CentraCare - Willmar Surgery Center

At CentraCare - Willmar Surgery Center, we do everything possible to make your same-day surgery personal, comfortable and convenient. From the time you come through the door until you leave, you will appreciate the quality and professionalism of our expert, trained team. Our goal is to provide you with the best, most effective care so you can return to your normal activities as quickly as possible.

CentraCare - Willmar Surgery Center is accredited by the AAAHC (Accreditation Association for Ambulatory Health Care).

What We Do

Specialties providing services at CentraCare - Willmar Surgery Center include:

• Anesthesiology
• Dermatology
• Gastroenterology
• Hand Surgery
• General Surgery
• Pain Management
• Podiatry
• Obstetrics & Gynecology
• Ophthalmology
• Orthopedics
• Otolaryngology
• Urology

Preparing for Your Surgery/Procedure

A nurse will call you two days before your surgery/procedure to review your medical history, discuss special instructions you need to follow, and answer any questions you may have.

Contact your doctor of the Surgery Center if you have a fever, cough, cold, vomiting or diarrhea. We may need to reschedule your surgery/procedure. If you think you may be pregnant, please notify your surgeon. Some anesthesia medications may be harmful to a developing fetus.

Surgery / Procedure Checklist:

1. A responsible adult needs to drive you home. We would like them to stay in the surgery center during your procedure. You will not be able to drive a vehicle the day of your procedure because of the anesthesia medicines. Do not plan on using public transportation.
2. A responsible adult must stay with you for the rest of the day and through the night following the procedure.
3. If you have small children, make childcare arrangements so you can rest when you get home.
4. Do not eat or drink anything after midnight to prevent complications from the anesthesia. If you eat or drink, your procedure may be cancelled. Young children may be given special instructions.
5. Do not take any medications after midnight unless instructed by the surgery center staff. If you are told to take a medication the morning of your procedure, it is very important that you take it. Certain medications protect your heart during your procedure.
6. Bring all prescription and over the counter medications (or a list of those medications with dosages) to your appointment. If you use an inhaler, bring it with you.
7. Shower or bathe the morning of the procedure to lower the chance of infection. You may use hibiclens. Do not put on lotion or makeup.
8. Leave valuables at home (including jewelry, tongue rings, body jewelry, and cash). We cannot be responsible for damaged or lost property.
9. Dress in loose fitting, comfortable clothes and flat shoes. Slip on styles are best.
10. Check your blood sugar in the morning if you are diabetic.
11. If you take blood thinner like Coumadin, have an INR drawn as directed.
12. Pain Management patients should not take Ginko or Ginseng for 1 week before your injection.
13. Bring your insurance, Medicare or Medical Assistance cards.
14. Bring your living will if it pertains to this appointment.
15. Do not smoke after midnight the night before your procedure.
16. If you wear contact lenses, you may be asked to remove them before surgery, so please bring your glasses and case.
17. If you have sleep apnea and use a CPAP, please bring your machine with you to the surgery center.

Additional Information

You need to Know When you arrive, the receptionist will welcome you and review all admission and insurance forms with you. Accurate insurance information is necessary to bill your procedure correctly. After checking in, you will be taken to a private, comfortable room where a nurse will ask you about your health history. The anesthesiologist will talk to you about anesthesia and answer any of your questions. Your family or escort will be able to stay with you until you go to surgery. During surgery, your family or escort will stay in the waiting area and rejoin you in the discharge waiting area after you recover from the anesthesia.

Special Care for Children

CentraCare - Willmar Surgery Center meets the needs of children with a friendly, relaxed, comfortable environment. To make your child feel more at home, bring along a favorite toy or blanket. We have special pajamas and slippers for children. We encourage you to talk to your child about the surgery to help them be less fearful.

You will stay with your child in the admission room until they go to the surgery room. You'll be together again as soon as possible after the initial recovery period. We recommend two adults be with your child on the way home; one adult to drive, and one adult to care for your child.

Special Attention for Dependent Adults

We understand that loved ones who depend on others for daily living, need special attention.

• The legal guardian needs to sign the consent for surgery on or before the day of surgery.
• As with other patients, the dependent adult needs a parent, legal guardian or other responsible adult to stay at CentraCare - Willmar Surgery Center during the procedure and for the next 24 hours.

