During your preoperative
phone call from our Centers' nurse, you will verbally be
given the information contained in this brochure and you
will be asked if you have received a written copy of
An advance directive
speaks for you if you are unable to speak and helps to
assure that your religious and personal beliefs will be
respected. It is a useful document for an adult of any
age to plan for future health care needs.
Although Ohio Valley
Ambulatory Surgery Center
do not honor advance directives, upon request we will
provide you with contact information and forms to assist
in writing an advance directive.
We strive to maintain a
professional and compliant atmosphere. Issues can arise.
The Grievance procedure is a means for patients and
related parties to inquire into issues raised and
identify whether action needs to be taken to resolve
identified issues and prevent recurrence.
Administrator will record the grievance complaint and
conduct a prompt investigation for quick resolution.
Any patient and/or
support person, visitor, employee, physician, or vendor
may lodge a grievance using the Centers procedure to
formally voice complaints, resolve disputes, or to bring
attention to possible violations of patient rights.
No person shall be
punished or retaliated against for using the Grievance
Any grievances, comments
and complaints are addressed to the Center
Administrator. Complete details and a copy of the
Centers Grievance Policy as well as a Grievance form
may be obtained by contacting Tracey Hood, the Centers'
740.423.4684 or P.O. Box
369, Belpre, OH. 45714 or
can be obtained from or to file a complaint with the
State of Ohio contact:
Ohio Department of Health
Consumer Complaint, Publication and Information Call
Center, ODH, PCSU, 246 N. High Street, Columbus, OH.
PATIENT'S BILL OF
As a patient you have
the right to:
care at all times and under all circumstances with
recognition of your personal dignity.
informational privacy, within the law.
your diagnosis, treatment, prognosis, to the degree
records and disclosures. Except when required by law you
have the right to approve
or refuse the release of
your medical records.
The opportunity to
participate in decisions involving your healthcare.
The right to make
decisions about medical care, including the right to
refuse or accept medical or surgical treatment.
The right to initiate
an Advance Directive such as Living Will or Durable
Power of Attorney.
Impartial access to
treatment regardless of race, color, sex, national
origin, religion, disability, or ability to pay.
Receive an itemized
bill for services received.
Know the identity and
professional status of all persons providing service
Report all comments,
questions or concerns concerning the quality of
care you received and receive timely follow-up
from Facility management.
Information about pain
and pain management relief measures provided by
staff committed to pain prevention and management
in a timely manner.
As a patient you are
Providing accurate and
complete information about your present health
status and past medical history
and reporting any
unexpected changes to the appropriate practitioner.
Following the treatment
plan recommended by the practitioner involved in
Providing an adult to
transport you home after surgery and stay with you
Indicating that you
clearly understand what is expected of you after
Your own actions should
you refuse treatment, leave the Facility against
medical advice, or choose to
purposefully not follow
the instructions of your practitioner.
and/or copies of an Advance Directive such as Living
Will or Durable Power of Attorney.
Ask your health
professional what to expect for pain management; discuss pain
relief options; discuss openly any concerns or
fears regarding pain
If you have any
questions or comments, please contact Tracey Hood, the
Center's Administrator at 740.423.4684.