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Patient Rights and Responsibilities
To request and receive medically appropriate treatment and services within the center’s capacity and mission.
To receive care that respects your individual cultural, spiritual and social values, regardless of race, color, creed, nationality, age, gender, disability, or source of payment.
To receive respectful, considerate, compassionate care that promotes your dignity, privacy, safety, and comfort and that manages your pain as well as possible.
To be free from all forms of abuse or harassment.
To receive physical support. To be as free from pain and in as much control of your environment as possible.
To expect that efforts will be made to provide you with the best of care during your stay here.
To be informed – in understandable language – of the nature of your illness and treatment options, including potential risks, benefits, alternatives and costs.
To be fully informed about a treatment or procedure and the expected outcome before it is performed.
To know the identity of your caregiver. To request a second opinion or change physicians.
To accept or refuse recommended tests or treatments, to the extent the law permits. To refuse to sign a consent form if there is anything you do not understand or agree to. To change your mind about any procedure to which you have consented. To be informed of the medical consequences of refusing tests or treatments.
To be informed of any proposed research or experimental treatment that may be considered in your care, and to consent or refuse to participate in this treatment.
To expect that appropriate decision - makers will be sought in case you lack decision - making ability and have no advance directive.
To formulate advance directives regarding your healthcare. We honor a patient’s decision to have a Health Care Representative or Power of Attorney make healthcare decisions and sign consent forms. We do not honor Advanced Directives that do not allow for life-saving measures such as cardiopulmonary resuscitation (CPR) in the Indiana Hand to Shoulder Center. For more information concerning advance directives for Indiana Hand to Shoulder Center or for state information please refer to Advance Directives: Your Right to Decide.
To be assured that medical and personal information will be handled in a confidential manner. To have access to the information in your medical record. It’s up to you whether we release any information at all, other than that required by your physicians and insurance company. Your caregiver can explain this option.
To be informed of the procedure you can follow to lodge complaints with the health care provider about the care that is, or fails to be furnished and about a lack of respect for property. To lodge complaints with us call our Practice Administrator Kelly Skidmore at (317) 471-4425.
To be notified in writing about the disposition of such complaints.
To exercise your rights without being subjected to discrimination or reprisal.
To lodge a complaint with the Indiana State Department of Health or CMS: Indiana Department of Health, Division of Long Term Care, 2 North Meridian Street, 4B, Indianapolis, Indiana 46204, https://www.in.gov/isdh/28349.htm, Medicare Beneficiary Ombudsman, www.cms.hhs.gov
To request and receive information regarding your bill, including payments, insurance status, and charge explanation. To receive information regarding financial assistance and help in determining financial needs.
To be informed that in accordance with House Bill 1306, Section 26, that Dr. William B. Kleinman, Dr. Thomas J. Fischer, Dr. Robert M. Baltera, Dr. Jeffrey A. Greenberg, Dr. F. Thomas D. Kaplan, Dr. Gregory A. Merrell, Dr. Nicholas E. Crosby, Dr. Kathryn M. Peck, Dr. Reed W. Hoyer, Dr. Brandon S. Smetana, and Dr. Sameer K. Puri are part-owners of the Surgery Center, the Hand Rehabilitation Center.
To be informed that these centers are appropriate settings for providing the medical care and services for which you may be referred. Nevertheless, the selection of a specific health care provider always rests with the patient, and you may choose to be referred to an alternate setting if you so desire.
To have all patient’s rights apply to the person who may have legal responsibility to make decisions regarding your care.
It is your responsibility as an Indiana Hand to Shoulder Center Patient or client:
To provide all required personal and family health information.
To participate as best you can in making decisions about your medical treatment and carry out the plan of care agreed upon by you and your caregivers.
To ask questions of your physician or other caregivers when you do not understand your diagnosis or treatment or if you desire a transfer of care to another physician, caregiver, or facility.
To be considerate of others receiving or providing care.
To observe facility policies and procedures, including those on smoking, noise, no weapons on premises, and visitors.
To accept your financial obligations associated with your care and to provide appropriate financial information when requesting financial assistance if needed.
To be reasonable in requests for medical treatment and other services.
To advise your caregivers of any dissatisfaction you may have.
My rights and responsibilities have been provided to me verbally and in writing, and I have been given the opportunity to ask any questions concerning these rights and responsibilities.