Understanding your rights will help you get the best possible care. Whenever the law or you allow someone else to exercise your rights or have your information, we will respect that decision.
If you have any questions or need more information, it is your right to ask.
- It is your right to take an active role in your healthcare. Your cooperation is important. To provide quality health care, we need you to be part of your health care team.
- It is your right to be treated without discrimination. You cannot be denied access to appropriate and necessary care or services because of any of the following:
- National Origin
- Sex or sexual orientation
- Marital Status
- Source of payment
- You have the right to:
- Be treated with respect at all times. You can expect us to be sensitive to your values, needs, and wishes.
- You can ask for a transfer to another room if another patient is unreasonably disturbing you.
- To have your cultural, psychosocial choices and beliefs respected.
- Be free from all forms of abuse and harassment.
- You have the right to be informed.
- If you have questions or need more information, you have the right to ask.
*Guardians and proxies exercise these rights for minor, and people under guardianship. However, minors and people under guardianship should make as many decisions as possible.
- Receive clearly written and spoken information. If needed, we can provide an interpreter or signer, or any other necessary communication aids you need.
- You have the right to information you can understand. An appropriate Surgery Center representative should tell you about:
- Your Illness
- Course of treatment
- Chances for recovery
- Except in emergency, you have the right to informed consent. Before you agree to any procedure, test, or treatment, you should receive all the information you need to make a decision.
- Get complete information. You have the right to ask for and receive information about your diagnosis, condition, treatment and chances for recovery.
- We must explain the following in a way you can understand:
- Your options, including the option of not doing anything
- The risk and benefits of each option
- Possible outcomes, including the expected length of recovery
- Possible side effects of medication and treatment
- Costs, including what your insurance may and may not cover
- Outcomes that you did not expect
- You have the right to accept or refuse care. We will tell you what will happen if you refuse care. As permitted by law, it is your right to:
- Decide for yourself.
You have the right to give, or refuse to give, consent for any procedure, test, or treatment.
- If you leagally cannot, a surrogate decision maker, as allowed by law, has the right to refuse care, treatment, and services on your behalf.
- Decide for yourself.
- You must give your informed consent before taking part in any special programs. It is your right to accept or refuse experimental treatment and/or participation in research
- You should be fully informed of your options for care. Except for an emergency, we will not send you to another facility for treatment until we have provided for your continuing care and they have agreed to take you.
- You have the right to make Advance Directives, including whether you wish organ donation. These documents can help make your choices clear if you ever become physically or mentally unable to:
- Decide for yourself
- Speak for yourself
- These are two types of advance directives:
- A living will gives instructions for the care you want if you ever are terminally ill.
- A health care power of attorney lets you name another person to make decisions about your care if you become unable to do so.
- It is your right to know the identity of all people involved in your care. You also have the right to know who is in charge of your care.
- You have the right to effective pain relief-or to refuse pain relief. Talk about your wishes for pain relief whith your health care provider. You should also include your wishes about pain relief in your advance directives.
- Take part in planning for your discharge after you leave. You should discuss what your needs are and how they can be met. We can give you a list of places that offer continuing care.
- Have a patient advocate, if you desire. This person can be a staff member or a person from outside the facility. He or she help you protect your rights and help resolve any conflict.
- You have the right to:
- Privacy. All your care, including examinations and tests, should be given in such a way to ensure your dignity.
- Have medical information about you kept private. This includes medical information in the computer.
- Anyone not directly involved in your care, including family members, should have your permission to get information about you.
- Understand that if you have privacy concerns you can contact the management at the Bluemound Surgery Center at: (262) 522-6400
- You have the right to access your medical record.
As permitted by law, you have the right to:
- See your medical records; In general, you have the right to see and request corrections to your health record, and to know who else has had access to them. You can have copies made at your own cost. Copies will be made within a reasonable length of time (usually 48 hours)
- You have the right to not be recorded or filmed, or request that filming or recording stop.
- You have the right to receive a copy and full explanation of your bill. Your bills should list all charges and costs. If you ask, we can give you information related to financial assistance.
- You have the right to know that your physician may have a financial interest in the Surgery Center.
Be involved in your care.
Provide complete and accurate information to the best of his/her ability about his/her current health, medication, including over-the-counter products and dietary supplement and any allergies or sensitivities.
Follow the treatment plan prescribed by his/her provider.
Provide a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider.
Be respectful of all Health care providers and staff, as well as other patients and property.
- Accept personal responsibility for any charges not covered by his/her insurance. Tell us complete information so your bills can be paid on time.
- If you feel that your rights have not been properly respected, you can:
- Alert Management Staff
- Talk to staff
- For any unresolved complaints, contact the Operating Room (OR) Supervisor, at (262) 522-6400, or contact the Medical Director at (262) 970-5606. In addition, the patient can contact:
State of Wisconsin Department of Health and Human Services, Bureau of Quality Assurance Health Services
Attn: Cremear Mims
1 West Wilson Street, Madison, WI 53704
Phone (608) 266-8481
Fax (608) 243-2026
For Medicare covered services, you may also contact the Office of the Medicare Beneficiary Ombudsman via toll free number or website below.
Concerns regarding care may also be addressed to the:
American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)
5101 Washington Street, Suite 2F
Gurnee, IL 60031