San Diego Outpatient Surgical Center is very pleased that you and your doctor will be with us for your surgery. Our facility is designed, equipped and staffed to provide you with a comfortable and safe environment for your outpatient surgery. Our anesthesiologists and nursing staff are highly qualified, licensed health care professionals.
Because of significant advances in medical technology, we can offer you the services you need without an overnight stay in the hospital. You can go home the same day you have surgery and recover in the supportive and familiar surroundings of your own home.
The following information has been put together for your convenience, health and safety. PLEASE READ IT CAREFULLY.
If you have any additional questions or concerns, our well-informed staff is ready and willing to help you prepare for your visit to the Center. Our business office is open from 7:00 a.m. to 5:00 p.m. weekdays.
Patient Rights & Responsibilities were established with the expectation that observance of these rights will contribute to more effective patient care and greater satisfaction for the patient, family, physician and facility providing services. Patients shall have the following rights and responsibilities without regard to age, race, gender, sexual orientation, national origin, cultural, economic, educational or religious background, physical handicap, personal values, belief systems or the source of payment for care.
Receive the care necessary to help regain or maintain his or her maximum state of health and, if necessary, cope with an adverse outcome.
Expect personnel who care for the patient to be friendly, considerate, respectful and qualified through education and experience to perform the services for which they are responsible with the highest quality of service. The patient has the right to be advised as to the credentials of health care professionals and the reason for the presence of any individual.
Expect full recognition of individuality, including personal dignity and privacy in treatment and care. In addition, all communications will be handled with discretion and records will be confidentially kept.
Complete information, to the extent known by the physician, regarding diagnosis, evaluation, treatment and prognosis, as well as alternative treatments or procedures and the possible risks and side effects associated with treatment. The patient has the right to be informed by the physician or designee of continuing health care requirements, including reasonable provisions for the time and location of next appointments. When it is medically inadvisable to give such information to the patient, it will be provided to the patient’s designated or legally authorized representative.
Be fully informed of the scope of services available at the facility, provisions for after-hours and emergency care and payment policies.
Be a participant in decisions regarding the intensity and scope of treatment. If the patient is unable to participate in those decisions, the patient’s rights shall be exercised by the patient’s designated representative or other legally designated person.
Make informed decisions regarding his or her care, except when such participation is contraindicated for medical reasons.
Refuse treatment to the extent permitted by the law and be informed of the medical consequences of such refusal. The patient accepts responsibility for his or her actions should he or she refuse treatment or not follow the instructions of the physician or facility.
Approve or refuse the release of medical records to any individual outside the facility, except in the case of transfer to another health facility, or as required by law or third-party payment contract.
Be informed of any human experimentation or other research/educational projects affecting his or her care or treatment and can refuse participation in such experimentation or research without compromise to the patient’s usual care.
Express grievances/complaints or suggestions at any time, verbally or in writing.
Change primary or specialty physicians or dentist if other qualified physicians or dentists are available.
Provide patient access to and/or copies of his or her individual medical records or billing information regardless of the source of payment.
Be informed as to the facility’s policy regarding advance directives/living wills.
Be fully informed before any transfer to another facility or organization, except when an emergency situation prevents it.
Express those spiritual beliefs and cultural practices that do not harm others or interfere with the planned course of medical therapy for the patient.
Have an initial assessment and regular reassessment of pain.
Receive educational information and instruction for patient and families, when appropriate, regarding their roles in managing pain, as well as potential limitations and side effects of pain treatment while considering personal, cultural, spiritual and/or ethnic beliefs in communicating to them and their families that pain management is an important part of care.
Being considerate of other patients, providers and personnel, following facility rules, such as a no smoking policy, and for assisting in the control of noise and other distractions.
Respecting the property of others and the facility.
Reporting whether he or she clearly understands the planned course of treatment, what is expected of him or her and the presence of any directives that could affect care.
