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? Introduction
? Procedure Descriptions
? Your Rights
? Your Responsibilities
? Legal Information
? Patient Guardian
? HIPAA Patient Privacy

For Patients:  Legal Information

Ownership Disclosure

The physician who referred you to this facility may have an ownership interest in this facility. You are free to choose another facility in which to receive the services that have been ordered by your physician.

Nondiscrimination Policy

This facility does not discriminate against any person on the basis of age, sex, race, color, religion, national origin, or disability in
admission, treatment, or participation in its programs, services
and activities or in employment.

Patient Grievances

The patient and family are encouraged to help the facility improve its understanding of the patient?s environment by providing feedback, suggestions, comments and/or complaints regarding the service needs, and expectations.

A complaint or grievance should be registered by contacting the center and/or a patient advocate at the Ohio Department of Health or Medicare (numbers listed below).

The surgery center will respond in writing with notice of how the grievance has been addressed.
Marcy DelVecchio R.N., Administrator
6520 West Campus Oval
New Albany, OH 43054


Ohio Department of Health Complaint Unit
246 N. High Street, 2nd FL, Columbus 43215

Medicare Beneficiary Ombudsman
1-800-MEDICARE (1-800-633-4227)
www.medicare.gov (ombudsman link is on left hand column)

The Joint Commission
One Renaissance Blvd.
Oakbrook Terrace, IL 60181

Advance Directives

In accordance with Ohio law, this center must inform you that we are not required to honor and do not honor DNR directives. A healthcare power of attorney will be honored.

If a patient should provide his/her advance directive a copy will be placed on the patient?s medical record and transferred with the patient should a hospital transfer be ordered by his/her physician.

At all times the patient or his/her representative will be able to obtain any information they need to give informed consent before any treatment or procedure.

In order to assure that the community is served by this facility, information concerning advance directives is available at the facility. While the state of Ohio does not have required a specific form for an advanced directive, sample forms are available at the center?s office. To obtain this form and information, please call (614)413-2233.

     ? 2006 Central Ohio Surgical Institute
         6520 West Campus Oval, New Albany, Ohio  43054
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