Patient Rights

• Patients have the right to be informed of his/her rights in a manner he/she can understand and to exercise these rights without being subjected to discrimination or reprisal
• Patients have the right to participate and make decisions regarding care.
• Patients are treated with respect, consideration, and dignity.
• Patients have the right to be free of all forms of abuse and harassment.
• Patients have the right to change their provider if other qualified providers are available.
• We follow the Health Insurance Portability and Accountability Act of 1996 (HIPPA). Under the HIPPA guidelines, patients are provided the appropriate privacy.
• Patients have the right to privacy of information given and services provided.
• Patients have the right to be informed of any person other than routine personnel that will be observing or participating in his/her treatment.
• Patients have the right to know the person or persons responsibility for coordinating his/her care and the credentials of health care professionals.
• Patients have the right for privacy and security individually identifiable health information. Personal disclosure and records are treated confidentially, and, except when required by law, patients are given the opportunity to approve or refuse their release.
• Patients are provided, to the degree known, complete information concerning their diagnosis, treatment, and prognosis. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person.
• Patients have the right to receive from his/her physician enough information so that he/she may understand the procedure or treatment being received in order to sign informed consent.
• Patients have the right to refuse treatment and to be informed of the consequences of his/her actions.
• Patients are given the opportunity to participate in the decisions involving their health care, except when such participation is contraindicated for medical reasons.
• Patients have the right for information regarding advanced directives as required by state or federal law and regulations.
• Patients have the right to expect that care provided and services rendered are consistent with quality standards.
• Patients have the right to be informed of the mechanism for continued health care following discharge from the Valley Surgery Center.
• Patients have the right to examine and receive an explanation of his/her statement of charges regardless of the source of payment.
• Patients have the right to know in advance the expected estimated amount of his/her patient financial responsibilities and payment policies.
• Patients have the right to know the services available at the Valley Surgery Center.
• Patients have the right to know provisions for after- hours care and emergency care.
• Patients have the right to information concerning the institution to which he/she may be transferred should an emergency occur.
• Marketing or advertising regarding the competency and capabilities of Valley Surgery Center is not misleading.
• Patients have the right to be advised if the facility/personal physician proposes to engage in or perform human experimentation affecting his/her care of treatment. The patient has the right to refuse to participate in such research project.
• Patients have the right to know methods for expressing grievances and suggestions to The Valley Surgery Center.
• Patients have the right to a fair and efficient process for resolving differences with their health plans, healthcare providers, and the institutions that serve them.

Responsibilities of the Patient

It is the patient’s responsibility:

• To read and understand all permits and/or consents you sign. If you do not understand your consent, it is your responsibility to ask the nurse or physician for clarification. If you do not understand the Financial Agreement, it is the patient’s responsibility to ask the Business Office Representative for clarification.
• To provide complete and accurate information to the best of his/her ability about his/her health, any medications, including over-the-counter products and dietary supplements and any allergies or sensitivities.
• To read carefully and follow any pre-operative written or oral instructions your physician or Valley Surgery Center has given and to notify your physician or Valley Surgery Center if you have not followed the pre-operative instructions.
• To inform his/her provider about any living will, medical power of attorney or other directive that could affect his/her care.
• To provide an adult to transport you home after the surgery if you have received medications and/or
• To provide for someone to be responsible for your care for the first 24 hours after your procedure.
• To follow carefully any written or verbal postoperative instructions from your physician(s) or nurse. This includes any keeping scheduled postoperative appointments with your physician.
• To contact your physician regarding any post-operative question, problem, or complication.
• To assure your financial obligations for services are fulfilled as promptly as possible and to assume ultimate responsibility for payment regardless of insurance coverage.
• To notify the Administrator or Medical Director if you feel any rights have been violated or if you have a complaint, or suggestion for improvement. This can be accomplished by completing and returning your patient questionnaire or by direct contact.
• To be respectful of all the health care providers and staff, as well as other patients

Patient Complaint or Grievance:

Patients’ Rights and Responsibilities were established with the expectation that observance of these rights will contribute to more effective patient care and greater satisfaction for the patient, family, physicians, and the facility caring for the patient. Patients shall have these rights regardless of age, race, sex, national origin, religion, culture, personal values, or belief systems. IF YOU HAVE A COMPLAINT ABOUT THE AGENCY OR PERSON PROVIDING OUTPATIENT SURGICAL SERVICES, YOU MAY CALL, WRITE, OR VISIT THE OFFICE OF HEALTH FACILITY COMPLAINTS, WISCONSIN DEPARTMENT OF HEALTH. YOU MAY ALSO CONTACT THE OMBUDSMAN FOR LONG-TERM CARE.

Valley Surgery Center Administrator Phone (651) 275-3040:
SARAH KARAU, RN, BSN
2651 Hillcrest Drive, Suite 301, Hudson, WI 54016
Email: [email protected]

HIPAA Privacy Officer Phone (608)-266-5484:
Wisconsin Department of Health Services
Bureau of Health Services of the Division of Quality
Website: http://www.dhs.wisconsin.gov/bqaconsumer/HealthCareComplaints.htm

St. Croix County Ombudsman Phone: (800)-815-0015:
Medicare: Medicare Ombudsman
Website: http://www.medicare.gov/Ombudsman/resources.asp
Medicare Website: http://www.medicare.gov/

Accreditation Association for Ambulatory Health Care Phone: (847)-853-6060:
5250 Old Orchard Road, Suite 200, Skokie, IL 60077
Website: https://www.aaahc.org/contact-us/