Patient Rights

Exercise these rights without regard to sex or cultural, economic, educational, or religious background or the source of payment for care. The patient will:

  • Be treated with respect, consideration and dignity by competent, caring providers who act as their advocate and treat pain as effectively as possible.
  • Be provided with appropriate personal privacy care in a safe setting and free from all forms of abuse or harassment.
  • Have knowledge of the name of the physician who has primary responsibility for coordinating care and the names and professional relationships of other physicians who will participate in the patient’s care.
  • Receive information from their physician about their illness, course of treatment and prospects for recovery in terms that the patient can understand.
  • Receive information from their physician about any proposed treatment or procedure, as the patient may need, 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 each, and knowledge of the name of the person who will carry out the procedure or treatment.
  • Actively participate in decisions regarding their medical care to the extent permitted by the law. This includes the right to accept or refuse treatment, to change their primary care physician, and the right to formulate an Advanced Directive.
  • Have a surrogate (parent, legal guardian, medical POA) exercise patient’s rights when they are unable to do so without coercion, discrimination or retaliation.
  • Know disclosures and records are treated confidentially, except when required by law, patients are given the opportunity to approve or refuse their release.
  • Have knowledge of provision of after- hours care and emergency care.
  • Be notified regarding fees for service, payment policies and financial obligations.
  • Good faith estimates will be provided to uninsured or self-paying individuals after a procedure is scheduled.
  • Have the right to decline participation in experimental or trial studies.
  • Have the right to receive marketing or advertising materials that reflect the services of the facility in a way which is not misleading.
  • Have the right to express concerns and receive a response to their inquiries in a timely fashion.
  • Have the right to know and understand what to expect related to their care and treatment.

Patient Responsibilities

Provide complete and accurate information to the best of their ability about their health, past medical history, and medications, including over-the-counter products and dietary supplements and any allergies or sensitivities.

The patient will:

  • Ask for an explanation if they do not understand papers they are asked to sign or anything about their or their child’s care.
  • Gather as much information as needed to make informed decisions.
  • Be available so staff can teach the patient how to care for themselves or their child. We want to share our knowledge, but the patient must be prepared to learn.
  • Follow the care prescribed or recommended for the patient or their child by the physicians, nurses and other members of the health care team. Remember, if the patient refuses treatment or does not follow instructions, they are responsible for their own actions.
  • Respect the privacy of others.
  • Assure the financial obligations associated with their or their child’s care are fulfilled. Be respectful of their personal property and that of other persons at the facility.
  • Take an active role in ensuring safe patient care. Ask questions or state concerns while in our care. If the patient does not understand, ask again.
  • Provide a responsible adult to transport them home from the facility and remain with them for 24 hours, if required by your physician.
  • Inform their physician about any living will, medical power of attorney, or other directive that could affect the patient’s care.

Patient Concerns and/or Grievances

Persons who have a concern or grievance regarding Coastal Surgical Institute including but not limited to, decisions regarding admission, treatment, discharge, denial of services, quality of services, courtesy of personnel or any other issue are encouraged to contact the Administrator or write a statement to:

Administrator
Coastal Surgical Institute
921 Oak Park Blvd., Suite 101
Pismo Beach, CA 93449
(805) 473-9850

Coastal Surgical Institute is Medicare Certified. Any complaints regarding services provided at Coastal Surgical Institute can be directed in writing or by telephone to:

California Department of Public Health
District Administrator
1889 North Rice Avenue, Suite 200
Oxnard, CA 93030
(805) 604-2926

Medicare patients should visit the website below to understand their rights and protections:

https://www.medicare.gov/basics/your-medicare-rights

Office of the Medicare Beneficiary Ombudsman
https://www.cms.gov/center/special-topic/ombudsman/medicare-beneficiary-ombudsman-home

Advance Directives

An “Advanced 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 advanced directives: a living will and a medical power of attorney. If you would like a copy of the official State advance directive forms, visit

https://calhospital.org/file/advance-health-care-directive

Our Advance Directive Policy

The majority of procedures performed at this facility are considered to be of minimal risk. Of course, no surgery is without risk. You and your physician will have discussed the specifics of your procedures, the risks associated with your procedure, the expected recovery and the care after your procedure, prior to your arrival. It is the policy of Coastal Surgical Institute, for all patients, 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 at this facility, the personal at Coastal Surgical Institute will initiate resuscitative or other stabilizing measures and transfer you to an acute care hospital for further evaluation (Cal. Probate Code §4735-4736). 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.

Notice of Nondiscrimination per Affordable Care Act Section 1557:

Coastal Surgical Institute complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.  Coastal Surgical Institute does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Coastal Surgical Institute:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:

○ Qualified sign language interpreters

○ Written information in other formats (large print, audio, accessible electronic formats, other formats)

  • Provides free language services to people whose primary language is not English, such as:

○ Qualified interpreters

○ Information written in other languages

If you need these services, contact us at 805-473-9850 and we will assist you in connecting to a language service.

If you believe that Coastal Surgical Institute has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Lucy Silva RN, BSN, our Civil Rights Coordinator, 921 Oak Park Blvd, Suite 101 in Pismo Beach, CA, 805-473-9850, fax: 805-473-9851, lsilva@coastalasc.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Lucy Silva, RN, BSN, our Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Department of Health and Human Services

200 Independence Avenue, SW

Room 509F, HHH Building

Washington, D.C. 20201

1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Your Rights and Protections Against Surprise Medical Bills

When you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.  Please click here to read more information.