Preparing for Surgery

Your doctor will discuss your operation or procedure with you. Be sure to tell your doctor about any medicines you are taking and ask if you should take them on the day of your procedure.

You will receive a phone call from a member of the Apple Hill Surgical Center nursing staff one to three weeks before your procedure. The nurse will assess your health status and give you instructions to prepare for your procedure. The assessment will take about 15-20 minutes. If you are not going to be home, you may contact the Center for your instructions at (717) 741-8631 between 7:30 a.m. and 4:30 p.m., Monday through Friday. You will be called again two to four business days before your procedure and will be given your arrival time during that call.

It is important for you to receive your preoperative instructions. Your procedure could be cancelled if we are unable to reach you for your instructions.

If a change occurs in your physical condition prior to surgery, such as a cold, rash, sore throat, cough, fever, or upset stomach, notify your physician. The doctor may wish to reschedule.

If you are having sedation, you MUST make arrangements for someone to drive you home following your procedure. We STRONGLY RECOMMEND someone stay with you for the first 24 hours following your procedure. Patients under the age of 18 must be accompanied by a parent or guardian. A waiting room is available for the comfort of your escort, and there is a small snack shop in the lower level serving breakfast and lunch. If you are unable to arrange for an escort, please inform us as soon as possible, as it may be necessary to reschedule.

Day of Surgery

You should bring the following with you:

• Photo ID
• Insurance cards, Insurance copays and deductibles
• Eye glass case (if you wear glasses)
• Contact lens container (if you wear contact lenses)
• A list of all medications you currently are taking.
• Adults – If you have an Advance Directive that is not already on file with WellSpan Health, please bring a copy and we will scan into your electronic medical record.

You should wear loose, comfortable clothing and low-heeled shoes so it is easier to dress following your procedure.

Once you have registered, a nurse will escort you into the preoperative area, where your pulse, temperature, respiration, and blood pressure will be taken. You will be asked to change into a gown provided by the Center. Your clothes will be placed in a secured locker until you are ready to be discharged. Warm blankets will be provided for your personal comfort. Soothing aromatherapy clips are available, upon request, to enhance your body, mind and spirit. For those patients receiving sedation, an I.V. will be started.

The anesthesiologist and your doctor will see you prior to your procedure. Just before going into the operating room, you may be asked to remove your contact lenses and any other prosthesis. Dentures and partial plates may need to be removed prior to surgery. These will be labeled, placed in your locker, and returned to you upon your discharge. You will be in the preoperative area for about one hour prior to your procedure.

After your procedure, you will be taken into the recovery area and/or the patient lounge, where your escort will be allowed to stay with you. Because space is limited, and for other patients’ privacy, we allow only one escort at a time in the patient lounge.

Coffee, juice, soda, and crackers are provided for patients in the patient lounge. We ask that you please do not bring food from home.

You may need to be admitted to the hospital if:

• More extensive surgery was/is necessary.
• Complications arose due to the anesthesia.
• You experience more pain than expected.

For Your Safety

Prior to proceeding to the operating/procedure room the following will occur:

• You will be asked numerous times to verify your name, date of birth, surgeon and procedure. Any discrepancies will be corrected.
• Your surgeon will visit you to mark the surgical site, if applicable, with a permanent marker.
• You are expected to be an active participant in the marking. You should feel comfortable voicing your opinion about discrepancies during the process.
• If there are multiple surgical sites, ALL areas should be marked.

Surgery for Children

Children are encouraged to bring a favorite toy or blanket with them. Parent(s) or legal guardians are required to stay with the child while in the preoperative area and the postoperative patient lounge. It will be necessary for parents to remain in the building while surgery is in progress. Should your child be in diapers and/or utilize a pacifier, bottle, or sipper cup, please bring them along to the Center.

If your child is under the age of 18, the Pennsylvania Department of Health requires that your pediatrician or family doctor give permission for the surgery to be performed in the outpatient setting. The child’s surgeon is responsible for obtaining this permission.

