Patient Rights and Responsibilities

  • The patient, the patient's representative or the patient's surrogate, is fully informed of all his/her rights and responsibilities prior to scheduled procedure.
  • The patient, the patient's representative or the patient's surrogate has the right to appropriate and professional care relating to physician orders.
  • The ASC will not take punitive action as a reprisal or discriminate against a patient, their representative or surrogate. This includes reprisals or discrimination against a patient merely because he or she has exercised their rights.
  • To agree or refuse the use of recording, films, or other pictures to be used for reasons other than your care.
  • The patient, the patient's representative or the patient's surrogate has the right of choice of care providers, or to change their primary or specialty physicians or dentist if others are available.
  • The patient, the patient's representative or the patient's surrogate has the right to receive information necessary to give informed consent prior to the start of any procedure or treatment.
  • The patient, the patient's representative or the patient's surrogate has the right to refuse treatment within the confines of the law and to be informed of the consequences of his/her actions.
  • The patient, the patient's representative or the patient's surrogate has the right to data privacy and confidentiality.
  • The patient, the patient's representative or the patient's surrogate right to choose to use your own interpreter or use one supplied by the ASC.
  • Have a family member, representative or surrogate of his or her choice and his or her own physicians notified promptly of his or her admission to the center.
  • Be informed of services available at the center, provisions for afterhours care, and fees for services.
  • The patient, the patient's representative or the patient's surrogate has the right to voice grievances and suggest changes in service or staff without being subjected to discrimination or reprisal.
  • The patient, the patient's representative or the patient's surrogate has the right to be fully informed of agency policies and charges for services.
  • The patient, the patient's representative or the patient's surrogate has the right to information regarding the absence of malpractice insurance coverage.
  • The patient, the patient's representative or the patient's surrogate has the right to information regarding advanced directives, as required by state or federal law and regulations.
  • The patient, the patient's representative or the patient's surrogate has the right to care that reflects consideration of personal values and belief systems, and is allowed to express those spiritual beliefs and cultural practices that do not harm others or interfere with the planned course of medical treatment.
  • The patient, the patient's representative or the patient's surrogate has the right to approve or refuse the release of their clinical records.
  • The patient, the patient's representative or the patient's surrogate has the right to refuse to participate in research projects.
  • The patient, the patient's representative or the patient's surrogate has the right to know what services are provided at this facility.
  • The patient, the patient's representative or the patient's surrogate has the right to information regarding 'after-hours and emergency care'.
  • The patient, the patient's representative or the patient's surrogate has the right to be free of all forms of abuse or harassment.

Patient Responsibilities

  • The patient, the patient's representative or the patient's surrogate has the responsibility to observe prescribed rules of the Facility for their stay and treatment and, if instructions are not followed, forfeits the right to care at the Facility and is responsible for the outcome.
  • The patient, the patient's representative or the patient's surrogate has the obligation to promptly fulfill the financial obligations to the Center.
  • The patient, the patient's representative or the patient's surrogate has the responsibility for being considerate of other patients and personnel and for assisting in the control of noise, smoking and other distractions.
  • The patient, the patient's representative or the patient's surrogate and family are responsible for the respect of property of others and the Center.
  • The patient, the patient's representative or the patient's surrogate has the responsibility to report whether he / she clearly understand the course of treatment and what is expected of them.
  • The patient, the patient's representative or the patient’s surrogate has the responsibility for his/her actions should he/she refuse treatment or does not follow the physician’s or facility’s instructions.
  • The patient, the patient’s representative or the patient’s surrogate has the responsibility for keeping appointments and, when unable to do so for any reason, of notifying the physician and facility.
  • The patient, The patient’s representative or the patient’s surrogate have the responsibility to inform the physician and facility personnel of changes in his/her medical condition which may affect the outcome of the procedure to be performed.
  • The patient is responsible for having a responsible adult drive them to and from the surgery center and provide care for the first 24 hours after surgery.


Filling complaints: If you have a complaint against and ambulatory surgical center

DAVENPORT AMBULATORY SURGERY CENTER, LLC
Nancy Kastner (407) 256-0933

OR

Call the Consumer Assistance Unit at 1-888-419-3456 (press 1)

OR

Write to the address listed below:
Agency for Health Care Administration
Consumer Assistance Unit
2727 Mahan Drive, Bldg 1
Tallahassee, FL 32306

If you have a complaint against a health care professional and want to receive a complaint form
call the Consumer Assistance Unit at 1-888-419-3456 (press 2)

OR

Write to the address listed below:
Agency for Health Care Administration
Consumer Assistance Unit
P.O. Box 14000
Tallahassee, FL 32317-4000

Website for medicare beneficiary Ombudsman https://www.cms.gov/center/ombudsman.asp