Advance Directives

CentraCare - Willmar Surgery Center respects the right for patients to choose, however, all advance directives will be suspended for the duration of time at CentraCare - Willmar Surgery Center. Though it is the expectation that patients will not be incapacitated due to the non-emergent nature of the procedures completed at this facility, life preserving measures will be implemented, at which time the patient would then be transferred to CentraCare - Rice Memorial Hospital for a higher level of care as necessary.

Insurance & Billing Information

• Before your surgery/procedure, you must get prior authorization from your insurance company. Surgery not covered by insurance must be pre-paid 10 days before surgery with cash, credit card or money order.
• Patients who do not have insurance will be notified if a payment is required on the day of surgery. A payment plan is available if needed.

Colonoscopy Preparation Instructions

CentraCare - Willmar Surgery Center
Minnesota Outpatient Surgical Center Patients’ Bill of Rights

Legislative Intent

It is the intent of the legislature and the purpose of this section to promote the interests and well being of the patients and residents of health care facilities. No health care facility may require a patient or resident to waive these rights as a condition of admission to the facility. Any guardian or conservator of a patient or resident or, in the absence of a guardian or conservator, an interested person, may seek enforcement of these rights on behalf of a patient or resident. An interested person may also seek enforcement of these rights on behalf of a patient or resident who has a guardian or conservator through administrative agencies or in district court having jurisdiction over guardianships and conservatorships. Pending the outcome of an enforcement proceeding the health care facility may, in good faith, comply with the instructions of a guardian or conservator. It is the intent of this section that every patient’s civil and religious liberties, including the right to independent personal decisions and knowledge of available choices, shall not be infringed and that the facility shall encourage and assist in the fullest possible exercise of these rights.

Definitions

For purposes of subdivisions 4 to 9, 12, 13, 15, 16, and 18 to 20, “patient” also means a person who receives health care services at an outpatient surgical center.

Information of Rights

Patients shall, at admission, be told that there are legal rights for their protection during their stay at the facility or throughout their course of treatment and maintenance in the community and that these are described in an accompanying written statement of the applicable rights and responsibilities set forth in this section. Reasonable accommodations shall be made for those with communication impairments and those who speak a language other than English. Current facility policies, inspection findings of state and local health authorities, and further explanation of the written statement of rights shall be available to patients, their guardians or their chosen representatives upon reasonable request to the administrator or other designated staff person, consistent with chapter 13, the Data Practices Act, and section 626.557, relating to vulnerable adults.

Courteous Treatment

Patients have the right to be treated with courtesy and respect for their individuality by employees of or persons providing service in a health care facility.

Appropriate Health Care

Patients shall have the right to appropriate medical and personal care based on individual needs.

Physician’s Identity

Patients shall have or be given, in writing, the name, business address, telephone number, and specialty, if any, of the physician responsible for coordination of their care. In cases where it is medically inadvisable, as documented by the attending physician in a patient’s care record, the information shall be given to the patient’s guardian or other person designated by the patient as a representative.

Relationships with Other Health Services

Patients who receive services from an outside provider are entitled, upon request, to be told the identity of the provider. Information shall include the name of the outside provider, the address, and a description of the service which may be rendered. In cases where it is medically inadvisable, as documented by the attending physician in a patient’s care record, the information shall be given to the patient’s guardian or other person designated by the patient as a representative.

Information about Treatment

Patients shall be given by their physicians’ complete and current information concerning their diagnosis, treatment, alternatives, risks, and prognosis as required by the physician’s legal duty to disclose. This information shall be in terms and language the patients can reasonably be expected to understand. Patients may be accompanied by a family member or other chosen representative. This information shall include the likely medical or major psychological results of the treatment and its alternatives. In cases where it is medically inadvisable, as documented by the attending physician in a patient’s medical record, the information shall be given to the patient’s guardian or other person designated by the patient or resident as a representative. Individuals have the right to refuse this information.

Every patient suffering from any form of breast cancer shall be fully informed, prior to or at the time of admission and during her stay, of all alternative effective methods of treatment of which the treating physician is knowledgeable, including surgical, radiological, or chemotherapeutic treatments or combinations of treatments and the risks associated with each of those methods.