After Your Discharge

You will be given specific written instructions regarding your care upon discharge from the Center. It is important to have your caregiver available during the post-procedure discharge instructions, as you may experience difficulty remembering those instructions due to the type of anesthesia you may receive.

For your comfort and safety, we recommend:

• You have someone stay with you for the first 24 hours following your procedure.
• Take it easy until your doctor says you can return to your normal routine.
• Do not drive, operate machinery or power tools, drink alcoholic beverages, or take any medications not prescribed by your doctor for at least 24 hours following surgery.
• It is natural to experience some discomfort in the area of the operation. You may also experience some drowsiness or dizziness for the first 24 hours depending on the type of anesthesia you receive.
• Follow your doctor’s instructions regarding diet, rest, and medication.
• If you feel you are having problems after discharge, contact your doctor. If your doctor is not available, call the York Hospital Emergency Department at (717) 851-2311.
• It is very important to remember you must have a responsible person to drive you home.
• Taxi transportation is allowed only for patients having local anesthesia or if the patient is accompanied by an escort.
• If you have any questions, you may contact the Center at (717) 741-8250 from 6:30 a.m. to 5 p.m. Monday through Friday.

You may be contacted by Press Ganey, a nationally known research firm engaged by WellSpan Health, to follow up with you regarding the care you received during your stay. Your comments are very important to us and will help us improve our services and provide the finest care in outpatient surgery in York County.

A member of the Surgical Center staff will call you one to two business days after your procedure to check on how you are doing. If your procedure is on Friday, you will be called on Monday. If you prefer not to be contacted, please let us know before you are discharged.

You will receive a bill for the services provided by the Surgical Center and all WellSpan providers. This covers the supplies, equipment, personnel, and use of the procedure/operating room and recovery rooms.

You will receive separate bills for the following:

• Your surgeon, dentist or podiatrist; (non-WellSpan).
• Anesthesia: If you received general anesthesia or required sedation administered by anesthesia personnel.

Billing for all WellSpan facilities and providers will be on one bill. As a convenience to you, our billing staff will make every effort to check your insurance coverage, based on the information that is given to us when scheduled. If our billing staff finds that you will be responsible for all or a portion of your bill, they may attempt to call you prior to your surgery. You may be given an estimate of any copayment or deductible your insurance company may require. Please be prepared to pay the copayments and deductibles on the day of the surgery. You are encouraged to contact your insurance company directly to find out about networks and what is covered by your plan. Any patients without insurance or whose insurance does not cover the procedure to be performed should also make arrangements to pay their facility fees on the day of the surgery. For your convenience, we accept cash, personal checks, VISA, MasterCard, Discover, and American Express. Payments may also be made online if you have an active My WellSpan account. We DO NOT accept Care Credit.

Regardless of the type of insurance you have, ultimate responsibility for the Surgical Center bill rests with the patient or guarantor. If your insurance company does not make payment within 60 days of submission, the account will become your responsibility, and payment in full will be required.

If you have any questions about your financial arrangements, you may contact WellSpan Customer Service at (717) 851-5005 or (877) 631-4262.

Statement of Patient Rights

As a patient of a WellSpan Health care location (including WellSpan hospitals), or as a family member or healthcare representative of a patient at this care location, we want you to know the rights you have under federal and Pennsylvania state law as soon as possible in your care location stay. We are committed to honoring your rights and want you to know that by taking an active role in your health care, you can help your caregivers meet your needs as a patient or family member. That is why we ask that you and your family share with us certain responsibilities.

Your Rights

This care location complies with applicable federal civil rights laws and does not discriminate on the basis of age, ancestry, color, disability, gender identity, language, national origin, race, religion, sex, sexual orientation, or source of payment.

As our patient, you have the right to safe, respectful, and dignified care at all times. You will receive services and care that are medically suggested and within the care location’s services, its stated mission, and as required by law and regulation.

