Patient Rights and Responsibilities

Patient Bill of Rights

Freeman Surgical Center adopts and affirms as policy the following rights of patient/clients who receive services from our Facility.  The Facility will provide the patient, the patient’s representative or surrogate verbal and written notice of such rights in advance of the  procedure in accordance with 42 C.F.R. § 416.50 Condition for Coverage- Patient Rights. The patient rights are as follows:

  • Treatment without discrimination as to age, race, color, religion, sex, sexual orientation, national origin, marital status, political belief, or handicap.  It is our intention to treat each patient as a unique individual in a manner that recognizes their basic human rights.
  • Considerate and respectful care including consideration of psychosocial, spiritual, and cultural variables that influence the perceptions of illness.
  • Be free from any act of discrimination or reprisal against the patient merely because he or she has exercised their rights.
  • Receive, upon request, the names of physicians directly participating in your care and of all personnel participating in your care.
  • Obtain from the person responsible for your health care complete and current information concerning your diagnosis, treatment, and expected outlook in terms you can be reasonably expected to understand.  When it is not medically advisable to give such information to you, the information shall be made available to an appropriate patient’s representative or surrogate in your behalf.
  • The patient may wish to delegate his/her right to make informed decisions to a patient’s representative or surrogate, even though the patient is not incapacitated. To the extent permitted by State law, the ASC must respect such delegation.
  • Receive information necessary to give informed consent prior to the start of any procedure and/or treatment, except emergency situations.  This information shall include as a minimum an explanation of the specific procedure or treatment itself, its value and significant risks, and an explanation of other appropriate treatment methods, if any.
  • The patient may elect to refuse treatment. The patient has the right to change primary or specialty physicians if other qualified physicians are available.  In this event, the patient must be informed of the medical consequences of this action.  In the case of a patient who is mentally incapable of making a rational decision, approval will be obtained from the guardian, next-of-kin, or other person legally entitled to give such approval.  The facility will make every effort to inform the patient of alternative facilities for treatment if we are unable to provide the necessary treatment.
  • The facility will provide the patient or, as appropriate the patient’s representative or surrogate with written information concerning its policies on advance directives, including a description of applicable State health and safety laws and, if requested, official State advance directive forms, if such exist.  Access to health care at this facility will not be conditioned upon the existence of an advance directive.
  • You may appoint a patient representative or surrogate to make health decisions on your behalf, to the extent permitted by law
  • Privacy to the extent consistent with adequate medical care.  Case discussions, consultation, examination, and treatment are confidential and should be conducted discreetly.
  • Privacy and confidentiality of all records pertaining to your treatment, except as otherwise provided by law or third party payment contract.
  • A reasonable response to your request for services customarily rendered by the facility, and consistent with your treatment.
  • Expect reasonable continuity of care and to be informed, by the person responsible for your health care, of possible continuing health care requirements following discharge, if any.
  • The identity, upon request, of all health care personnel and health care institutions authorized to assist in your treatment.
  • Refuse to participate in research or be advised if your personal physician and/or facility propose to engage in or perform human experimentation affecting his/her care or treatment. Refusal to participate or discontinuation of participation will not compromise the patient’s right to access care, treatment, or services
  • Upon patient request, examine and receive a detailed explanation of your bill including an itemized bill for services received, regardless of sources of payment.
  • Know the facility’s rules and regulations that apply to your conduct as a patient.
  • Be advised of the facility grievance process. The investigation of  all grievances made by a patient, the patient’s representative or surrogate regarding treatment of care that is (or fails to be) furnished. Notification of the grievance process includes: who to contact to file a grievance, and that the patient, the patient’s representative or surrogate will be provided with a written notice of the grievance determination that contains the name of the contact person, the steps taken on his or her behalf to investigate the grievance, the results of the grievance, and the grievance completion date.
  • Complaint or criticisms will not serve to compromise future access to care at this facility.  Staff will gladly advise you of procedures for registering complaints or to voice grievances including but not limited to grievances regarding treatment or care that is (or fails to be) furnished.
  • Access and copy information in the medical record is pursuant to the provisions of the law.  If patient is incompetent, the record will be made available to his/her representative and/or surrogate.
  • Expect to be cared for in a safe setting regarding: patient environmental safety, infection control, security, and freedom from abuse or harassment.
  • Receive care free of restraints, unless medically reasonable issues have been accessed and pose a greater health risk without restraints.
  • Participate in the development, implementation, and revision of his/her care plan.

Patient Responsibilities

  • The patient has the responsibility to provide accurate and complete information concerning his or hers present complaints, past illnesses, hospitalizations, medications and other matters relating to his/her health.
  • The patient is responsible for reporting perceived risks in his or her care and unexpected changes in his/her condition to the responsible practitioner.
  • The patient, patient’s representative, or surrogate are responsible for asking questions about the patient’s condition, treatments, procedures, laboratory and other diagnostic test results.
  • The patient, patient’s representative, or surrogate are responsible for asking questions when they do not understand what they have been told about the patient’s care or what they are expected to do.
  • The patient, patient’s representative, or surrogate are responsible for immediately reporting any concerns or errors they may observe.
  • The patient is responsible for following the treatment plan established by his/her physician, including the instructions of nurses and other health professionals as they carry out the physician’s orders.
  • The patient is responsible for his/her actions should he/she refuse treatment or not follow his/her physician’s orders and accept the consequences of failing to following recommended treatment.
  • The patient is responsible for assuring that the financial obligations of his/her care are fulfilled as promptly as possible.
  • The patient is responsible for following facility rules and regulations.
  • The patient is responsible for being considerate of the rights of other patients and facility personnel.
  • The patient is responsible for being respectful of his/her personal property, facility property, and that of other persons in the facility.

Complaints/Grievances

  • Complaints may be directed to the following Facility Contact:  Debbie Cizerle, Administrator, Freeman Surgical Center, 811 West 34th Street, Joplin, MO 64804; 417-622-4270 or Bryan Clouse, Director of Nursing, Freeman Surgical Center, 811 West 34th Street, Joplin, MO 64804; 417-622-4270.
  • Complaints may be directed to the following State Agency: Bureau of Health Services Regulation, PO Box 570, Jefferson City, MO 65102; 573-751-6303.
  • Web site for the Medicare Beneficiary Ombudsman: http://www.medicare.gov/claims-and-appeals/file-a-complaint/complaints.html or 1-800-633-4227

Freeman Surgical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. 
ATTENTION:  If you speak English, language assistance services, free of charge, are available to you.  Call 1-417-622-4270 TTY: 1-417-553-4265
Freeman Surgical Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. 
ATENCIÓN:  si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.  Llame al 1-417-622-4270  TTY: 1-417-553-4265.
Freeman Surgical Center erfüllt geltenden bundesstaatliche Menschenrechtsgesetze und lehnt jegliche Diskriminierung aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab. 
ACHTUNG:  Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.  Rufnummer: 1-417-622-4270  TTY 1-417-553-4265.