PATIENT RIGHTS

Casco Bay Endoscopy Center and staff have adopted the following statement of patient rights. This list shall include but not be limited to the patient’s right to:

• Become informed of his/her rights as a patient in advance of or when discontinuing the provision of care. The patient may appoint a representative to receive this information should he/she so desire.  The patient may exercise these rights without discrimination or reprisal.
• Exercise these rights without regard to gender, cultural, economic, educational, religious background, reprisal or the source of payment for care.
• Considerate and respectful care with concern for personal privacy, provided in a safe environment, free from all forms of abuse or harassment with protection of clinical records.
• Remain free from seclusion or restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience or retaliation by staff.
• Knowledge of the name of the physician who has primary responsibility for coordinating his/her care and the names and professional relationships of other physicians and healthcare providers who will see him/her.
• Receive information from his/her physician about his/her illness; his/her course of treatment and his/her prospects for recovery in terms that he/she can understand.
• Receive as much information about any proposed treatment or procedure and the expected outcome in order to give informed consent or to refuse the course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved in the treatment, alternate course of treatment or non-treatment and the risks involved in each and to know the name of the person who will carry out the procedure or treatment.
• Participate in the development and implementation of his/her plan of care and actively participate in decisions regarding his/her medical care. To the extent permitted by law, this includes the right to request and/or refuse treatment.
• Formulate advance directives regarding his/her healthcare and have endoscopy staff and practitioners who provide care in the Endoscopy Center comply with these directives to the extent provided by state laws and regulations. Under Maine law, the term “advance directive’ means any spoken or written instructions you give about the healthcare you want if a time comes when you are too ill to decide.
• If they have an Advance Directive having a “Do Not Resuscitate” request in place, meet with the physician after the admitting process for a detailed discussion to review his/her desires of treatment should an unforeseen circumstance develop. If resuscitation or treatment for an acute occurrence during the procedure is refused by the patient, the procedure will not be done. Alternative arrangements will be made.  
• Have a family member or representative of his/her choice notified promptly of his/her admission to the Endoscopy Center.
• Full consideration of privacy concerning his/her medical care program. Case discussion, consultation, examination and treatment are confidential and should be conducted discretely. The patient has the right to be advised as to the reason for the presence of any individual involved in his/her care.
• Confidential treatment of all communications and records pertaining to his/her care and his/her stay in the Endoscopy Center. His/her written permission will be obtained before his/her medical records can be made available to anyone not directly concerned with his/her care.
• Access information contained in his/her medical record within a reasonable time frame (usually within 48 hours of request).
• Reasonable responses to any reasonable request he/she may make for service.
• Leave the Endoscopy Center even against the advice of his/her physician.
• Reasonable continuity of care and to know in advance the time and location of appointment as well as the physician providing the care.
• Be advised of the Endoscopy Center grievance process, should he/she wish to communicate a concern regarding the quality of the care he/she receives or if he/she feels determined discharge time is premature. To file a grievance, a patient should contact the Practice Manager. After a grievance has been filed, the patient will be provided with a written notice of the grievance determination that contains the name of the Endoscopy Center contact person, the steps taken on his or her behalf to investigate the grievance, the results of the grievance and the grievance completion date.
• Be advised if Endoscopy Center/personal physician proposes to engage in or perform human experimentation affecting his/her care of treatment. The patient has the right to refuse to participate in such research projects.
• Be informed by his/her physician or a delegate of his/her physician of the continuing healthcare requirements following his/her discharge from the Endoscopy Center.
• Examine and receive an explanation of his/her bill regardless of source of payment.
• Know which Endoscopy Center rules and policies apply to his/her conduct while a patient.
• Have all patient’s rights apply to the person who may have legal responsibility to make decisions regarding medical care on behalf of the patient.
• Know the Endoscopy Center is owned by Harold H. Sullivan, Jr, MD, MPH and he is the sole LLC member.
• Know that complaints may be directed to State of Maine, Department of Human Services, Division of Licensing and Certification, 442 Civic Center Drive, 11 State House Station, Augusta, Maine, 04333-0011, telephone (207) 287-9308, attention Cheryl Sherwood &/or www.medicare.gov/ombudsman/resources.asp.

PATIENT RESPONSIBILITIES

• The patient has the responsibility to provide accurate and complete information concerning his/her present complaints, past illnesses and hospitalization and other matters relating to his/her health.
• The patient is responsible for making it known whether he/she clearly comprehends the course of his/her medical treatment and what is expected of him/her.
• The patient is responsible for following the treatment plan established by his/her physician, including the instruction of nurse and other health professionals as they carry out the physician’s orders.
• The patient is responsible for keeping appointments and for notifying the Endoscopy Center or physician when he/she is unable to do so.
• The patient is responsible for his/her actions should he/she refuse treatment or not follow his/her physician’s orders.
• The patient is responsible for assuring that the financial obligations of his/her Endoscopy Center care are fulfilled as promptly as possible.
• The patient is responsible for following Endoscopy Center policies and procedures.
• The patient is responsible for being considerate of the rights to other patients and Endoscopy Center personnel.
• The patient is responsible for being respectful of his/her personal property and that of other persons in the Endoscopy Center.

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