Communication

You have the right to:

• Have a family member, lay caregiver, or another person that you choose, or your physician or advanced practice provider notified if you are admitted to a WellSpan hospital.
• Receive information in a way that you understand. This includes interpretation and translation, free of charge, in the language you prefer for talking about your health care. This also includes providing you with needed help if you have vision, speech, hearing, or cognitive impairments.
• Designate a support person, if needed, to act on your behalf to assert and protect your patient rights.

Informed Decisions

You have the right to:

• Receive information about your current health, care, outcomes, recovery, ongoing health care needs, and future health status in terms that you understand.
• Be informed about proposed care options including the risks and benefits, other care options, what could happen without care, and the outcome(s) of any medical care provided, including any outcomes that were not expected. When it is not medically advisable to give such information to you, it will be given on your behalf to your next of kin or other appropriate person. You may need to sign your name before the start of any procedure and/or care, but “Informed consent” is not required in the case of an emergency.
• Be involved in all aspects of your care and to take part in decisions about your care.
• Make choices about your care based on your own spiritual and personal values.
• Request care. This right does not mean you can demand care or services that are not medically needed.
• Refuse any care, therapy, drug, or procedure against the medical advice of a physician or advanced practice provider. There may be times that care must be provided based on the law.
• Expect the care location to get your permission before taking photos, recording, or filming you, if the purpose is for something other than patient identification, care, diagnosis, or therapy.
• Decide to take part or not take part in research or clinical trials for your condition, or donor programs, that may be suggested by your physician or advanced practice provider. Your participation in such care is voluntary, and written permission must be obtained from you or your legal representative before you participate. A decision to not take part in research or clinical trials will not affect your right to receive care.

Visitation

You have the right to:

• Decide if you want visitors or not while you are here. The care location may need to limit visitors to better care for you or other patients, but will not restrict, limit or otherwise deny visitation privileges on the basis of age, ancestry, color, disability, gender identity, language, national origin, race, religion, sex, sexual orientation, or source of payment.
• Designate those persons who can visit or accompany you while you are in the care location. These individuals do not need to be legally related to you. Visitors will enjoy full and equal visitation privileges consistent with your preferences.
• Designate a support person who may determine who can visit you if you become incapacitated.
• Access an individual or agency who is authorized to act on your behalf to assert or protect your rights as a patient.
• Request a room transfer within the care location. Room transfer requests will be permitted if deemed necessary to promote the patient’s well-being.

Advance Directives

You have the right to:

• Create advance directives, which are legal papers that allow you to decide now what you want to happen if you are no longer healthy enough to make decisions about your care. You have the right to have staff comply with these directives.
• Ask about and discuss the ethics of your care, including resolving any conflicts that might arise such as, deciding against, withholding, or withdrawing life-sustaining care.

Note: Apple Hill Surgical Center will not honor requests made by a patient and/or their representative to withold cardiopulmonary resucitation in the event of cardiac or respiratory arrest.

Care Planning

You have the right to:

• Receive a medical screening exam to determine treatment.
• Participate in the care that you receive in the care location.
• Receive instructions on follow-up care and participate in decisions about your plan of care after you are out of the care location.
• Receive a prompt and safe transfer to the care of others when this care location is not able to meet your request or need for care or service. You have the right to know why a transfer to another health care facility might be required, as well as learning about other options for care. The care location cannot transfer you to another care location unless that care location has agreed to accept you.

Care Delivery

You have the right to:

• Expect emergency procedures to be implemented without unnecessary delay.
• Receive care in a safe setting free from any form of abuse, harassment, and neglect.
• Receive kind, respectful, safe, quality care delivered by skilled staff.
• Know the names of physicians, advanced care providers, and nurses providing care to you and the names and roles of other health care workers and staff that are caring for you.
• Receive assistance in obtaining a consultation by another healthcare provider at your request and expense.
• Receive proper assessment and management of pain, including the right to request or reject any or all options to relieve pain.
• Receive care that is free from restraints or seclusion unless necessary to provide medical, surgical, or behavioral health care.
• Receive efficient and quality care with high professional standards that are continually maintained and reviewed.
• Expect good management techniques to be implemented within this care location considering effective use of your time and to avoid your personal discomfort.

