Preparing for Your Surgery l Day of Surgery l Recovery l At Home After Surgery
Financial Information l Patient Rights, Responsibilities and Advance Directives l Ownership Disclosure

Our professional staff is dedicated to providing the highest quality of individualized care to each of our patients.

We want your upcoming visit as pleasant and comfortable as possible. To make your surgery a successful experience, please read the following information carefully:

PREPARING FOR YOUR SURGERY

The day before your surgery date, a staff member from the Surgery Center will call you between the hours of 9:00 a.m. and 1:00 p.m. to confirm your surgery time. If you would like to contact the Surgery Center yourself and you have not already been contacted by a member of the Surgery Center Staff, please call between the hours of 11:00 a.m. and 1:00 p.m. the day before your surgery date.

During this phone call the staff will ask you questions regarding current or past medical conditions, allergies, and medications you are taking. Please do not hesitate to ask any questions you may have, and be sure to let the staff know of any special needs.

• The Center’s nurse will instruct you as to WHAT TIME YOU ARE TO STOP EATING AND DRINKING prior to surgery.
• If you take any medication for any conditions ask your doctor and/or the Center’s nurse whether or not to take it the day of surgery.
• For women, if there is any possibility you are pregnant, please notify your doctor and the Center’s nurse. If you are of childbearing age your doctor will order a urine pregnancy test which will be done in the Center on the day of your surgery.
• Leave all valuables at home, including watches, rings, jewelry, wallets and purses. Remove any body piercings.
• Where applicable, bring proof of Power of Attorney or Legal Guardianship. This is required for the Surgical Consent to be signed.
• Notify your surgeon and the Center’s nurse of any change in your health, such as a cold, fever or sore throat.
• For your safety, please arrange for a responsible individual to drive you home after surgery. You will not be allowed to drive yourself home.

DAY OF SURGERY

• Arrive promptly at the scheduled time. This will allow adequate time for all necessary admission procedures.
• Please bring your insurance identification cards. If special financial arrangements are necessary, please call the Surgery Center prior to admission.
• Be sure to bring any paperwork your doctor gave you, such as test results or your medical history, and a list of medications you are taking.
• Wear comfortable loose fitting clothing.
• Upon arrival, you will change into a gown and slippers which we provide. You will be asked to remove contact lenses, dentures, jewelry, and any prosthesis.
• Please remember to leave all valuables at home.
• You will have the opportunity to meet with the anesthesiologist and /or anesthesia provider prior to entering the operating room. They will be happy to answer any questions you may have concerning your anesthesia.
• One to two family members may wait with the patient in the preoperative holding area. For the safety and privacy of all patients, family members are not allowed to accompany the patient into the operating rooms or procedure areas.

RECOVERY

• After surgery, you will be moved to the Recovery Room where you will be closely monitored until you are ready to go home.
• We encourage your family members to remain in the facility while you are in surgery. If you desire, the surgeon will meet with your family at the conclusion of your surgery. If they leave the facility they may forfeit the opportunity to meet with the doctor. We ask that the parents of minor children under the age of 19 remain in the Facility throughout the duration of the admission.
• When you are fully awake, your family will be able to join you. Although the times may vary, most patients are discharged 1 to 3 hours after surgery.
• It is perfectly normal to feel discomfort in the area of your surgery. You may also experience some drowsiness or dizziness, depending on the type of anesthesia you received.
• A Center nurse will review any post-operative instructions left for you by your surgeon prior to your being discharged from the Center. We encourage you or your family to ask questions if there is anything you do not understand. You will receive a printed copy of these instructions.

AT HOME AFTER SURGERY

• Your surgeon will provide specific instructions for care while recovering at home. In the event of any difficulty, please call your surgeon or go to the nearest emergency room.
• For the first 24 hours following surgery, do not drive, engage in strenuous activities, do not drink any alcoholic beverages, or make any critical decisions.
• With your permission, a nurse from the Surgery Center will call you within a day or two to evaluate how you are recovering at home.
• You will be asked to complete a questionnaire about the care you received. Your comments will enable us to continue to improve our services.

