Patient’s Rights and Responsibilities

RIGHTS OF THE PATIENT:

• Every patient has the right to courtesy, respect, dignity, privacy, responsiveness, and timely attention to his/her needs regardless of age, race, sex, national origin, religion, cultural, or physical handicap, personal value and beliefs.
• Every patient has the right to every consideration of his/her privacy and individuality as it relates to his/her social, religious and psychological well-being.
• Every patient has the right to confidentiality. Has the right to approve or refuse the release of medical information to any individual outside the facility, except in the case of transfer to another health facility, or as required by law or third party payment contract.
• Every patient has the right to express grievances or complaints without fear of reprisals.
• Every patient has the right to continuity of health care. The physician may not discontinue treatment of a patient as long as further treatment is medically indicated, without giving the patient sufficient opportunity to make alternative arrangements.
• Every patient is to be provided complete information regarding diagnosis, treatment and prognosis, as well as alternative treatments or procedures and the possible risk and side effects associated with treatment. If medically inadvisable to disclose to the patient such information, the information is to be given to a person designated by the patient or to a legally authorized individual.
• Every patient has the right to make decisions regarding the health care that is recommended by the physician. Accordingly, the patient may accept or refuse any recommended medical treatment.
• Every patient has the right to be informed of any research or experimental projects and to refuse participation without compromise to the patient’s usual care.
• Every patient has the right to appropriate treatment and care to include the assessment/managements of pain.
• Every patient has the right to understand facility charges. You have the right to an explanation of all facility charges related to your health care.
• Every patient has the right to all resuscitative measures; therefore we will not honor Advance Directives.
• Every patient has the right to participate in their health care treatment and decisions.

RESPONSIBILITIES OF THE PATIENT:

• Patients are responsible to be honest and direct about matters that relate to them, including answering questions honestly and completely.
• Patients are responsible to provide accurate past and present medical history, present complaints. Past illnesses, hospitalizations, surgeries, the existence of advance directive, medication and other pertinent data.
• Agree to accept all caregivers without regard to race, color, religion, sex, age, gender preference, handicap, or national origin.
• Patients are responsible for assuring that the financial obligations for health care rendered are paid in a timely manner.
• Patients are responsible to sign required consents and releases as needed.
• Patients are responsible for their actions if they should refuse treatment or procedure, or if they do not follow or understand the instructions given them by the physician or Crown Point Surgical Suites employees.
• Patients are responsible for keeping their procedure appointment. If they anticipate a delay or must cancel, they will notify Crown Point Surgical Suites as soon as possible.
• Patients are responsible for the disposition of their valuables, as Crown Point Surgical Suites does not assume the responsibility.
• Patients are responsible to be respectful of others, or other people’s property and the property of Crown Point Surgical Suites.
• Patients are to observe safety and no smoking regulations.
• Patients must have a responsible adult over the age of 18 to accompany them to the facility, and drive them home after the procedure. Then stay with them for 24 hours after surgery for patient’s SAFETY.

PATIENT COMPLAINT OR GRIEVANCE:

To report a complaint or grievance you may contact the facility administrator by phone at (219) 900-0686 or by mail to the center address.

Complaints and grievances may also be filed through the Indiana State Department of Health Services, in writing by using this form:
Complaint_Report_Form_-_January_30_2013
or by online at complaints@isdh.in.gov.

All Medicare beneficiaries may file a complaint or grievance with the Medicare Beneficiary Ombudsman Online.

Contact the Indiana State Department of Health
Toll-free Complaint Report Line: 1-800-246-8909 [available during state business hours].
When calling the complaint report line, you will be transferred to the Complaint Reporting Program if there is an available intake specialist. If there is not an intake specialist available to take the call, your call will go to the report line voicemail and your call will be returned as soon as possible. 

Complaint report line voicemail: (317) 233-7241
If the complaint report line is busy, you may call the voicemail line and leave the report on voicemail.

Website: https://www.in.gov/isdh

General Email: complaints@isdh.in.gov

Mailing Address:
Indiana State Department of Health
Health Care Facility Complaint Program
2 North Meridian Street, 4B
Indianapolis, IN 46204