Privacy and Confidentiality

You have the right to:

• Limit who knows about your being in the care location.
• Be interviewed, examined, and discuss your care in places designed to protect your privacy.
• Be advised why certain people are present and to ask others to leave during sensitive talks or procedures.
• Expect all communications and records related to care, including who is paying for your care, to be treated as confidential except as otherwise provided by law or third-party contractual arrangements.
• Receive written notice that explains how your personal health information will be used and shared with other health care professionals involved in your care.
• Review and request copies of your medical record unless restricted for medical or legal reasons.

Care Location Bills

You have the right to:

• Review, obtain, request, and receive a detailed explanation of your care location charges and bills.
• Receive information and counseling on ways to help pay for the care location bill.
• Request information about any business or financial arrangements that may impact your care.

Please feel free to ask questions about any of these rights that you do not understand. If you have questions about these rights, please discuss them with your physician, advanced practice provider, or nurse, or the care location’s Customer Services and Collections department. You will receive a personal response.

Concerns, Complaints/Grievances, and Questions

You and your family/lay caregiver/healthcare representative have the right to:

• Tell the staff providing your care about your concerns or complaints regarding the care you are receiving. This will not affect your future care.
• Seek review of quality of care concerns, coverage decisions and concerns about your discharge.
• It is our priority to resolve concerns in a timely fashion during your care encounter, but if you have unresolved concerns you may call the WellSpan Health Care Line at (877) 232-5807 to bring them to our attention.
  • WellSpan’s desires to provide an acknowledgement and apology as soon as possible after receipt of a concern, ideally within 24-48 hours for the best possible service recovery.
  • WellSpan will send a written response to grievances within 7 days (2 days for Behavioral Health Inpatients and Involuntary Outpatients) either acknowledging receipt of the grievance and explaining the grievance process or outlining the resolution of the grievance.
  • WellSpan expects to resolve grievances within 30 days, unless there is an extraordinary circumstance.
• If your care was provided by a WellSpan hospital, the Pennsylvania Department of Health is also available to assist you with any questions or concerns about your care. You can reach the Department of Health by calling (800) 254-5164 or writing to:
  • Acute and Ambulatory Care Services
    Pennsylvania Department of Health
    Room 532, Health and Welfare Building
    625 Forster St.
    Harrisburg, PA 17120
• If your care was provided by a WellSpan location that is accredited by The Joint Commission, you can contact them with concerns about your care by contacting:
  • Office of Quality and Patient Safety
    The Joint Commission
    One Renaissance Boulevard
    Oakbrook Terrace, IL 60181
    (800) 994-6610
    patientsafetyreport@jointcommission.org
• WellSpan Health supports and celebrates the rights of all people. If you believe that WellSpan has failed to provide services to you – or discriminated in any way – including but not necessarily limited to the basis of age, ancestry, color, disability, gender identity, language, national origin, race, religion, sex, sexual orientation, or source of payment, you can file a grievance in two different ways:
  • Directly to WellSpan Health by emailing civilrightscoordinator@wellspan.org or by calling (local) 717-812-4795 or (toll free) 877-604-4066;
  • By notifying the U.S. Department of Health and Human Services, Office of Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf , or by mail or phone at:
  U.S. Department of Health and Human Services
  200 Independence Avenue SW
  Room 509F, HHH Building
  Washington, D.C. 20201
  1-800-368-1019, 800-537-7697 (TDD)
  Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
• Medicare beneficiaries may contact Livanta (the State Quality Improvement Organization) about concerns regarding the quality of care received, coverage decisions or an issue of premature discharge:
  Livanta BFCC-QIO Program (888) 396-4646 TTY: (888) 985-2660 www.livantaqio.com/en/Provider/Contact_Information

Statement of Patient Responsibilities

As a patient, family member, or healthcare representative, you have the right to know all care location rules and what we expect of you during your care location stay.

