It is the policy of Michigan Institute for Advanced Surgery that each patient cared for shall have the following Rights and Responsibilities that are within Michigan Institute for Advanced Surgery’s capacity, mission, and law application. We believe that a patient who understands and participates in his or her health care may achieve better results. Michigan Institute for Advanced Surgery prepared these Rights and Responsibilities for your benefit.


Your rights as a patient include:

Access to Care

You have the right to be treated by personnel who are qualified through education and experience to perform the services for which they are responsible. You have the right to be treated, when accommodations are available and treatment is medically indicated; regardless of race, religion, culture, creed, sex, national origin, age, handicap, marital status, sexual preference, or sources of payment.

Respect/Dignity

You have the right to have your dignity as an individual human being recognized and respected. Your care will include consideration of your Advance Directives, psychosocial, spiritual, and cultural needs that may influence the perceptions of illness. You as a patient or your representative may exercise your rights without the fear of discrimination or reprisal. You as a patient have the right to be free from all forms of abuse or harassment.

Privacy

You are entitled to privacy, to the extent possible, during any patient/staff interview, discussions about your care, as well as in the course of treatment to be followed. You are entitled to confidential treatment of personal and medical records, and may refuse their release to a person outside the health facility or agency except as required because of a transfer to another health care facility, as required by law or third party payment contract, or as permitted or required under the health insurance portability and accountability act of 1996, Public Law 104-191, or regulations under that act 45 CFR parts 160 and 164.

Care Plan

Your physician will provide you with appropriate care, information about your medical condition, proposed course of treatment and prospects for recovery. You have the right to be fully informed before transfer to another facility. Refusal of Medical or Surgical Treatment: You are entitled to refuse medical or surgical treatment to the extent provided by law and to be informed of the consequences of that refusal. When a refusal of treatment prevents the physician or staff from providing appropriate care according to ethical and professional standards, the relations with the patient may be terminated.

Personal Safety

You have the right to expect reasonable safety.

Information

As an individual who is or has been a patient, you are entitled to inspect, or receive for a reasonable fee, a copy of your medical record upon request in accordance with the medical records access act, 2004 PA 47, MCL 333.26261 to 333.26271. Except as otherwise permitted or required under the health insurance portability and accountability act of 1996, Public Law 104-191, or regulations promulgated under that act, 45 CFR parts 160 and 164. A third party shall not be given a copy of your medical record without your prior written authorization except as required by law:

  • Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care.
  • Right to Amend. If you feel that the medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the office.
  • Patient Advocate. You have the right to have your designated representative participate in your care.
  • Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you.
  • Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.
  • Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail
  • Right to a Paper Copy of the Privacy Notice. You have the right to a paper copy of our Privacy Notice.
  • Quality Improvement Information. You have the right to request information regarding Michigan Institute for Advanced Surgery’s Quality Improvement Program, including information on progress towards meeting quality improvement goals.
  • Preventive Health. Michigan Institute for Advanced Surgery will provide you with copies of, and/or information regarding, preventive health guidelines. If a preventive health guideline is not provided, you have the right to request a copy. Michigan Institute for Advanced Surgery is dedicated to informing and encouraging our patients to utilize available health promotion, health education and preventive health services.

Pain

Your reports of pain will be acknowledged and assessed. You will be provided with information about pain, pain relief measures, and effective pain management, as appropriate.

Decisions Involving Your Care are Based on Appropriateness of Care and Services

You have the right to be fully informed of the scope of services available at Michigan Institute for Advanced Surgery, provisions for emergency care, and related fees for services rendered. You have the right to be provided to the extent known by the physician, complete information regarding diagnosis, treatment and the prognosis, as well as alternative treatments or procedures and the possible risks and side effects associated with treatment. You have the right to continuing medical services throughout the period of need. The plan for these services will be timely and will involve appropriate personnel and community resources. You have the right to change your provider if other qualified providers are available.