Keeping appointments and providing a responsible adult to transport and give aftercare, as required by the provider, and, when unable to do so for any reason, notifying the facility and physician.
Providing caregivers with the most accurate and complete information regarding present complaints, past illnesses and hospitalizations, medications, including over-the counter products and dietary supplements, any known allergies or sensitivities, unexpected changes in the patient’s condition or any other patient health matters.
Observing rules of the facility during his or her stay and following the treatment plan prescribed by the providers and, if such instructions are not followed, forfeiting the right to care at the facility and being responsible for the outcome.
Accepting and promptly fulfilling his or her financial obligations to the facility.
Persons who have a concern or grievance regarding San Diego Outpatient’s decisions regarding admission, treatment, discharge, denial of services, quality of services, courtesy of personnel or any other issue are encouraged to contact the Administrator in person, by phone (619-299-9530) or in writing to:
San Diego Outpatient Surgical Center
3939 Ruffin Road, Suite 101
San Diego, CA 92123
San Diego Outpatient is Medicare Certified. Any complaints regarding services provided at the facility can be directed in writing or by phone to:
Department of Public Health
San Diego District Manager
7575 Metropolitan Drive, Suite 211
San Diego, CA 92108
Medicare patients may visit the following website to understand their rights and protections: www.cms.hhs.gov/center/ombudsman.asp
San Diego Outpatient is owned and operated by a group of local surgeons. Your doctor may have an ownership interest in this facility. If this is a concern to you, please discuss it with your surgeon and be aware that you have the option to schedule your procedure at another facility.
An “Advance Directive” is a general term that refers to your oral and written instructions about your future medical care, in the event that you become unable to speak for yourself. Each state regulates the use of advance directives differently. There are two types of advance directives: a living will and a medical power of attorney. If you would like a copy of the official State advance directive forms you may download them from: www.calhealth.org
Although the elective, outpatient procedures performed at the Surgery Center are considered to be of minimal risk, no surgery is without risk. You and your surgeon will have discussed the specifics of your procedure and the risks associated with it, the expected recovery and the care after your surgery.
It is the policy of this 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 here, the personnel at the Surgery Center will initiate resuscitative or other stabilizing measures and transfer you to an acute care hospital for further evaluation. The center will only take a copy of your Advance Directive for your chart in order to send it along with you to an acute care hospital for further treatment or withdrawal of treatment measures already begun, in accordance with your wishes, advance directive or health care power of attorney.
On the day of surgery, patients will be asked to sign a statement indicating that they received all of the above information on patient rights, patient responsibilities, advance directive policy, physician disclosure and grievance policy in advance of surgery.
San Diego Outpatient Surgical Center Notice of Privacy Practices for Protected Health Information
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Please review it carefully!
With your consent, San Diego Outpatient Surgical Center is permitted by federal privacy laws to make uses and disclosures of your health information for purposes of treatment, payment and health care operations. Protected health information is the information we create and obtain in providing our services to you. Such information may include documenting your symptoms, examination and test results, diagnoses, treatment and applying for future care or treatment. It also includes billing documents submitted for those services.
Treatment information about you is recorded in a health record. During the course of your treatment, the doctor determines a need to consult with another specialist concerning your care. The doctor will share the information with such a specialist and obtain input.
We submit a request for payment to your health insurance company. The health insurance carrier requests additional information from us regarding the care given. We will provide that information to them about you.
We obtain services from our insurers or other business associates such as quality assessment, quality improvement, outcome evaluation, protocol and clinical guidelines development, training programs, credentialing, medical review, legal services and insurance. We will share information about you with such insurers or other business associates as necessary to obtain these services. This will be done with all identifying information removed whenever possible; however, on occasion, information about you and your care may be revealed.
