Northwest Kansas Surgery Center and the Medical Staff have adopted the following statement of patient rights. This list shall include, but not be limited to, the patient’s right:

I. To safe, high quality, medical care, without discrimination, that is compassionate and respects personal dignity, values and beliefs.

II. To be provided with appropriate privacy and security of self and belongings
while a patient.

III. To access information contained in the patient’s medical record within the limits of the state law by each patient or patient’s designated representative.

IV. To be provided, to the degree known, complete information concerning their proposed treatment for procedures performed, potential complications, expected outcome and prognosis. When it is medically inadvisable to give such information to a patient, the information is provided to a person designated by the patient to be a legally authorized person.

V. To be given an opportunity to participate in decisions involving their health care, except when participation is contraindicated for medical reasons.

VI. To expect emergency procedures to be implemented without unnecessary delay.

VII. Except in emergency cases, the practitioner shall obtain necessary consent prior to the start of a procedure.

VIII. To be given the names of all practitioners and health care personnel participating in his/her care.

IX. To receive good quality care and high professional standards.

X. To refuse drugs or procedures and to receive information regarding the medical consequences of his/her refusal.

XI. To be informed of charges and receive counseling on the availability of known financial resources for health care.

XII. To be informed about transfers to another facility or organization and be provided complete explanation including alternatives to a transfer.

XIII. To access advocacy or protective service agencies and a right to be free from abuse.

XIV. To have your compliments, concerns and complaints (grievances) addressed. Sharing your concerns and complaints will not compromise your access to care, treatment and services. Please call:

Patient Responsibilities

I. You are responsible for providing as much information as possible about your health, medical history, and insurance benefits.

II. You are responsible for asking the care provider when you do not understand medical words or instructions about your plan of care.

III. You are responsible for following your plan of care. If you are unable/unwilling to follow the plan of care, you are responsible for telling your care provider. Your care provider will explain the medical consequences of not following the recommended treatment. You are responsible for the outcomes of not following your plan of care.

IV. You are responsible for following the facility’s rules and regulations.

V. You are responsible for acting in a manner that is respectful of other patients, staff and facility property.

VI. You are responsible for meeting your financial obligation to the facility.

Advanced Directives

I understand that Northwest Kansas Surgery Center is an outpatient surgery center that performs only elective surgeries/procedures and performs no high risk surgeries, and that it is the policy of Northwest Kansas Surgery Center not to acknowledge advance directives of any patient while in this facility. I further understand and agree that if I have an advance directive, it will not be honored while I am a patient in this facility.
For more information you can call Kansas Health Ethics, 316-684-1991.

Financial Ownership

I, also, understand that Dr. Ronald Holweger and Jim Manning, CRNA, maintain joint ownership in Northwest Kansas Surgery Center.