Patient Rights

As a Patient, You have the Right to:

Treatment without regard to race, sex, age national origin or cultural, economic, educational or religious background or the source of payment of his care.
Receive considerate and respectful care. Be free from all forms of abuse and harassment.
The knowledge of the name of the surgeon who has primary responsibility for coordinating his care and the names and professional relationships of other practitioners who will see him.
Receive information from his surgeon about his illness, his course of treatment, and his prospects for recovery in terms he can understand. When it is medically inadvisable to give such information is provided to a person designated by the patient or to a legally authorized person.
Receive the necessary information about any proposed treatment or procedure in order to give informed consent or to refuse this course of treatment. Except in emergencies, this information shall include a description of all the procedures(s) or treatment(s) the medically significant risk(s) involved in each, and the name of the person who would carry out the treatment(s) or procedure(s)
Participate actively in decision-making regarding his medical care, to the extent that is permitted by law.
Refuse treatment
Full consideration of privacy concerning his medical care program. Case discussion, consultation, examination and treatment are confidential and shall be conducted discreetly. The patient has the right to be advised as the reason for the presence of any individual.
Confidential treatment of all communications and records pertaining to his care. His written permission shall be gained before these medical records are made available to anyone not concerned with his care.
Reasonable responses to any reasonable request he makes for services.
Reasonable continuity of care and to know in advance the time and location of appointment(s), as well as, the practitioner providing the care.
Be advised if the surgeon proposes to engage in or perform human experimentation affecting his care or treatment. The patient has the right to refuse to participate in such research projects.
Be informed by his surgeon, or his designee, of his continuing health care requirements.
Examine and receive an explanation of his bill regardless of the source of payment.
Have all patients’ rights explained to the person who has the legal responsibility to make decisions regarding medical care on behalf of the patient.
Express any grievances or suggestions verbally or in writing.
All patients receiving anesthesia services or conscious sedation (all but straight local anesthesia) will be asked if there are advance directives the Center should be aware of, but it is clearly explained to the patient that the Atlantic Surgery Center does not honor advance directives, as an ambulatory surgery center and all efforts will be made to resuscitate them for transfer to an acute care facility where the advance directives will be followed.
Change their provider if other qualified providers are available

As a Patient, You Are Responsible for:

The Surgery Center expects that a patient will provide accurate and complete information about matters relating to his/her health history in order for the patient to receive effective medical treatment.
A patient is responsible for reporting whether he/she clearly comprehends a contemplated course of action and what is expected of them.
The Surgery Center expects that the patient will cooperate with all the Surgery Center’s personnel and ask questions if directions and/or procedures are not clearly understood.
A patient is expected to be considerate of other patients and the Surgery Center personnel and to observe the no-smoking policy of the surgery center. A patient is also expected to be respectful of the property of other persons and the property of the Surgery Center.
The patient is expected to help the physicians, nurses, and allied medical personnel in their efforts to care for the patient by following their instructions and medical order.
It is understood that a patient assumes the financial responsibility of paying for all services rendered whether through third-party payers (his/her insurance company) or being personally responsible for payment for any services which are not covered by his/her insurance policies.
It is expected that the patient will not take any drugs which have not been prescribed by his/her attending physician and administered by the Surgery Center.

If you have any questions regarding your rights or responsibilities, complaints or grievances of how these rights were or were not administered, you may speak to the Administrator/Administrator Designee, or the management team, who will conduct an investigation into your issue. The following contact information is provided for your convenience.

Administrator Atlantic Surgery Center 541 Health Blvd. Daytona Beach, FL 32114 Phone: 386-239-0021

AAAHC 5250 Old Orchard Road #200 Skokie, IL 60077 Phone: 847-853-6060

The State Department of Health Phone: 850-245-4444 Florida Department of Health 2585 Merchants Row Boulevard Tallahassee, FL 32199

Medicare Phone: 800-633-4227 http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

Office of Civil Rights U.S. Department of Health and Human Services 200 Independence Ave SW Room 509F, HHH Building Washington, D. C. 20201 Phone: 800-368-1019, 800-527-7697 (TDD) https://ocrportal.hhs.gov/ocr/portal/lobby.jsf Complaint forms are available at: http://www.hhs.gpv/ocr/office/file/index.html

State of Florida HHS 1-888-633-4227 or http://www.hss.gov/ocr

Elder Abuse Hotline: 800-963-5337