Your responsibilities as a patient include:

Honesty

You are responsible for being honest and direct about everything that is related to you as a patient. You must provide to the best of your knowledge complete and accurate medical history including information about present complaints, past illnesses, hospitalizations, medications including over-the-counter and dietary supplements and allergies. You are responsible to inform your caregiver about any Living Will, Medical Power of Attorney or other directive that could affect your care.

Understanding

You are responsible for understanding your health problems to your own satisfaction. If you do not understand your illness or treatment, ask the doctors and staff to explain it to you.

Following Your Treatment Plan

It is your responsibility to tell those treating you whether you can and/or want to follow a certain treatment plan. Remember that your health is your own responsibility. Following your doctor’s instructions/advice is very important. You must have a responsible adult to drive you home after your procedure. Your procedure will be cancelled if you do not have a driver. Having a responsible adult accompany you home in a taxi is also acceptable. A responsible adult is to remain with you for 24 hours following your procedure.

Refusal of Treatment

You are responsible for your actions if you refuse treatment. You do have that right, but you also can change your mind. We respect you and your decisions. Reporting Changes: It is your responsibility to let us know about any changes in your health and how you feel as you receive medical treatment. Providing Requests for Information in Writing: It is your responsibility, when you request information from us that you provide it in writing. If you need a copy of a sample letter, please ask the office.

Appointments

You are responsible for keeping appointments, and when unable to do so for any reason, for notifying Michigan Institute for Advanced Surgery.

Charges

You are responsible for providing Michigan Institute for Advanced Surgery with accurate and timely information about your sources of payment and ability to meet financial obligations. You are responsible to accept personal financial responsibility for any charges not covered by your insurance.

Respect and Consideration

You are responsible for being considerate to your doctor and staff and other Michigan Institute for Advanced Surgery patients. You are responsible for observing rules Michigan Institute for Advanced Surgery and if instructions are not followed, you may forfeit care provided to you at Michigan Institute for Advanced Surgery.

Pain

As a patient at Michigan Institute for Advanced Surgery, we expect that you will ask your doctor or nurse what to expect regarding pain and pain management. Discuss pain relief options with your doctors and nurses. It is important that you ask for pain relief when your pain first begins. Help your doctor and nurse assesses your pain. Tell your doctor or nurse if your pain is not relieved, and tell your doctor or nurse about any worries you have about taking pain medication.

Complaints or Suggestions for Improvement

You, our patient, are our primary concern. We want to make your care at Michigan Institute for Advanced Surgery as pleasant as possible. If you are dissatisfied with the care or services that you receive, or if you feel that your privacy rights have been violated, you have the right to initiate the complaint process and discuss your concerns with the Executive Director or your physician. You may also file a complaint to:

Medicare Beneficiary Ombudsman

1-800-MEDICARE (800-633-4227)
www.cms.hhs.gov/center/ombudsman.asp

Michigan Department of Licensing and Regulatory Affairs

PO Box 30664
Lansing, MI 48909
1-800-882-6006

Physician Disclosure of Ownership

The following individuals and corporations are investors at Michigan Institute for Advanced Surgery: Michigan Knee Institute, LLC; Crittenton Development Corporation; M.P.Donahue D.O.,PLLC; MJB Hand Surgery, LLC; Smithfield Surgical Partners; Andrew P. Ciarlone, DO; Matthew R. Prince, DO; Outpatient Joints, PLLC; Comfortable Living; Jon Hain, MD; Ryan Siwiec, DO; Sabry Mansour, MD; Mark Weingarten, MD; Gouri Pimputkar, DO;.

Advance Directives

An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions. It is our policy that we do not honor living wills at Michigan Institute for Advanced Surgery. In all instances of emergency or life threatening situations, life-sustaining treatment will be instituted and patients will be transferred to a higher level of care. We will honor Health Care Representatives and Durable Power of Attorneys.