As a patient at High Plains Surgery Center, you have the right:

• To have High Plains Surgery Center respond to your requests and needs for treatment or service provided that the space is available, and to receive the care that reflects your interests and that has been determined by your physician. An Advance Directive can be placed on file with our facility in the event you are transferred to another facility as part of your visit to High Plains Surgery Center. However, DNR (Do Not Resuscitate) orders will not be honored in our facility.
• To be informed of the right to care that is respectful, recognizes dignity and is private to the extent possible.
• To have patient information treated confidentially, based on applicable laws and regulations.
• To be involved in making decisions regarding your care, including assessment and management of pain.
• To be given information in the language you understand or to have information interpreted.
• To give informed consent. That is, to make decisions in collaboration with your physician that involve your health care. Consent may be given by the patient or the patient’s legal representative. In order to give consent, the patient will be provided information to include:
  • An explanation of recommended treatments or procedures in terms that are understandable.
  • An explanation of the risks and benefits of treatment, including the chance of success, mortality risk and serious side effects.
  • An explanation of the alternatives and the risks and benefits of such.
  • An explanation of the likely consequences if no treatment is pursued.
  • An explanation of the recuperative period, including anticipated problems and anticipated length of recuperation.
  • An explanation that the patient or his/her legal representative is free to withdraw consent and discontinue participation in treatment.
  • A disclosure statement that the patient’s physician is participating in teaching, research, experimental or education projects relating to the patient’s case.
• To an explanation of admission procedures, which shall include disclosure upon admission, of the facility’s policy statement on patient rights, which shall include:
  • The right to participate in all decisions involving care or treatment, consistent with state and federal statutes.
  • The right to refuse any drug, test, treatment, procedure or treatment consistent with the state and federal statutes, including likely medical consequences of such refusal.
  • The right to receive considerate and respectful care in a clean and safe environment, free of unnecessary restraint.
  • The right to be informed of the facility’s rules and regulations applicable to the patient.
  • The right to be informed of the facility’s grievance procedure. The Administrator may be reached by calling (307) 635-7070.
  • The right to file a grievance with the appropriate state agency.*
• To know the name, professional status and experience of the staff providing care or treatment.
• To be informed prior to the initiation of general billing procedures:
  • Prior to the initiation of non-emergency treatment, upon request, the patient has the right to be informed of routine, usual and customary charges or estimated charges for service based on an average patient with diagnosis similar to the tentative admission diagnosis of the patient.
  • If you have questions, please call (307) 635-7070 for medical cost information between the hours of 8:00 a.m. and 4:30 p.m. on weekdays.
  • Based upon insurance information provided by the patient, the facility shall provide assistance as needed with estimates of co-payments, deductibles or other charges that must be paid by the patient. Such assistance may be obtained weekdays between 8:00 a.m. and 4:30 p.m. by calling the facility business office manager.
  • The facility may include a disclaimer with the disclosure of any charges. Such disclaimer may include further variables, which may alter any disclosed charge. Any charges prohibited by law or third party payor contract will include a no-charge disclaimer in the disclosure.
• To be provided with information regarding teaching, research, educational or experimental projects related to your care. You have the right to refuse to participate in such projects.
• To have your medical records maintained in confidence and in accordance with the medical staff bylaws, rules and regulations. You have the right to have access to your medical record by contacting the facility at (307) 635-7070.

*Grievance Mechanism

The High Plains Surgery Center administrative staff is available to help with any concerns or suggestions you may have regarding your stay. Complaints will be investigated and a response provided under the provisions of the facility grievance mechanism.

If a grievance or complaint is not solved to the patient’s or family’s satisfaction, the grievance may be filed in writing with the State Department of Public Health and Environment. If still dissatisfied with physician, the patient or his or her legal representative may file a complaint with the State Board of Medical Examiners, the State Board of Dental Examiners, or the Podiatry Board. Upon request, the facility shall provide the address of the appropriate board. These boards are prohibited from arbitrating or adjudicating fee disputes.