RIGHTS and RESPONSIBILITIES
As a patient of Saltzer Surgery Center you have the right to:
Get information about your rights, when possible before receiving care. This includes having your rights read, explained, or interpreted if needed so you understand them.
As a patient of Saltzer Surgery Center you are responsible to:
OTHER PERSONS’ RIGHTS AND RESPONSIBILITIES:
Any person, visitor, customer, and/or vendor at Saltzer Surgery Center shall:
- Be free from discrimination.
- Respect the property, comfort, and privacy of other patients.
- Support mutual consideration and respect by maintaining civil language and conduct in interactions with staff and licensed independent practitioners.
- Have the right to file a discrimination complaint or grievance (see below for more information).
Nondiscrimination Policy: As a recipient of Federal financial assistance, Saltzer Surgery Center does not exclude, deny benefits to, or otherwise discriminate against any person on the grounds of age, race, color, ethnicity or national origin, disability, religion, creed, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, gender identity or expression and/or veteran status in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, and in staff and employee assignments to patients, whether carried out by Saltzer Surgery Center directly or through a contractor or any other entity with which Saltzer Surgery Center arranges to carry out its programs and activities. This policy is in accordance with Section 1557 of the Affordable Care Act and Section 504 of the Rehabilitation Act.
If you have a complaint or grievance about the quality of your care, you, your family member, or surrogate should contact the immediate supervisor of the unit or department, or call the Director of Nursing at 1(208) 960-0870,or send an email to firstname.lastname@example.org.
To file a grievance with the State of Idaho, call Idaho Bureau of Facility Standards at 1(208) 334-6626, P.O. Box 83720, Boise, Idaho 83720-0009 or 3232 Elder Street, Boise, Idaho 83705 or the Idaho Board of Medicine at 1(208) 327-7000.
Medicare Beneficiaries can file a complaint regarding the quality of care, disagree with a coverage decision, or to appeal a premature discharge with the Quality Improvement Organization (QIO) in the following ways: Idaho-KEPRO QIO 1-888-305-6759. Or, contact the Office of Medicare Ombudsman at http://www.cms.gov/center/ombudsman.asp.
Any patient or other person who believes he/she may have been subject to discrimination can file a discrimination complaint or grievance by contacting Saltzer Surgery Center’s 504/Civil Rights Coordinator at 1(800) 442-4845 (TTY Users: 711) or email@example.com. You can also contact the Office for Civil Rights at 1(800) 368-1019 (TTY Users: 1(800) 537-7697), through the Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf, by fax (202) 619-3818, or by mail at “U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Ave. SW, Suite 509 F, HHH Building, Washington, D.C. 20201.” Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.