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Advanced Directives

NOTICE TO PATIENTS

Surgical Care Affiliates

Patient Rights and Responsibilities

SCA observes and respects a patient’s rights and responsibilities without regard to age, race, color, sex, national origin, religion, culture, physical or mental disability, personal values or belief systems.

  • Considerate, respectful and dignified care and respect for personal values, beliefs and preferences.
  • Access to treatment without regard to race, ethnicity, national origin, color, creed/religion, sex, age, mental disability, or physical disability. Any treatment determinations based on a person’s physical status or diagnosis will be made on the basis of medical evidence and treatment capability.
  • Respect of personal privacy.
  • Receive care in a safe and secure environment.
  • Exercise your rights without being subjected to discrimination or reprisal.
  • Know the identity of persons providing care, treatment or services and, upon request, be informed of the credentials of healthcare providers and, if applicable, the lack of malpractice coverage.
  • Expect the center to disclose, when applicable, physician financial interests or ownership in the center.
  • Receive assistance when requesting a change in primary or specialty physicians or dentists if other qualified physicians or dentists are available.
  • Receive information about health status, diagnosis, the expected prognosis and expected outcomes of care, in terms that can be understood, before a treatment or a procedure is performed.
  • Receive information about unanticipated outcomes of care.
  • Receive information from the physician about any proposed treatment or procedure as needed in order to give or withhold informed consent.
  • Participate in decisions about the care, treatment or services planned and to refuse care, treatment or services, in accordance with law and regulation.
  • Be informed, or when appropriate, your representative be informed (as allowed under state law) of your rights in advance of furnishing or discontinuing patient care whenever possible.
  • Receive information in a manner tailored to your level of understanding, including provision of interpretative assistance or assistive devices.
  • Have family be involved in care, treatment, or services decisions to the extent permitted by you or your surrogate decision maker, in accordance with laws and regulations.
  • Appropriate assessment and management of pain, information about pain, pain relief measures and participation in pain management decisions.
  • Give or withhold informed consent to produce or use recordings, film, or other images for purposes other than care, and to request cessation of production of the recordings, films or other images at any time.
  • Be informed of and permit or refuse any human experimentation or other research/educational projects affecting care or treatment.
  • Confidentiality of all information pertaining to care and stay in the center, including medical records and, except as required by law, the right to approve or refuse the release of your medical records.
  • Access to and/or copies of your medical records within a reasonable time frame and the ability to request amendments to your medical records.
  • Obtain information on disclosures of health information within a reasonable time frame.
  • Have an advance directive, such as a living will or durable power of attorney for healthcare, and be informed as to the center’s policy regarding advance directives/living will. Expect the center to provide the state’s official advance directive form if requested and where applicable.
  • Obtain information concerning fees for services rendered and the center’s payment policies.

You may contact the following entities to express any concerns, complaints or grievances you may have:

CENTER

Kim Barber, ADMINISTRATOR/CEO
(727)447-0888

STATE
AGENCY

ATTN: LUCY GEE, DIVISION DIRECTOR
FLORIDA DEPARTMENT OF HEALTH
DIVISION OF MEDICAL QUALITY ASSURANCE
CONSUMER SERVICES UNIT, BIN C75
(888) 419-3456

MEDICARE

OFFICE OF THE MEDICARE BENEFICIARY OMBUDSMAN:

www.cms.hhs.gov/center/ombudsman.asp