Right to Refuse Care

Competent patients shall have the right to refuse treatment based on the information required in subdivision 9. In cases where a patient is incapable of understanding the circumstances but has not been adjudicated incompetent, or when legal requirements limit the right to refuse treatment, the conditions and circumstances shall be fully documented by the attending physician in the patient’s medical record.

Experimental Research

Written, informed consent must be obtained prior to a patient’s participation in experimental research. Patients have the right to refuse participation. Both consent and refusal shall be documented in the individual care record.

Treatment Privacy

Patients shall have the right to respectfulness and privacy as it relates to their medical and personal care program. Case discussion, consultation, examination, and treatment are confidential and shall be conducted discreetly. Privacy shall be respected during toileting, bathing, and other activities of personal hygiene, except as needed for patient safety or assistance.

Confidentiality of Records

Patients shall be assured confidential treatment of their personal and medical records, and may approve or refuse their release to any individual outside the facility. Copies of records and written information from the records shall be made available in accordance with this subdivision and section 144.335. This right does not apply to complaint investigations and inspections by the Department of Health, where required by third party payment contracts, or where otherwise provided by law.

Responsive Service

Patients shall have the right to a prompt and reasonable response to their questions and requests.

Personal Privacy

Patients shall have the right to every consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being. Facility staff shall respect the privacy of a resident’s room by knocking on the door and seeking consent before entering, except in an emergency or where clearly inadvisable.

Grievances

Patients shall be encouraged and assisted, throughout their stay in a facility or their course of treatment, to understand and exercise their rights as patients and citizens. Patients may voice grievances and recommend changes in policies and services to facility staff and others of their choice, free from restraint, interference, coercion, discrimination, or reprisal, including threat of discharge. Notice of the grievance procedure of the facility or program, as well as addresses and telephone numbers for the Office of Health Facility Complaints and the area nursing home ombudsman pursuant to the Older Americans Act, section 307(a) (12) shall be posted in a conspicuous place.

Compliance by outpatient surgery centers with section 144.691 and compliance by health maintenance organizations with section 62D.11 is deemed to be compliance with the requirement for a written internal grievance procedure.

FEDERAL RIGHTS

This CentraCare Surgery Center is certified by the Centers for Medicare and Medicaid Services. Additional Ambulatory Surgery Center patient rights are listed below:

§ 416.50 Condition for Coverage – Patient Rights

The ASC must inform the patient or patient’s representative or surrogate of the patient’s rights, and must protect and promote the exercise of these rights, as set forth in this section. The ASC must also post the written notice of patient rights in a place or places within the ASC likely to be noticed by patients waiting for treatment or by the patient’s representative or surrogate, if applicable.

§ 416.50 (a) Standard: Notice of Rights

An ASC must, prior to the start of the surgical procedure, provide the patient or the patient’s representative, or the patient’s surrogate with verbal and written notice of the patient’s rights in a language and manner that ensures the patient, the representative, or the surrogate understand all the patient’s rights as set forth in this section. The ASC’s notice of rights must include the address and telephone number of the State agency to which patients may report complaints, as well as the Web site for the Office of the Medicare Beneficiary Ombudsman.

§ 416.50 (b) Standard: Disclosure of physician financial interest or ownership

There is no physician financial interest or ownership of this CentraCare Surgery Center.

§ 416.50 (c) Standard: Advance Directives

This CentraCare Surgery Center shall adhere to the wishes of all patients who have written advance directives that are brought to the facility and placed in a prominent part of the patient’s current medical record. However, this CentraCare Surgery Center cannot in good conscience uphold a DNR/DNI request. This CentraCare Surgery Center provides non-emergency surgical and endoscopy procedures to patients who are expected to be discharged home within hours of the procedure. If a patient requires resuscitation, their care will be transferred to the hospital.

Patient or patient’s representative will be informed of their rights to make informed decisions during their care.

§ 416.50(d) Standard: Submission and investigation of grievance

The ASC must establish a grievance procedure for documenting the existence, submission, investigation and disposition of a patient’s written or verbal grievance to the ASC. The following criteria must be met:

1. The grievance process must specify timeframes for review of the grievance and the provisions of a response
2. The ASC, in responding to the grievance, must investigate all grievances made by a patient, the patient’s representative, or the patient’s surrogate regarding treatment or care that is (or fails to be) furnished.
3. The ASC must document how the grievance was addressed, as well as provide the patient, the patient’s representative, or the patient’s surrogate with written notice of its decision. The decision must contain the name of an ASC contact person, the steps taken to investigate the grievance, the result of grievance process and the date the grievance processed was completed.