FINANCIAL INFORMATION

• The Surgery Center fees cover the use of the facility only, and DO NOT include laboratory, pathology, surgeon or anesthesiologist fees. You will be billed separately for these services.
• As a courtesy, we will bill your primary and secondary insurance carriers or governmental agency directly for the Surgery Center’s charges. Be sure to bring your most current insurance, Medicare, or public assistance card with you on the day of your surgery. If you have more than one insurance carrier, we will also need accurate secondary billing information.
• Be prepared to pay any co-pay or deductible amounts on the day of your surgery. Patients who do not have insurance coverage or those having cosmetic surgery are also required to pay their charges in advance. We realize, however, that at times you may require special financial arrangements. In these instances, please phone our office prior to your surgery to discuss alternative methods of payment. The Surgery Center accepts cash, cashier’s checks, credit cards, and personal checks with a valid I.D.
• Please feel free to contact our business office at any time if you have questions or concerns regarding the facility charges, the financial policy, or billing procedures.

PATIENT RIGHTS, RESPONSIBILITIES, AND ADVANCE DIRECTIVES

PATIENT RIGHTS

This Facility adopts and affirms as policy the following rights of patient/clients who receive services from our facility.  The facility will provide the patient or the patient’s representative verbal and written notice of such rights in advance of the date of the procedure in accordance with 42 C.F.R. § 416.50, and these patient rights will be posted within the facility in the facility’s waiting room(s).

The patient rights are as follows:

• Treatment without discrimination as to age, race, color, religion, sex, national origin, political belief, or handicap. It is our intention to treat each patient as a unique individual in a manner that recognizes their basic human rights.
• Considerate and respectful care including consideration of psychosocial, spiritual, and cultural variables that influence the perceptions of illness.
• Receive, upon request, the names of physicians directly participating in your care and of all personnel participating in your care.
• Obtain from the person responsible for your health care complete and current information concerning your diagnosis, treatment, and expected outlook in terms you can be reasonably expected to understand. When it is not medically advisable to give such information to you, the information shall be made available to an appropriate person in your behalf.
• Receive information necessary to give informed consent prior to the start of any procedure and/or treatment, except for emergency situations. This information shall include as a minimum an explanation of the specific procedure or treatment itself, its value and significant risks, and an explanation of other appropriate treatment methods, if any.
• The patient may elect to refuse treatment. In this event, the patient must be informed of the medical consequences of this action. In the case of a patient who is mentally incapable of making a rational decision, approval will be obtained from the guardian, next-of-kin, or other person legally entitled to give such approval. The facility will make every effort to inform the patient of alternative facilities for treatment if we are unable to provide the necessary treatment.
• The facility will provide the patient or patient representative with the facilities policies and description of the State health and safety laws on advance directives, and upon request, refer you to resources for general information on how to formulate an advance directive, including where to obtain the official State advance directive form, and appointing a surrogate to make health care decisions on your behalf, to the extent permitted by law. Access to health care at this facility will not be conditioned upon the existence of an advance directive.
• Privacy to the extent consistent with adequate medical care. Case discussions, consultation, examination and treatment are confidential and should be conducted discreetly.
• Privacy and confidentiality of all records pertaining to your treatment, except as otherwise provided by law or third party payment contract.
• A reasonable response to your request for services customarily rendered by the facility, and consistent with your treatment.
• Expect reasonable continuity of care and to be informed, by the person responsible for your health care, of possible continuing health care requirements following discharge, if any.
• The identity, upon request, of all health care personnel and health care institutions authorized to assist in your treatment.
• Refuse to participate in research or be advised if your personal physician and/or facility proposes to engage in or perform human experimentation affecting his/her care or treatment. Refusal to participate or discontinuation of participation will not compromise the patient’s right to access care, treatment or services
• Upon patient request, examine and receive a detailed explanation of your bill including an itemized bill for services received, regardless of sources of payment.
• Know the facility’s rules and regulations that apply to your conduct as a patient.
• Be advised of the facility grievance process, should he or she wish to communicate a concern regarding the quality of the care he or she receives or if he or she feels the determined discharge date is premature. Notification of the grievance process includes: who to contact to file a grievance, and that he or she will be provided with a written notice of the grievance determination that contains the name of the contact person, the steps taken on his or her behalf to investigate the grievance, the results of the grievance and the grievance completion date.
• Complaint or criticisms will not serve to compromise future access to care at this facility. Staff will gladly advise you of procedures for registering complaints or to voice grievances including but not limited to grievances regarding treatment or care that is (or fails to be) furnished.
• Access and copy information in the medical record at any time during or after the course of treatment. If patient is incompetent, the record will be made available to his/her guardian.
• Expect to be cared for in a safe setting regarding: patient environmental safety, infection control, security and freedom from abuse or harassment.
• Receive care, free of restraints unless medically reasonable issues have been accessed and pose a greater health risk without restraints.
• Participate in the development, implementation and revision of his/her care plan.

