PATIENT RIGHTS AND RESPONSIBILITIES
You have the right to:
- To receive care regardless of your age, race, color, national origin, culture, ethnicity, language,socioeconomic status, religion, physical or mental disability, sex, sexual orientation, or gender identity or expression.
- Have a family member (or another chosen representative) notified promptly of your admission to a hospital in case of an emergency.
- Know the name of the physician primarily responsible for coordinating your care and the terms and professional relationships of other physicians, physical therapists, and other health care providers who will be involved in your care and treatment.
- Make decisions about medical care and receive as much information about any proposed treatment or procedure as you may need to give informed consent or refuse a course of treatment. Except in emergencies, this information shall include a description of the procedure or treatment, the medically significant risks involved, alternate courses of treatment or non-treatment, the risks involved in each, and the name of the person who will conduct the procedure or treatment.
- Request or refuse treatment to the extent allowed by law. However, this does not give you the right to demand inappropriate or medically unnecessary treatment or services.
- If a conflict arises about treatment decisions that cannot be adequately resolved, you have the right to find another provider.
- Be fully informed if asked to participate in any clinical research. You have the right to refuse to take part in such research projects.
- Reasonable responses to any reasonable requests made for service.
- Formulate advance directives to appoint a decision-maker if you become mentally incapacitated or unable to communicate your wishes about care. Facility staff and practitioners who supply care at Synergy Orthopedics shall follow these directives. All patients’ rights apply to the person with the legal responsibility to make decisions about medical care on your behalf.
- Your consultation, examination, and treatment are confidential and should be conducted discreetly. You have the right to be told the reason for the presence of any individual. You have the right to have a guest leave before an examination or when treatment issues are discussed. Privacy curtains will be used in semi-private rooms.
- Confidential treatment of all communications and records about your care and stay in the facility. You will receive a separate “Notice of Privacy Practices” detailing your privacy rights and how Synergy Orthopedics may use and disclose your protected health information.
- Receive care safely, free from mental, physical, sexual, or verbal abuse, neglect, exploitation, or harassment. You can access protective and advocacy services, including notifying government agencies of neglect or abuse.
- Be free from restraints and seclusion of any form as a means of coercion, discipline, convenience, or retaliation by staff.
- Reasonable continuity of care and knowing in advance the time and location of appointments and the identity of the person(s) providing the care.
- Be informed by the physician, or delegate of the physician, of continuing health care requirements and options following discharge from the facility. You have the right to be involved in developing and implementing your discharge plan. Upon your request, a friend or family member may also be provided with this information.
- Be informed of which Synergy Orthopedics rules and policies apply to your conduct while you are a patient.
- Bring a guest of your choice during your visit.
- Have a guest or segregate that will speak on your behalf during your visit.
- Examine and receive an explanation of your medical bill, regardless of the payment source.
- Request the services of an interpreter at no cost to you if you have limited English skills or are hearing impaired.
- Receive information about your health status, diagnosis, prognosis, course of treatment, prospects for recovery, and outcomes of care (including unanticipated consequences) in the language you can understand. You have the right to effective communication and to participate in developing and implementing your plan of care. You have the right to participate in discussions concerning ethical questions during your care, including conflict resolution, withholding resuscitative services, and forgoing or withdrawing life-sustaining treatment.
- Assessment and management of pain, information about pain, pain relief measures, and taking part in pain management decisions. You may request or reject using all modalities to relieve pain, including opiate medication if you suffer from severe or chronic intractable pain. The physician may refuse to prescribe the opiate drug. If so, refer you to a physician willing to assess you for the appropriateness of opioid medication or offer you a referral to the pain service for evaluation.
- Have the right to transparency of standard charges under the 2019 CMS guidelines.
- Exercise these rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, age, disability, medical condition, sexual orientation, gender identity, gender expression, marital status, registered domestic partner status, or the source of payment for care.
- Express concerns or share feedback about your care without fear that the quality of your care or future access to care will be affected.
- Provide feedback or file a formal complaint about your care at Synergy Orthopedics. Contact email@example.com or call 858-412-6080.
- File a complaint or grievance with the California Department of Public Health (CDPH) regardless of whether you use the facility’s grievance process, in writing or by calling: California Department of Public Health (CDPH) – Licensing and Certification 7575 Metropolitan Drive, Suite 211, San Diego, CA 92108-4402. (619) 688-6190.
- File a complaint or grievance regarding the conduct of a physician with the Medical Board of California, in writing or by calling: Medical Board of California 2005 Evergreen Street, Suite 1200 • Sacramento, CA 95815-2322 • (800) 633-2322 www.mbc.ca.gov
You have the responsibility to:
- Provision of Information:
- Provide accurate and complete information about present complaints and illnesses, past illnesses, facilitations, medications, and other matters relating to your health to the best of your knowledge
- Report unexpected changes in condition to your physician or medical team.
- Report whether you understand and accept a proposed treatment plan, including what will be expected of you.
- Compliance with Instructions:
- Follow the treatment plan you and the practitioner primarily responsible for your care agree upon. For example, you may be asked to follow instructions by nurses and other health care personnel as they participate in the physician’s coordinated plan of care, conduct physicians’ orders, or enforce the applicable facility rules and regulations.
- Keep health care appointments. You should notify the health care provider, clinic, or facility as soon as you know that you cannot keep a work, regardless of the reason.
- Follow all facility rules and regulations that affect patient care and conduct.
- Ask Questions: Accept responsibility for being informed. Ask questions when you do not understand what you have been told about their care.
- Refusal of Treatment: Accept responsibility for your actions if you refuse treatment or do not follow the health care practitioner’s instructions.
- Healthcare Charges: Cooperate in meeting the financial obligations of your healthcare by providing applicable third-party payor information or making appropriate payment arrangements. Financial counseling is available if you need help to make proper financial arrangements.
- Respect and Consideration: Be considerate of the rights of other patients and facility personnel. This includes controlling the number of guests that come to see you in the facility and assisting in the noise control. Patients are asked to respect the property of other persons and the facility.
- Role in Patient Safety: Report any perceived or identified safety issues related to your care or the facility’s physical environment.
- Synergy Orthopedics is committed to safety and being a healing environment.
- WE WILL NOT TOLERATE any threatening or aggressive behavior toward our staff. Assaults and batteries against our staff are crimes and may result in a criminal conviction. All staff have the right to conduct their work without fearing for safety.
- We take all forms of aggression and violence seriously. Incidents may result in removal from the facility, dismissal, and prosecution.
- Examples of aggressive behaviors include:
- Physical aggression
- Verbal harassment includes abusive cursing or sexual language.
- Not following instructions from staff members.
If you would like to have a copy of these rights and responsibilities, please inform a staff member or contact:
Synergy Orthopedic Specialists, Inc.
4445 Eastgate Mall, Suite 105, San Diego, CA 92121
Phone: (858) 412-6080 Fax: 858-430-2591.