Patient Rights & Responsibilities

Essential Information

  • Policy and information regarding advanced directives
  • Your rights and responsibilities as a patient
  • Your surgeon may have a financial interest in the Gulf Coast Outpatient Surgery Center

Please click below for quick access to the “Mississippi Advance Directive Form”

Mississippi Advance Directives Form

Policy and Information Regarding directives

  • Because the surgery you are having is not related to end-of-life care, it is our policy, regardless of the contents of your advanced directive, that if an adverse event occurs during your care at the surgery center, we will initiate resuscitative (CPR) or other stabilizing measures and transfer you to a an acute care hospital.
  • If you do have an Advance Directive /Living Will and wish to provide us with a copy of the document, we will place a copy in your medical record. In the event a transfer to a hospital is required a copy will be forwarded to the hospital.
  • If you do not have an Advance Directive/ Living Will and wish to create one you may refer to one of the following:
  • Legal Zoom
  • Do Your Own Will
  • If you would like a copy of the State of Mississippi’s official Advance Directives form, please ask when you arrive at the center and a copy will be provided to you.

Your Responsibility as a patient

  • Respecting the property of others and the facility.
  • Following the rules and regulations of the facility.
  • Following the treatment plan prescribed by the provider and participating in your care.
  • Providing caregivers with the most accurate and complete information regarding present complaints, past illnesses and hospitalizations, medications, unexpected changes in the patient’s condition or any other patient health matters. Patients are responsible for asking questions when they do not understand what they have been told or what they are expected to do.
  • Meeting their financial obligations to the facility as agreed to with the organization

Our Responsibility as a Facility

Gulf Coast Outpatient Surgery Center is required to make available to you the following information:

  • The patient rights above.
  • Your patient conduct responsibilities.
  • The services available at the organization
  • How we provide after hours and emergency care.
  • Your expected financial obligation for services.
  • Our payment policies.
  • Our advance directives policy.
  • The credentials of health care professionals.
  • Methods for providing feedback, including complaints
  • How to voice grievances regarding treatment or care that is (or fails to be) furnished.

You have the right to receive a “Good Faith Estimate”

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Effective January 1, 2022

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call Gulf Coast Outpatient Surgery Center at 228-594-2900.

Policy & Information Regarding Advance Directives

Gulf Coast Outpatient Surgery Center respects the right of patients to make informed decisions regarding their care. The Center has adopted the position that an Ambulatory Surgery Center setting is not the most appropriate setting for end of life decisions.

Therefore, it is the policy of this surgery center that if there is a deterioration in the patient’s condition during treatment at the surgery center, the personnel at the center will initiate resuscitative and or all other stabilizing measures. The patient would then be transferred to the appropriate hospital where further treatment decisions will be made.

In the event of a transfer, if the patient has provided Gulf Coast Outpatient Surgery Center with advance directives or a living will then a copy will be sent with the patient to the hospital.

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Your Rights as a Patient

  • Receive the care necessary to help regain or maintain his or her maximum state of health and to receive this care in a safe setting.
  • Expect personnel who care for the patient to friendly, considerate, respectful and qualified through education and experience and perform the services for which they are responsible with the highest quality of service.
  • Expect full recognition of individuality, including personal privacy in treatment and care. In addition, all communications and records will be kept confidential.
  • Complete information, to the extent known by the physician, regarding diagnosis, treatment and prognosis, as well as alternative treatments or procedures and the possible risks and side effects associated with treatment.
  • Be fully informed of the scope of services available at the facility, provisions for after-hours and emergency care and related fees for services rendered.
  • Be a participant in decisions regarding the intensity and scope of the treatment. If the patient is unable to participate in those decisions, the patient’s rights shall be exercised by the patient’s designated representative, legally designated person, or patient surrogate.
  • Refuse treatment to the extent permitted by law and be informed of the medical consequences of such a refusal. The patient accepts responsibility for his or her actions should he or she refuse treatment or not follow the instructions of the physician or facility.
  • Approve or refuse the release of medical records to any individual outside the facility, except in the case of transfer to another health facility, or as required by law or third-party payment contract.
  • Be informed of any human experimentation or other research/educational projects affecting his or her care or treatment, and can refuse participation in such experimentation or research without compromise to the patient’s usual care.
  • Express grievances/complaints and suggestions at any time, including grievances regarding treatment or care that is (or fails to be) furnished.
  • Be informed as to the facility’s policy regarding advance directives/living wills.
  • Be fully informed before any transfer to another healthcare facility or organization.
  • Be free from any act of discrimination or reprisal based on race, color, religion, gender, sexual preference, disability, national origin, age or veteran’s status.
  • Patients are informed of their right to change providers if other qualified providers are available
If you have any special concerns or complaints about our center, especially in regards to your care and safety, please speak up! Ask to see the Administrator, Rick Liwanag, MSN, MPH. We will make every effort to address your concerns. In the event we are unable to address your concerns to your satisfaction you may contact any of the following agencies: For Medicare Inquiries: Office of Medicare Ombudsman Website: http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html

For all other Inquiries

Health Facilities Licensure and Certification
Mississippi State Department of Health
PO Box 1700
Jackson, MS 39215-1700
Phone: 601-354-7300
Fax: 601-354-7230
AAAHC Accreditation
5250 Orchard Rd
Suite 250
Skokie, IL 6007
Phone: 1-847-853-6060