Patient Rights and Advanced Notification

Northwest Michigan 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: 

Northwest Michigan Surgery Center
LoAnn Vande Leest, 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 NMSC 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 NMSC'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

It is our policy, regardless of the contents of any Advance Directive, that if an adverse event occurs during treatment at Northwest Michigan Surgery Center (NMSC), we will initiate resuscitative or other stabilizing measures and transfer the patient to an acute care hospital for further evaluation. At the acute care hospital, further treatment or withdrawal of treatment measures already begun will be ordered in accorance with the  patient's wishes, Advance Directive, or Health Care Power of Attorney. If you have an Advance Directive and would like a copy placed in your medical record at NMSC, we would be happy to do so. 

Asc Ownership information

Ownership of the Northwest Michigan 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. 

"Everyone was friendly from check in to discharge. I am very impressed and pleased. You have a fabulous staff. It couldn't possibly have been a better experience. "
- Claudia S.
"If procedures are necessary, it is a pleasure having them done at the Surgery Center. All processes have been well thought out and streamlined with the patient in mind. There does not seem to be any unnecessary steps or duplication of effort."
- Gary P.
"Excellent care --- and my anesthesiologist was very caring about my comfort throughout the surgery."
- Ellen L.
"Always such a nice experience here when you're having medical procedures done. It's never fun, but I try to be positive about it and the staff and docs are great. Glad to find good care here 'Up North.' "
- Heidi P.
"The follow up phone calls both from the surgeon and nurse were very comforting, and appreciated. All in all, a first class operation; thanks for your caring"
- Lee M.