PATIENT BILL OF RIGHTS

PURPOSE: The goal of the Waterfront Surgery Center is to provide quality patient care. In keeping with that goal we wish to advise you that you have the right to expect the following:

  1. Respectful care in a safe setting, provided by competent personnel, free from all forms of abuse or harassment.
  2. Upon request, to be given the names of all practitioners participating directly in your care and the names and functions of other health care persons with whom you have direct contact.
  3. Consideration of privacy. Care discussion, consultation, examination and treatment are considered confidential and shall be conducted discreetly. Records pertaining to your care will be kept confidential except as otherwise required by law or third party contractual arrangements. You have the right to approve or refuse the release of your records, except when release is required by law.
  4. Information concerning facility rules and regulations related to patient responsibilities.
  5. Emergency procedures to be implemented without delay.
  6. Quality care in keeping with professional standards, which are continually reviewed and maintained.
  7. Full information in layman’s terms concerning your diagnosis, evaluation, treatment, procedure, expected outcome and prognosis, including information about alternative treatments and possible complications before it is performed. In the event that direct communication of this information to the patient is inadvisable, information will be provided to a person designated by the patient or to a legally authorized person.
  8. Opportunity to provide informed consent for procedures except in the event of emergencies.
  9. The opportunity to participate in decisions involving the patient’s health care, except when such participation is contraindicated for medical reasons.
  10. To change providers if other qualified providers are available.
  11. To be advised when the plan of care is part of a research or donor program and to refuse to continue in any program for which previous consent has been given.
  12. To refuse drugs or procedures as permitted by law and to be informed of the medical consequences of such refusal. This includes the opportunity to request and obtain a second opinion from another physician at your own expense.
  13. Medical and nursing services without discrimination based upon age, race, color, religion, sex, sexual orientation, national origin, handicap, or disability.
  14. Interpreter services when possible.
  15. Access to information contained in the medical record unless access is restricted by attending practitioner for medical reasons, or is prohibited by law.
  16. Employ of systems within the facility, which promote patient comfort, a pain free recovery and respect the use of patient’s time.
  17. Expect that when an emergency occurs and a patient is transferred to another facility, the responsible person shall be notified. The institute receiving the patient will be notified prior to the transfer. Upon transfer to another facility, the patient can expect to receive complete information and an explanation concerning the needs for and alternatives to the transfer when medically permissible.
  18. Examine and receive a detailed explanation of his/her bill.
  19. Full information and counseling on the availability of known financial resources for his/her health care.
  20. Expect the Waterfront Surgery Center to provide information on the patient’s continuing health care needs and the means for meeting them upon discharge.
  21. Be informed of his/her rights at the earliest possible moment in the course of his/her care at the Surgery Center.
  22. As an adult patient or emancipated minor, you may convey in advance (advance directive) your wishes regarding extraordinary treatment or the person you would like to make decisions for you should you become unable to speak for yourself, and have Waterfront personnel comply with these directives.
  23. To exercise his or her rights without being subjected to discrimination or reprisal.
  24. To voice grievances regarding treatment, care that is (or fails to be) furnished or payment.
  25. To be informed by the practioner/surgeon or surgery center of failure to carry liability insurance

We encourage you to be an informed consumer of health care services. Please do not hesitate to ask our staff questions pertaining to any aspect of your care at our facility.

Please forward any concerns to:

Waterfront Surgery Center
Director of Nursing
495 East Waterfront Drive
Suite 110
Homestead, PA 15120

Phone: (412) 325-0774

Waterfront Surgery Center notwithstanding, a patient may address a concern to:

PA Department of Health
Division of Acute and Ambulatory Care
Room 532 Health and Welfare Building
625 Forster Street
Harrisburg, PA 17108-0090

If a patient has a concern about the quality of care provided, or feels that they were discharged too early, they may contact:

KePRO
777 East Park Drive
P.O. Box 8310
Harrisburg, PA 17105-8310
1-800-322-1914

Patients and visitors may also contact AAAHC with comments or complaints regarding the Waterfront Surgery Center at:

AAAHC
5250 Old Orchard Road, Suite 200
Skokie, IL 60077
Tel: 847-853-6060
Fax: 847-853-9028
Email: [email protected]

Web site for the Office of the Medicare Beneficiary Ombudsman: www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

Advance Directives Policy

Advance Directives allows a person to give directions about future medical care or to designate another person(s) to make medical decisions if he or she should lose decision-making capacity. Advance directives may include living wills, durable powers of attorney or similar documents portraying the patient’s preference.

The existence of an advance directive, or lack thereof, will not determine the patient’s access to care, treatment and services.

Patients presenting with an Advance Directive will be informed that all patients are treated as a “Full Code” at the Waterfront Surgery Center and that means all measures to resuscitate and sustain life will be taken.

NOTE: As stated in: UNDERSTANDING ADVANCE DIRECTIVES FOR HEALTH CARE “Living Wills and Powers of Attorney in Pennsylvania” “…there is no law in Pennsylvania that guarantees that your medical providers will follow your instructions in all circumstances…”

In the event the patient should need to be transferred to the hospital, the presence of an Advance Directive will be communicated to the receiving facility. The Advanced Directives will then follow the patient during transfer and go into effect upon admission to the hospital.

If the patient has a notarized Advance Directive, a copy will be placed in the permanent medical record and the attending physician and anesthesiologist will be notified.

Information regarding Advance Directives is available to all patients in the Waiting Room at the Waterfront Surgery Center.

Transfer

In the event of medical need, you may require transfer/admission to the hospital.

Ownership Disclosure

This is to inform you that your physician might have a financial interest or ownership in the Waterfront Surgery Center.  The following have an ownership interest of 5% or more:

Name: Address: UPIN:
Roxana Barad, MD 4424 Penn Ave., Suite 103
Pittsburgh, PA  15224
C33070
Alfonso Barbati, DO 1200 Brooks Lane, Suite 260
Clairton, PA  15025
E12902
Shashi Kumar, MD 1200 Brooks Lane, Suite 260
Clairton, PA  15025
E18253
Howard Wilen, MD 1200 Brooks Lane, Suite 260
Clairton, PA 15025
B40139
Jefferson Regional Medical Center 565 Coal Valley Road
Jefferson Hills, PA  15025

First Name:

Last Name:

Date:

I confirm that I have read and understand the Waterfront Surgery Center Patient Bill of Rights, Advance Directives Policy and Ownership Disclosure.