PATIENT BILL OF RIGHTS AND RESPONSIBILITIES

WENTWORTH SURGERY CENTER recognizes your rights while you are choosing to receive medical care at the facility. Please ask to speak to the Administrator if you have any concerns or complaints. Grievance numbers are posted in our waiting room and a full text of the laws pertaining to Patient Rights and Responsibilities, as well as grievance procedures, is available to you, upon request, from the Administration.

• Patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.
• Patient has the right to a prompt and reasonable response to questions and requests. 
• Patient has the right to know who is providing medical services, to view their credentials and to know who is responsible for his or her care.
• Patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
• Patient has the right to know what rules and regulations apply to his or her conduct.
• Patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks and prognosis.
• Patient has the right to appropriate assessment and management of pain.
• Patient has the right to refuse any treatment, except as otherwise provided by law.
• Patient has the right to be free of restraints or seclusion unless they are deemed necessary by the physician to ensure his or her physical safety, and only if no less restrictive intervention is available.
• Patient has the right to receive care in a safe setting, free from all forms of abuse or harassment.
• Patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.
• Patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.
• Patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have the charges explained.
• Patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap or source of payment.
• Patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the healthcare provider or health care facility accepts the Medicare assignment rate.
• Patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
• Patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
• Patient has the right to express grievances regarding any violation of his or her rights, as stated in law, through the grievance procedure of the health care provider or health care facility, which served him or her, and to the appropriate state licensing agency.
• Patient has the right to receive notice of all protected health information practices.
• Patient has the right to view all protected health information pertaining to him or her.
• Patient has the right to access an accounting of all disclosures.
• Patient has the right to request amendments and corrections to personal information they feel is incorrect.
• Patient has the right to receive confidential communications.
• Patient has the right to complain to the covered entity and the Department of Health and Human Services.
• Patient has the right to change their provider if other qualified providers are available.
• Patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters relating to his or her health.
• Patient is responsible for being honest in reporting unexpected changes in his or her condition, health status and medications to the health care provider.
• Patient is responsible for reporting unexpected changes in his or her condition to the health care provider.
• Patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
• Patient is responsible for following the treatment plan recommended by the health care provider.
• Patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.
• Patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider’s instructions.
• Patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.
• Patient is responsible for following health care facility rules and regulations affecting patient care and conduct.
• Patient is responsible for being respectful at all times towards staff, other patients, visitors and Wentworth Surgery Center property.

When a Patient is deemed incompetent:

Inform the patient or, as appropriate, the patient’s representative of the patient’s right to make informed decisions regarding the patient’s care.

And a patient is adjudged incompetent under applicable State laws by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed under state law to act on the patient’s behalf.

And 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.