Medicare Conditions of Coverage

Federal regulations require that ambulatory surgery centers disclose the following to their patients in advance of the day of surgery:

  • Patients Rights
  • Facility policy on Advance Directives
  • Physician Financial Interest/Ownership in the ambulatory surgery center

Patient Rights:
The Patient has the Right:
  • To be treated with courtesy, respect, and with appreciation of his or her individual dignity and with protection of his or her need for privacy.
  • To an environment that is safe and secure for self and property.
  • To confidentiality of information gathered during treatment
  • To prompt and reasonable response to questions and requests.
  • To know who is providing and is responsible for his or her care.
  • To know what patient support services are available, including whether an interpreter is available if he or she does not speak English.
  • To know what rules and regulations apply to his or her conduct.
  • To be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.
  • To refuse treatment, except as otherwise provided by law. 
  • To be given, upon request, full information and necessary counseling on the availability of financial resources for his or her care. 
  • To know, upon request and in advance treatment, whether the healthcare provider or healthcare practices accepts Advance Directives.
  • To receive, upon request, prior to treatment, a reasonable estimate of charges for medical care. 
  • To receive a copy of reasonably clear and understandable, itemized bill and, upon request, to have charges explained. 
  • To receive impartial access to medical treatment or accommodations, regardless of race, national origin, physical handicap, or source of payment.
  • To receive treatment for any emergency medical condition that will deteriorate from failure to provide treatment. 
  • To know if medical treatment is for purposes of experimental/research and to give his or her consent or refusal to participate in such experimental research. 
  • To express grievances regarding any violation of his or her rights, through the grievance procedure of the healthcare provider which served him or her. 
  • To participate in all aspects of health care decisions, unless contraindicated by concerns for their health. 
  • To appropriate assessment and management of pain.

Facility Policy on Advanced Directives
Our team is dedicated to delivering the highest quality care in a safe environment that places the patient at the center of our care. The majority of procedures performed at Blake Woods Medical Park Surgery Center are considered to be of minimal risk. It is the policy of Blake Woods Medical Park Surgery Center that if an adverse event occurs during your treatment, the medical team will initiate resuscitative or other stabilizing measures and transfer you 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.
If you do have an Advanced Directive or Living Will and wish to provide us with a copy of the document, we will place a copy in your medical record. In the unlikely event that a transfer to a hospital is required, a copy will be forwarded to the hospital.
If you do not have an Advanced Directive/Living Will and wish to create one, you may pick up a form in our lobby.


Reporting Concerns or Complaints:
If you should have a concern or complaint regarding any services rendered at our center, please let us know while you are here so that we have the opportunity to improve. You may also call the administrator of facilities at (517) 787-2906.
If you feel a need to direct your concern or complaint further, you may contact:
Michigan Department of Licensing and Regulatory Affairs
Bureau of Community and Health Systems, Health Facility Complaints
P.O. Box 30664
Lansing, MI 48909
Phone: (800) 882-6006
Fax: (517) 241-0093
OR
The Joint Commission 
Office of Quality and Patient Safety
One Renaissance Blvd.
Oakbrook Terrace, IL 60181
Fax: (630) 792-5636
OR 
Office of the Medicare Beneficiary Ombudsman
(The role of the Medicare Beneficiary Ombudsman is to ensure that Medicare beneficiaries receive information and help they need to understand their Medicare options and to apply their Medicare rights and protections.)