§ 416.50(d) Standard: Submission and investigation of grievance.

The following criteria must be met:

1. All alleged violations/grievance relating, but not limited to, mistreatment, neglect, verbal, mental, sexual, or physical abuse, must fully be documented.
2. All allegations must be immediately reported to a person in authority in the ASC.
3. Only substantiated allegation must be reported to the State authority or the local authority, or both.

§ 416.50(e) Standard: Exercise of rights and respect for property and person.

1. The patient has right to the following:
   1. Be free from any act of discrimination or reprisal
   2. Voice grievances regarding treatment or care that is (or fails to be) provided
   3. Be fully informed about a treatment or procedure and the expected outcome before it is performed.
2. If a patient is adjudged incompetent under applicable State laws by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed under State law to act on the patient’s behalf.
3. If a State court has not adjudged a patient incompetent, any legal representative or surrogate designated by the patient in accordance with State law may exercise the patient’s rights to extent allowed by State law.

§ 416.50(f) Standard: Privacy and Safety

The patient has the right to:

1. Personal privacy.
2. Receive care in safe setting.
3. Be free from all forms of abuse or harassment.

§ 416.50(g) Standard: Confidentiality of Clinical Records

The ASC must comply with the Department’s rules for the privacy and security of the individually identifiable health information, as specified at 45 CFR Parts 160 and 164.

Patient Conduct and Responsibilities

The collaborative nature of health care requires that patients or their families/surrogates, participate in their care.The effectiveness of care and patient satisfaction with the course of treatment depends in part, on the patient fulfilling certain responsibilities.

• Patients are responsible for providing complete and accurate information to the best of his/her ability about his/her health, past illnesses, hospitalizations, any medication, including over-the-counter products and dietary supplements and any allergies or sensitivities and other matters related to their health status.

• Patients are responsible for participating effectively in decision-making; patients are encouraged to take responsibility for requesting additional information or clarification about their health status or treatment when they do not fully understand information and instructions.

• Patients are also responsible for informing this CentraCare Surgery Center about any living will, medical power of attorney or other directive that could affect his/her care.

• Patients are responsible for following the treatment plan prescribed by his/her provider and informing his/her provider if they anticipate problems in following the prescribed treatment.

• Patients should also be aware of the surgery center’s obligation to be reasonably efficient and equitable in providing care to other patients and the community. The surgery center’s rules and regulations are designed to help the surgery center meet this obligation. Patients and their families are responsible for making reasonable accommodations to the needs of the surgery center, other patients, medical staff, and surgery center employees.

• Patients are responsible for providing necessary information for insurance claims and for working with the surgery center to make payment arrangements, when necessary. Patients accept personal financial responsibility for any charges not covered by his/her insurance.

• Patients are responsible for recognizing the impact of their life-style on their personal health.

• Patients must have a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider

• Patients must be respectful of all the health care providers and staff, as well as other patients.

• Patients have the right to change their provider, if other qualified providers are available.

IF YOU HAVE A COMPLAINT ABOUT THE AGENCY OR PERSON PROVIDING YOU OUTPATIENT SURGICAL SERVICES, YOU MAY CALL, WRITE, EMAIL OR VISIT:

• CentraCare Surgery Center
  1900 CentraCare Circle, Suite 1900, St. Cloud, MN 56303
  Director: 320-229-4964, Fax: 320-229-5198
• CentraCare Patient Relations
  1406 6th Avenue North, St. Cloud, MN 56303
  Email: patientrelations@centracare.com
• Office of Health Facility Complaints-Minnesota Department of Health
  85 East Seventh Place, Suite 300 P.O. Box 64970, St. Paul, MN 55164-0970
  651-201-4201, 800-369-7994
  Fax: 651-281-9796
• Ombudsman for Long-Term Care
  P.O. Box 64971, St. Paul, MN 55164-0971
  651-431-2555, 800-657-3591
  Fax: 651-431-7452
  https://mn.gov/ooltc
• Medicare Beneficiary Ombudsman
  800-633-4227
  www.cms.gov/center/ombudsman.asp

Spanish: Carta de Derechos de los Pacientes