The patient has the right to:

1. Treatment without regard to race, sex, cultural, economic, educational, religious background or the source of payment for their care.
2. Considerate, respectful care and ensuring the right to personal privacy. All patient’s have the basic right to respect, dignity and comfort including at a minimum, that patient’s have privacy during personal hygiene activities, during medical/surgical treatments/procedures and when requested as appropriate. A patient’s right to privacy may be limited in situations where a person must be continuously observed such as when there is an emergency and transfer to a hospital is pending.
3. The knowledge of the name of the physician who has primary responsibility for coordinating their care and the names and professional relationships of other physicians who will see them.
4. Receive information from his physician about their illness, their course of treatment and their prospects for recovery in terms they can understand. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient or to a legally authorized person.
5. Receive the necessary information about any proposed treatment or procedure to give informed consent or to refuse this course of treatment. Except in emergencies, this finromation shall include a description of the procedure or treatment, the medically significant risks involved with this treatment, alternate course of treatment, or non-treatment risks involved in each, and the name of the person who would carry out the treatment procedure.
6. Participate active in decisions regarding their medical care. To the extent permitted by law, this includes the right to refuse treatment without being subjected to discrimination or reprisal.
7. Full consideration of privacy concerning their medical care program. Case discussion, consultation, examination and treatment are confidential and shall be conducted discreetly. The patient has the right to be advised as to the reason for the presence of any individual.
8. Confidential treatment of all communications are record pertaining to their care. Their written permission shall be obtained their medical records are made available to anyone not participating with their care.
9. Reasonable responses to any reasonable request they make for services.
10. Reasonable continuity of care and to know in advance the time and location of appointments as well as the physician providing the care.
11. Be advised if the physician proposes to engage in or perform human experimentation affecting his care or treatment. The patient has the right to refuse to participate in such research projects.
12. Be informed by his physician or designee of their continuing health care requirements.
13. Examine and receive an explanation of his bill regardless of source of payment.
14. Have all patients rights explained to the person who has legal responsibility to make decisions regarding medical care on behalf of the patient.
15. Express any grievances or suggestions verbally or in writing to the Administrator or Medical Director. Complaints may also be reported to the Department of Health and Human Services at (909) 383-4777, 464 W. 4th Street, Ste 530, San Bernardino, CA 92401. Attn: Complaints Dept. OR https://www.medicare.gov/claims-appeals/your-medicare-rights/get-help-with-your-rights-protections
16. The patient has the right to receive care in a safe setting. The staff at the surgery center will follow current standards of practice for patient environmental safety, infection control and security.
17. The patient has the right to be free from all forms of abuse and harassment. The surgery center will prohibit from all forms of abuse, neglect and harassment from staff, other patients or visitors. Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish or mental illness and neglect is a failure to provide goods and services necessary to avoid physical harm, mental anguish or mental illness. Harassment is defined as an unpleasant or hostile situation especially by uninvited and unwelcome verbal or physical conduct.
18. The patient has the right to have all necessary information available to them in a manner that is thorough and understandable , within reason, to either the patient or their representative.
19. It is the policy of the Surgery Center, regardless of the contents of any advance directive or instructions from a health care surrogate or attorney in fact, that if an adverse event occurs during your treatment at the Surgery Center, the personnel at the Surgery Center will initiate resuscitative or other stabilizing measures and transfer you to 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 accordance with your wishes, advance directive, or health care power of attorney. Advance Directives and information regarding Advanced Directives will be made available to all patients.

As required by California law found in Business and Professional code section 654.2, this notice is to inform you that the physicians listed below have a 5% or greater ownership interest in this surgery center, Mountain View Surgery Center and medical clinics. We maintain this interest in order to ensure that we provide the highest quality of service at competitive prices. There may be other organizations form which you can obtain these services. You should consult the Yellow Pages of a local telephone directory or your insurance if you wish to obtain the names of such alternative organizations.

Revised June 2020