• Complaints may be directed to the following Facility Contacts: 1490 E. Foremaster Drive, Bldg. C., St. George, UT 84790. Facility Administrator: Michael Christensen,. Phone: 435-628-9152. Director of Nursing: Ken Summerhays, Phone 435-627-5304. Business Office Manager: Dana Stoddard, Phone: 435- 627-5301.
• Complaints may be directed to the following State Agency: Utah Bureau of Health Facility Licensing, Certification and Resident Assessment, P.O. Box 144103, Salt Lake City, UT 84114-4103; or call 1-800-662-4157.
• Web site for the Medicare Beneficiary Ombudsman: www.medicare.gov or 1-800-633-4227 or www.cms.hhs.gov/center/ombudsman

PATIENT RESPONSIBILITIES

As the Patient you have the responsibility to:

1. Respect the property, comfort, environment and privacy of other patients and staff.

2. Cooperate with all persons providing your care and treatment.

3. Provide accurate and complete information concerning your health and medical history by answering all questions as truthfully and completely as you can, including “NPO” status.

4. Inform the nurse of any medications you are currently taking and all known allergies.

5. Try to understand and follow instructions concerning your treatment and ask questions if you do not understand or need an explanation.

6. Agree to follow all discharge instructions.

7. Accept responsibility for consequences following a decision to refuse treatment or to follow instructions.

8. Immediately inform your physician of any changes in your condition or adverse reactions.

9. Report the effectiveness of interventions for pain on my behalf and work with the nursing staff to achieve a comfortable level of pain control.

10. Be responsible in your payment for treatment and to be cooperative and timely in providing insurance and other necessary financial information.

Advance Directives

• Although not required for admission to Coral Desert Surgery Center, Advance Directives serve to provide family and medical personnel with information concerning your wishes for medical care should you become incapacitated.
• In the ambulatory surgery care setting, should you suffer a cardiac or respiratory arrest, or other life threatening situation, you will agree to any resuscitation necessary with a transfer to a higher level of care.
• If you have an Advance Directive please bring a copy of it with you, it will be included as a part of your medical record. You will find information and forms provided by the State of Utah concerning Advance Directives by following these links:
• o Advance Directives Form: Living Will Utah Department of Human Services
• o Advance Directives Form: Power of Attorney for Health Care Utah Department of Human Services
• o Living Wills & Health Care Power of Attorney (Advance Directives) Utah Department of Human Services

You may also visit the following website for information; follow the link to the State of Utah.                   www.noah-health.org/en/rights/endoflife/adforms.html

OWNERSHIP DISCLOSURE

• The physician who referred you to Coral Desert Surgery Center may have an ownership interest in this facility. You are free to choose another facility in which to receive the service that has been ordered by your physician.