The health record and billing records we maintain are the physical property of the facility. The information in it, however, belongs to you. You have a right to:
Request a restriction on certain uses and disclosures of your health information by delivering the request in writing to our office. We are not required to grant the request, but we will comply with any request granted;
Request that you be allowed to inspect and copy your health record and billing record. You may exercise this right by delivering the request in writing to our office;
Appeal a denial of access to your protected health information, except in certain circumstances;
Request that your health care record be amended to correct incomplete or incorrect information by delivering a written request to our center;
File a statement of disagreement if your amendment is denied, and require that the request for amendment and any denial be attached in all future disclosures of your protected health information;
Obtain an accounting of disclosures of your health information as required to be maintained by law by delivering a written request to our center. An accounting will not include internal uses of information for treatment, payment, or operations, disclosures made to you or made at your request, or disclosures made to family members or friends in the course of providing care;
Request that communication of your health information be made by alternative means or at an alternative location by delivering the request in writing to our center; and,
Revoke authorizations that you made previously to use or disclose information, except to the extent information or action has already been taken, by delivering a written revocation to our center.
If you want to exercise any of the above rights, please contact our facility administrator, in person or in writing, during normal hours. Our administrator will provide you with assistance on the steps to take to exercise your rights.
San Diego Outpatient Surgical Center
3939 Ruffin Road, Suite 101
San Diego, CA 92123
The center is required to:
Maintain the privacy of your health information as required by law;
Provide you with a notice of our duties and privacy practices as to the information we collect and maintain about you;
Abide by the terms of this Notice;
Notify you if we cannot accommodate a requested restriction or request; and
Accommodate your reasonable requests regarding methods to communicate health information with you.
We reserve the right to amend, change, or eliminate provisions in our privacy practices and access practices and to enact new provisions regarding the protected health information we maintain. If our information practices change, we will amend our Notice. You are entitled to receive a revised copy of the Notice by calling and requesting a copy of our “Notice” or by visiting our center and picking up a copy.
If you have questions, would like additional information, or want to report a problem regarding the handling of your information, you may contact our Administrator as stated above.
Additionally, if you believe your privacy rights have been violated, you may file a written complaint at our facility by delivering the written complaint to our Administrator. You may also file a complaint by mailing it or e-mailing it to the Secretary of Health and Human Services whose street address and e-mail address is:
Office of Civil Rights – Federal Office Building
U.S. Department of Health & Human Services
50 United Nations Plaza – Room 322
San Francisco, CA 94102
We cannot, and will not, require you to waive the right to file a complaint with the Secretary of Health and Human Services (HHS) as a condition of receiving treatment from the center.
We cannot, and will not, retaliate against you for filing a complaint with the Secretary.
Other Disclosures and Uses
Unless you object, we may use or disclose your protected health information to notify, or assist in notifying, a family member, personal representative or other person responsible for your care, about your location and about your condition.
If you do not object or in an emergency situation, we may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person’s involvement in your care or regarding payment for such care.
We may disclose to the FDA your protected health information relating to adverse events with respect to products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.
If you are seeking compensation through Workers Compensation, we may disclose your protected health information to the extent necessary to comply with laws relating to Workers Compensation.
As required by law, we may disclose your protected health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
We may disclose your protected health information to public authorities as allowed by law to report abuse or neglect.
If you are an inmate of a correctional institution, we may disclose to the institution, or its agents, your protected health information necessary for your health and the health and safety of other individuals.
We may disclose your protected health information for law enforcement purposes as required by law, such as when required by a court order, or in cases involving felony prosecutions, or to the extent an individual is in the custody of law enforcement.
Federal law allows us to release your protected health information to appropriate health oversight agencies or for health oversight activities.
We may disclose your protected health information in the course of any judicial or administrative proceeding as allowed or required by law, with your consent, or as directed by a proper court order.
Other uses and disclosures besides those identified in this Notice will be made only as otherwise authorized by law or with your written authorization and you may revoke the authorization as previously provided.
If we maintain a website that provides information about our entity, this Notice will be on the website.
Effective Date: APRIL 14, 2003