Patient Rights & Responsibilities

The Surgery Center complies with applicable Federal Civil rights laws and does not discriminate based on race, color, religion, personal values, national origin, age, disability, sex, or payment source. As our patient, you are entitled to safe, considerate, respectful, and dignified care.

As our patient at The Surgery Center, you have the right to:

• Receive care in a safe setting, free from abuse or harassment.
• Receive appropriate assessment and management of pain.
• Have a family member or representative of your choice and your physician promptly notified if a need arises for you to be admitted to the hospital.
• Change your provider if other qualified providers are available.
• Exercise your rights without being subjected to discrimination or reprisal.

You are entitled to personal and informational privacy as required by law. This includes your right to:

• Know the identity, professional status, role, and business relationship of all those involved in your care.
• Undergo examinations in reasonably private visual and auditory surroundings.
• Request that a person of your gender be present during physical examinations.
• Review or obtain copies of your medical and financial records.
• Obtain a list of certain disclosures of your medical information made following state and federal laws.
• Request an amendment to your medical records if you believe the information is not correct.
• Have your medical records read and discreetly discussed only by those directly involved with or related to your care, by anyone to whom you have given permission, by those with legal custody, or by other authorized individuals.
• Experience confidentiality in all aspects of your care and payment sources.
• The Surgery Center will involve only those acting in an official capacity for the Center and will exclude any individuals you choose to exclude.
• Protective privacy when necessary to provide for your safety or the safety of other patients, visitors, and staff.
• Preservation of the safety and security of your personal belongings from search or seizure, except for reasonable cause.

As a patient at The Surgery Center, you have the right to:

• Receive information in a manner tailored to your level of understanding.
• Be involved in all aspects of your care and participate in decisions regarding your care. This includes your right to be informed of the diagnosis and prognosis of your condition. When it is medically inadvisable to give such information, it will be provided to a person designated by you or to a legally authorized person.
• Be informed of appropriate treatment options, including their risks and benefits, alternative treatment options, the consequences of no treatment, and medical care results, including any unanticipated adverse outcomes.
• Request restrictions on how your medical and financial records are used and shared. However, The Surgery Center may choose not to accept these restrictions if necessary to your care.
• Have access to appropriate staff to report suspected child abuse or adult abuse.
• Communicate with individuals outside the Center.
• You can use an interpreter of your own or one supplied by the facility.
• Refuse treatment (to the extent permitted by law).
• Examine and receive an explanation of bills regardless of the payment source.
• Request The Surgery Center to contact you at an alternative phone number or address.
• You will not be transferred to another facility or location without a complete explanation of the necessity for such an action.
• You and your family/guardian have the right to express dissatisfaction regarding the quality of care without jeopardizing future care, including reprisals or discrimination.

Formal Advance Directives are documents that state your choices for health care. Advance Directives allow you to make known your wishes regarding the medical care you do or do not want to receive if you become too sick to speak for yourself. Procedures in an ambulatory care setting are generally performed to enhance or improve the patient’s quality of life; therefore, it is our policy that if you suffer a cardiac or respiratory arrest or other life-threatening situation, resuscitative measures will be initiated, and you will be transferred to a hospital. At the hospital, further treatments or withdrawal of treatment measures will be exercised following your Advance Directive. The Surgery Center respects your right to make decisions regarding your medical care. If you present an Advance Directive at the time of your admission, a copy will be made and become part of your medical record and will be transferred with you to a hospital if a higher level of care should be required. If you disagree with this policy, please address this issue with your physician before your procedure.

As a patient, you are encouraged to promote your safety by becoming an active, involved, and informed member of your healthcare team. This includes your right to:

• Ask questions if you are concerned about your health or safety.
• Verify the site/side of the body that will be operated on before the procedure.
• Remind staff to check your ID before medications are given, blood samples are obtained, or before an invasive procedure.
• Remind the caregivers to wash their hands before giving care.
• Be informed about which medications are given to you and why you are taking them.

As a patient at The Surgery Center, you are responsible for providing accurate and complete information about present complaints, past illnesses, hospitalizations, medications (including over-the-counter and dietary supplements), allergies, sensitivities, piercings and jewelry, and other matters relating to your health.

As a patient at The Surgery Center, it is your responsibility to:

• Provide a responsible adult to transport you home from the facility and remain with you for 24 hours if your physician requires.
• Ask questions.
• Follow the treatment plan recommended by your caregivers and ask questions if necessary.
• Accept personal responsibility if you refuse treatment.
• Observe the Center’s rules.
• Adhere to The Surgery Center’s Tobacco Free Policy.
• Recognize and respect the rights of other patients, families, and staff, including property.
• Report perceived risks and unexpected changes in your condition to your healthcare provider, including those relating to infectious illnesses.
• Accept financial responsibility for any charges not covered by your insurance.
• To ensure that all fees are paid before surgery.
• Be respectful of all healthcare providers, staff, and other patients and visitors.
• Adhere to the facility’s no weapons policy.
• Keeping appointments, and when unable to do so, notify the Center and your physician.
• You are encouraged to ask questions about any of these rights you do not understand. If you would like to express concerns regarding the quality of care you received at The Surgery Center, contact the Director of Nursing or Administrator. Contact the Business Office Manager or Administrator if you have concerns regarding your insurance or financial responsibility. You will receive a personal response. In the event you are not satisfied with the results internally, the following facilities may be contacted:

PATIENT COMPLAINT OR GRIEVANCE:

The center strives to provide quality care and achieve patient satisfaction. Patient grievances or complaints offer a means to measure this goal’s achievement and identify the need for performance improvement. Patients shall be provided with a means to register a complaint concerning any aspect of the service/care provided by the center.

Each patient shall receive a patient survey upon discharge: allowing them to evaluate their care.

Any patient may express their concerns through the survey, formal grievance form, or by a simple, informal complaint. Such a complaint may be registered by telephone, in writing, or in-person to any PREMIER SURGICAL SUITES LLC staff member. All complaints received by PREMIER SURGICAL SUITS LLC staff shall be forwarded to the center’s administrator or the designee on the same day.

The administrator or the designee will attempt to address and resolve the concern by telephone or in-person within three (3) days.

If, after this contact by the center, the patient continues to have a concern, the patient may submit the complaint or grievance in writing to the Medical Director. The Medical Director will consider the submitted grievance and may request additional information or documentation.

Once the collection of relevant information for the grievance is determined to be complete, the Medical Director will respond to the grievance in writing within thirty (30) days. If the Medical Director cannot decide within this thirty (30) day period, he/she will notify the patient in writing regarding the status of their grievance.

To report a complaint or grievance, you may contact the facility administrator by mail at the center address. 

PREMIER SURGICAL SUITES LLC

2111 Drew Street, Suite 100, Clearwater, FL 33765

Complaints and grievances may also be filed through the Florida Department of Health Services in writing at:

State Reporting Agency

Agency for Health Care Administration, Complaint Administration Unit

2727 Mahan Drive, Bldg. 1

Tallahassee, FL 32308

Phone: (888) 419-3456

Medicare Ombudsman

File a complaint at Medicare.gov.

Accrediting Organization

Accreditation Association for Ambulatory Health Care, Inc.

5250 Old Orchard Road, Suite 200

Skokie, IL 60077

Phone: (847) 853-6060

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

Office for Civil Rights Complaint Forms.

Florida Department of Health

4052 Bald Cypress Way, Bin C75, Tallahassee, Florida 32399-3260 

by phone at 850-245-4444 or online at https://www.flhealthcomplaint.gov.