Centers for Medicare and Medicaid Services (CMS)
The patient and the patient's representative or surrogate has the right to:
- Be free from discrimination or reprisal
- Voice grievances regarding treatment or care that is (or fails to be) provided
- Be fully informed about a treatment or procedure and the expected outcome before it is performed
- Participate in making informed decisions regarding care
- To the provision and explanation of the notice of rights in a language and manner that the patient or the
patient's representative or surrogate understands, including patients who do not speak English or with limited
communication skills. The patient has a choice of using an interpreter of his or her own, or one supplied by the
ASC.
- Personal privacy
- Receive care in a safe setting
- Be free from all forms of abuse, harassment or neglect.
- Confidentiality of medical record information
- Access to medical records, including current records, upon oral or written request in the form and format
requested by the individual within a reasonable timeframe. Note: The organization shall not impede the
legitimate efforts of individuals to gain access to their own clinical records and shall actively seek to meet
these requests as quickly as the record keeping system permits and ASC policy.
- Respect, dignity and comfort
- Receive information about their privacy rights and how their information can be used
- Formulate an Advance Directive
- Delegate his/her right to make informed decisions to another person
- Know if your physician has a financial interest or ownership in the center
- File a grievance
If a patient is adjudged incompetent under applicable State laws by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed under State law to act on the patient's behalf.
If a State court has not adjudged a patient incompetent, any legal representative or surrogate designated by the
patient in accordance with State law may exercise the patient's rights to the extent allowed by State law.
The patient or as appropriate the patient's representative is responsible for:
- Providing complete and accurate information to the best of his/her ability about his/her health, any
medications taken, including over-the-counter products and dietary supplements, and any allergies or
sensitivities
- Following the treatment plan prescribed by his/her provider and participating in his/her care
- Providing a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours,
if required by the provider
- Accepting personal financial responsibility for any charges not covered by insurance
- Behaving respectfully toward all the health care professionals and staff, as well as other patients
Complaint/grievance process:
If you, your representative or surrogate have a problem or complaint, please speak to the receptionist, nurse,
physician or your caregiver; we will address your concern(s). You may also contact the Facility Administrator. If
your concern cannot be immediately resolved the facility will investigate the complaint/grievance (2 weeks) and
notify you (within 5 days of the conclusion of the investigation), in writing, the outcome of the investigation.
If you are not satisfied with the response of the Surgery Center you may contact the MS Department of Health via:
- Online: Submit a report via the Make a Health Facility Complaint page.
- Phone: Call the complaint hotline at 800-227-7308 (available weekdays from 8 a.m. to 5 p.m.).
- Email: Send supporting documentation to [email protected].
- Mail: Send written details to:
Mississippi State Department of Health
Facilities Licensure
143B Lefleur's Square
Jackson, MS
You may also contact the Facility's Accrediting Organization (AO) DNV via
https://www.dnvhealthcareportal.com/patient-complaint-report
Medicare Beneficiaries who have a complaint regarding quality of care may contact the Medicare Ombudsman to
lodge a complaint.
NOTE: Role of Medicare Ombudsman is to ensure that Medicare Beneficiaries receive the information and help
them need to understand their Medicare options and to apply their Medicare rights and protections.
All Medicare beneficiaries may also file a complaint or grievance with the Medicare Beneficiary Ombudsman. Visit
the Ombudsman's webpage on the web at: https://www.cms.gov/Center/Special-Topic/Ombudsman/Medicare-Beneficiary-Ombudsman-Home