to be informed of third party coverage including Medicare and Arizona Health Care Cost Containment System.

12. The patient has the right to know what facility rules and regulations apply to his/her conduct as a patient.

13. The patient has the right to request information about the grievance process at the Center. If a patient has grievance with the Center, he/she has the right to speak immediately with the Director of Nursing or the substitute person assigned to answer the grievances. A formal written grievance may be completed for further review of the grievance.

14. The patient has the right to be free from chemical, physical, psychological abuse or neglect.

15. The patient has the right to timely and appropriate pain management.

16. The patient has the right to choose where to receive services, including a facility where my physician does or does not have an ownership interest.

PATIENT RESPONSIBILITIES:

1. It is the patient’s responsibility to fully participate in decisions involving his/her own health care and to accept the consequences of these decisions if complications occur.

2. Provide complete and accurate information to the best of his/her ability about his/her health, any medications, including over-the-counter productsand dietary supplements and allergies and sensitivities.

3. Provide a responsible adult to transport him/her home from the facility.

4. Inform his/her provider about any living will, medical power of attorney, or other directive that could affect his/her care.

5. Accept financial responsibility for any charges not covered by his/her insurance.

6. Be respectful of all the health care providers and staff, as well as other patients.

7. The patient is expected to follow up on his/her doctor’s instructions, take medication when prescribed, and ask questions concerning his/her own health care that he/she feels is necessary.

For Medicare Beneficiaries complaints may be reported to the Medicare Ombudsman at; http://www.cms.hhs.gove/ombudsman/resources.asp. For all others, complaints may be reported to: Arizona Department of Health Services, Assistant Director, Division of Licensing Services at 150 N 18th Avenue 4th Floor, Phoenix, AZ 85007, 602-364-2536.