Copper Ridge Surgery Center     Patient's Bill of Rights

Your Rights

1. Considerate, respectful care at all times and under all circumstances with recognition of your personal dignity.
2. Personal and informational privacy within the law.
3. Be fully informed about your diagnosis, treatment, and prognosis to the degree known.
4. Confidentiality of records and disclosures. Except when required by law, you have the right to approve or refuse the release of records.
5. The opportunity to participate in decisions involving your health care, including the right to accept or refuse medical or surgical treatment, unless contraindicated by concerns for your health.
6. Change primary or specialty physician or dentist if others are available.
7. Information concerning implementation of any advance care directive.
8. Impartial access to treatment regardless of race, color, sex, national origin, religion, handicap or disability. (The Surgery Center adheres to all Federal and State rules, regulations, and policies to promote a safe and non-discriminatory environment for all of our guests).
9. Request information on fees for services or payment policies and receive a bill for services upon request.
10. Know the identity and professional status of individuals providing service to you.
11. Report any comments concerning the quality of services provided to you during the time spent at the facility and receive fair follow-up on your comments, complaints or grievances without discrimination or reprisal.
12. If adjudged incompetent under applicable state health and safety laws by a court of proper jurisdiction, your rights will be exercised by the person appointed under state law to act on your behalf.
13. If not adjudged incompetent, any legal representative or surrogate designated by you in accordance with state laws may exercise your rights to the extent allowed by state law.
14. Exercise any and all of these rights without being subjected to discrimination or reprisal.

Your Responsibilities

1. Providing to the best of your knowledge, accurate and complete information about your present health status and past medical history and reporting any unexpected changes to the appropriate practitioner(s).
2. Following the treatment plan recommended by the primary practitioner involved in your case.
3. Providing an adult to transport you home after surgery and an adult to be responsible for you at home for the first twenty-four (24) hours after surgery.
4. Indicating whether you clearly understand a contemplated course of action and what is expected of you.
5. Your actions if you refuse treatment, leave the facility against the advice of the practitioner, and/or do not follow the practitioner's instructions relating to your case.
6. Assuring that the financial obligations of your health care are fulfilled as expediently as possible.
7. Providing information about and/or copies of any living will, power of attorney or other directives that you desire us to know about.
8. Being respectful of all healthcare providers and staff as well as other patients.

SUBMISSION AND INVESTIGATION OF GRIEVANCES

If you have any concerns regarding your rights and responsibilities, or if you have any complaints or grievances on how these rights were or were not administered, please contact the Civil Rights Coordinator who will investigate your issue. The Civil Rights Coordinator can be reached at: 

Copper Ridge Surgery Center
Tina Piotrowski, CEO
4100 Park Forest Drive
Traverse City, MI 49684
(231) 392-8900

You may also register complaints with the state of Michigan through the following: 

Michigan Department of Licensing and Regulatory Affairs
Bureau of Community and Health Systems
Health Facility Complaints
P.O. Box 30664 
Lansing, MI 48909

E-mail: BHCS-Facility-Complaints@michigan.gov
Hotline: (800) 882-6006

Or with the Office of the Medicare Beneficiary at: 
1-(800)-MEDICARE or 
www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

Discrimination is against the law

If you feel that CRSC has failed to provide these services or discriminated in any other way on the basis of race, color, national origin, age, disability, sex, or religion, in addition to contacting CRSC's Civil Rights Coordinator, you can contact the Office of Civil Rights (OCR) in one of three ways: 

1. Via e-mail to ocrcomplaint@hhs.com
2. Via web portal at https://ocrportal.hhs.gov/ocr
3. Via mail or phone at: 
   
   Centralized Case Management Operations
   U.S. Department of Health and Human Services
   200 Independence Avenue SW
   Room 509F
   Washington, DC 20201
   1-(800)-368-1019 or 1-(800)-537-7697 (TDD)

other important information

information about advance directives

CRSC recognizes the right of each patient to participate in decision-making concerning their medical treatment, including the right to give informed consent or informed refusal of medical care. CRSC will, to the best of our ability, honor any legally executed Advance Directives presented; however, patients with a DNR order will be asked to reconsider this order prior to entering the pre-operative area. 

Asc Ownership information

Ownership of the Copper Ridge Surgery Center is as follows:

49% Munson Medical Center
51% ASC Partnership, LLC

ASC Partnership, LLC is composed of a group of area physicians who provide medical and surgical care to patients of all ages in the Grand Traverse Area and beyond.