BEND SURGERY CENTER – PATIENT’S BILL OF RIGHTS
1. The patient has the right to considerate and respectful care.
2. Patient has right to personal privacy – by virtue of physical surrounding modification and respect of dignity by healthcare workers and business office employees.
3. Patient has right to receive care in safe setting – by virtue of trained, professional healthcare workers and adherence to State, Local and Federal safety standards.
4. Patient has right to be free from all forms of abuse.
5. The patient has the right to obtain from his physician complete and current information concerning his diagnosis, treatments and prognosis in terms the patient can be reasonably 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 on his behalf. He has the right to know, by name, the physician responsible for coordinating his care.
6. The patient has the right to receive from his physician information necessary to give informed consent prior to the start of the procedure and/or treatment. Except in emergencies, such information should include but not necessarily be limited to their diagnosis, the specific procedures and/or treatments, the medically significant risks involved, prognosis, and the probable duration of incapacitation. Where medically significant alternatives for care or treatment exist, or when the patient requests information concerning medical alternatives, the patient has the right to such information.
7. The patient has the right to participate in decisions involving his care except when contraindicated for health reasons and to refuse treatment to the extent permitted by law and to be informed of the medical consequences of his action.
8. The patient has the right to exercise his or her rights without being subjected to discrimination or reprisal.
9. The patient has the right to expect the Surgery Center to use and disclose information pertaining to his care in accordance with the Surgery Center’s Notice of Privacy Practices. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. Bend Surgery Center will comply with State and Federal rules for privacy and security of the individually identifiable health information as specified at 45 CFR parts 160 & 164. HIPPAA guidelines must be followed.
10. The patient has the right to expect that within its capacity, the Surgery Center must make a reasonable response to the request of a patient for services. The Surgery Center must provide evaluation, service and/or referral as indicated by the urgency of the case. When medically permissible, a patient may be transferred to another health care facility after he has received complete information and explanations concerning the needs for and alternatives to such a transfer. The institution to which the patient is to be transferred must first have accepted the patient for transfer.
11. The patient has the right to obtain information as to any relationship of this Surgery Center to other health care and educational institutions, insofar as his care is concerned. The patient has the right to obtain information as to the existence of any professional relationships among individuals, by name that is treating him.
12. The patient has the right to be advised when the Surgery Center 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.
13. The patient has the right to expect reasonable continuity of care and to know in advance what appointment times and physicians are available and when. The patient has the right to expect that the Surgery Center will provide a mechanism whereby he is informed by his physician or a delegate of the physician of the patient’s continuing health care requirements following discharge.
14. The patient has the right to appropriate assessment and management of pain.
15. The patient has the right to know what Surgery Center rules and regulations apply to his conduct as a patient; e.g., the patient is responsible for providing information about his health, including past illnesses, hospitalizations, and medication. The patient is responsible for asking questions to seek information or clarification of things not understood and for advising the physician if the decision is made to stop the treatment plan. The patient is responsible for providing payment information and making arrangements to pay.
16. The patient has the right to receive services without regard to age, race, color sexual orientation, religion, marital status, sex, national origin or sponsor.
17. The patient has the right to be informed of the services available at the Surgery Center.
18. The patient has the right to be informed of the provisions for off-hour emergency coverage.
19. The patient has the right to be informed of the charges for services, eligibility for third-party reimbursements and, when applicable, the availability of free or reduced-cost care.
20. The patient has the right to information about the Surgery Center’s payment plans and to examine and receive an explanation of his bill regardless of the source of payment.
21. The patient has the right to receive an itemized copy of his account statement upon request.
22. The patient has the right to voice grievances relating to but not limited to mistreatment, neglect, verbal, mental, sexual or physical abuse with either verbal or written complaints, and recommend changes in policies and services to Bend Surgery Center staff, the Privacy Officer and the Agency for Healthcare Administration without fear of reprisal. Information below to file complaint.
23. The patient has the right to express complaints about the care and services provided and to have the Surgery Center investigate such complaints. The Surgery Center is responsible for notifying the patient that the patient or his designee also may complain to the Bend Surgery Center Privacy Officer or the Department of Human Resources, Oregon State Health Division, the Agency for Healthcare Administration, or the Joint Commission.
24. The patient has the right to review his record and to approve or refuse the release or disclosure of the contents in accordance with the Surgery Center’s Notice of Privacy Practices.
25. The patient has the right to expect that marketing and/or advertising conducted by the Surgery Center is not misleading.
26. The patient has the right to have an advance directive, such as a Living Will or health care proxy. These documents express the patient’s choices about his future care or name someone to decide if he cannot speak for himself. If the patient has a written advance directive, a copy should be provided to the Surgery Center.
27. The Surgery Center complies with the Medicare ASC conditions of Coverage concerning patient rights (42 CFR 416.50).
SUBMISSION AND INVESTIGATION OF GRIEVANCES
The patient and/or family/responsible party has the right to voice grievances relating to but not limited to mistreatment, neglect, verbal, mental, sexual or physical abuse or privacy practice complaints with either verbal or written complaints.
These can be submitted to the Privacy Officer at Bend Surgery Center, 1303 NE Cushing Dr. Suite 200, Bend, OR 97701 (Phone number 541-318-0858).
You may contact the Secretary of the U.S. Department of Health and Human Services at: 200 Independence Ave, SW, Room 509F, HHH Building, Washington DC 20201 (e-mail: firstname.lastname@example.org).
This facility is accredited through The Joint Commission and you may register an unresolved complaint by contacting:
Joint Commission 1 800 994-6610 or online Complaint forms are available at
Patients who are Medicare beneficiaries, or their representative, should be informed that the role of the Medicare Beneficiary Ombudsman is to ensure that Medicare Beneficiaries receive the information and help they need to understand their Medicare options and to apply their Medicare rights and protections.
Office of the Medicare Beneficiary Ombudsman is at
You can download and view a copy of our Notice of Patients Rights via this link.