This facility and medical staff have adopted the following list of patient rights and responsibilities. The list shall include, but is not limited to:

Patient Rights

  1. To receive care in a safe setting.
  2. Impartial treatment without regard to race, color, sex, national origin, religion, handicap or disability.
  3. Considerate and respectful care and to be free from all forms of abuse and harassment.
  4. Knowledge of the name of the physician who has primary responsibility for coordination of your care. All healthcare professionals practicing at the facility have had their credentials verified and have been approved to practice at the center by the Member Manager(s).
  5. To receive the necessary information about any proposed treatment or procedure in order to give informed consent or to refuse this course of treatment. Except in emergencies, this information shall include a verbal description of all the procedures, treatments, and risks involved with the treatment.
  6. To participate actively in decisions regarding your medical care. To the extent permitted by law, this includes the right to refuse treatment.
  7. Full consideration of privacy concerning your medical care program. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly.
  8. Confidential treatment of all communications and records pertaining to care. The patient’s written permission shall be obtained before medical records can make available to anyone not directly concerned with your care.
  9. Responsible responses to any reasonable requests for service.
  10. To leave the facility even against medical advice.
  11. To expect reasonable continuity of care.
  12. To be advised if the physician proposes to engage in or perform human experimentation affecting your care or treatment. The patient has the right to refuse to participate in such research projects.
  13. To be informed of the continuing health care requirements following discharge from the center.
  14. Examine and receive an explanation of a bill for service, regardless of source of payment.
  15. To have all patients’ rights explained to you or the person who has legal responsibility to make decisions regarding medical care on behalf of the patient.
  16. Express any grievances or suggestions verbally or in writing.
  17. Be informed of their right to change primary or specialty physicians if other qualified physicians are available.
  18. Provide appropriate information regarding malpractice insurance coverage.
  19. You may exercise these rights without fear of discrimination or reprisal.

Responsibilities of Patient

  1. Provide complete and accurate information to the best of his/her ability about his/her health care, which includes ALL medications, including over-the-counter products and dietary supplements, and any allergies or sensitivities.
  2. Follow the treatment plan prescribed by his/her provider.
  3. Provide a responsible adult to transport him/her from the facility and to remain with him/her for 24 hours, if required by his/her provider.
  4. Inform his/her provider about any living will, medical power of attorney, or other directive that could affect his/her health.
  5. Accept personal financial responsibility for any charges not covered by his/her insurance.
  6. Be respectful of all the health care providers and staff, as well as other patients.

Responsibilities of Visitors

  1. Be respectful of all health care providers and staff as well as other patients.
  2. All visitors are to remain in waiting area during friend/family member’s procedure.
  3. If authorized by patient, the provider will review your friend/family member’s procedure results and home instructions.
  4. As designated responsible adult, you will transport him/her from the facility and remain with him/her for 24 hours. If required by his/her provider.

Living Will and Durable Power of Attorney

The center will accept your Advanced Directive, but per policy we DO NOT honor Advanced Directives. Due to the nature of care provided at the center, we do not anticipate and incurable, irreversible condition caused by injury, disease or illness to arise. If you wish information about Advanced Directives we will gladly assist you or you can go online at http:www.doh.wa.gov/living will/default.htm

Physician Ownership Disclosure Form

In accordance with federal ASC Regulations (42C.F. & 416.50 (a) (ii), the following ownership disclosure is made in advance of the date of the procedure.
Advanced Endoscopy Center, PLLC is owned and operated by Dr. Samuel Sim.
You have the right to be treated at another health care facility such as Legacy Salmon Creek.

We are interested in hearing from you about our services. If you have a COMPLAINT, please feel free to contact us about your complaint.

Address complaints to: Nurse Manager
2415 NE 134th St., Suite 205
Vancouver, WA 98686
Phone: 360-576-5060
Fax: 360-576-1133

Complaints can also be filed with the following state and federal agencies:

HSQA Complaint Intake
PO BOX 47857
Olympia, WA 98504-7857
Phone: 360-236-4700
Fax: 360-236-2626
Email: HSQAComplaintIntake@doh.wa.gov

Office of the Medicare Beneficiary Ombudsman:
www.medicare.gov/omsbudsmand/resources.asp

Medicare Help and Support: 1-800-MEDICARE