Provide Information

As a patient, family member, lay caregiver, or healthcare representative, we ask that you:

• Provide accurate and complete information about current health care problems, past illnesses, hospitalizations, medications and other matters relating to your health.
• Report any condition that puts you at risk (for example, allergies or hearing problems).
• Report unexpected changes in your condition to the health care professionals taking care of you.
• Provide copies of your Advance Directive, Living Will, Durable Power of Attorney for health care, and any organ/tissue donation permissions to the health care professionals taking care of you.
• Tell us who, if anyone, you would like to visit or accompany you while in the care location.

Respect and Consideration

We trust that our patients, their families and visitors, share our commitment to treating all physicians, advanced practice providers, staff, and other persons in this care location with the dignity and respect that they deserve.

As a patient, family member, or healthcare representative, we expect that you:

• Recognize and respect the rights of other patients, families and staff. Any threatening, violent or harassing behavior exhibited toward other patients, visitors and/or care location staff for any reason, including but not necessarily limited to age, ancestry, color, disability, gender identity, language, national origin, race, religion, sex, sexual orientation, or source of payment will be considered discriminatory and will not be tolerated.
• Understand that the care location will attempt to accommodate a patient’s choice of care giver whenever possible, however, we cannot accommodate a patient’s choice of care giver, or refusal of treatment, based upon the care giver’s ethnic background, religion, national origin or other discriminating factors. The patient’s refusal to be treated, under these circumstances, may result in transfer of the patient’s care to another facility. Also, in the event of an emergency, patients may receive treatment by any qualified physician or health care professional, regardless of patient preference.

Safety

As a patient, family member, lay caregiver, or healthcare representative, we ask that you:

• Promote your own safety by becoming an active, involved and informed member of your health care team.
• Ask questions if you are concerned about your health or safety.
• Make sure your provider knows the site/side of the body that will be operated on before a procedure.
• Remind staff to check your identification before medications are given, blood/blood products are administered, blood samples are taken, or before any procedure.
• Remind caregivers to wash their hands before taking care of you.
• Be informed about which medications you are taking and why you are taking them.
• Ask all care location staff members to identify themselves.
• Comply with the care location’s no smoking policy.
• Refrain from conducting any illegal activity on the care location’s property. If such activity occurs, the care location will report it to the police.

Refusing Care

As a patient:

• You are responsible for your actions if you refuse care or do not follow care instructions.

Charges

As a patient:

• You are responsible for paying for the health care that you received as promptly as possible.

Cooperation

As a patient:

• You are expected to follow the care plans suggested by the health care professionals caring for you while in the care location. You should work with your health care professionals to develop a plan that you will be able to follow while in the care location and after you leave the care location.

A Disclosure to Patients Who Have Been Referred to Apple Hill Surgical Center:

The professionals listed below are Limited Partners in Apple Hill Surgical Center Partners, which owns and operates Apple Hill Surgical Center. WellSpan Health also has ownership interest in Apple Hill Surgical Center.

If you have been referred to Apple Hill Surgical Center for treatment and have questions about the ownership interest of any of these parties, please contact your physician. If you would prefer to utilize a treatment facility other than Apple Hill Surgical Center, your physician will assist you in making other arrangements, subject to any relevant criteria set by your payor and/or relevant treatment facilities.

Physician Investors (Updated 2/2/2021)

Glenn Amsbaugh
Marsha Bornt
Vincent Butera
Michael Dobish
Russel Etter
Brian Flowers
Michael Gangloff
Garth Good
Kenneth Heaps
Denise Kenna
Stephen Laucks
James Macbride
C. Edwin Martin
Michael Moritz
David and Marilyn Neuburger
Steven Olkowski
Charles Reilly
Peter VanGiesen
B. Emmerich Yoder