All patients receiving care in this facility shall have their rights observed, respected, and enforced by the healthcare providers of this facility (including clinical and business staff, as well as any other personnel that has contact and/or provides services to the patient.
- Understand and use these rights. If for any reason you do not understand or you need help, the center MUST provide assistance, including an interpreter.
- Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, source of payment, or age.
- Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
- Receive emergency care if you need it. Be informed of the provisions for off-hour emergency coverage.
- Be informed of the services available at the center.
- Be informed of the name and position of the doctor who will be in charge of your care. Know the names, positions and functions of any facility staff involved in your care and refuse their treatment, examination or observation.
- A smoke-free facility.
- Receive complete information about your diagnosis, treatment and prognosis.
- Receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment. Receive from your physician information necessary to give informed consent prior to the start of any nonemergency procedure or treatment or both. An informed consent shall include, as a minimum, the provision of information concerning the specific procedure or treatment or both, the reasonably foreseeable risks involved, and alternatives for care or treatment, if any, as a reasonable medical practitioner under similar circumstances would disclose in a manner permitting the patient to make a knowledgeable decision;
- Refuse treatment and be told what effect this may have on your health.
- Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
- Privacy while in the center and confidentiality of all information and records regarding your care, except as otherwise provided by law or third party payment contract (privacy to the extent consistent with the ability to provide appropriate medical care to the patient). This shall not preclude discreet discussion of the patient’s case. The patient shall be interviewed and examined in surroundings designed to assure reasonable audiovisual privacy. This includes the right to have a person of one’s own gender present during a physical examination, treatment or procedure performed by a health professional of the opposite sex and the right not to remain disrobed any longer than necessary.
- Participate in all decisions about your treatment. The center must provide you with written discharge instructions.
- Review your medical record without charge. Obtain a copy of your medical record for which the facility can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
- Receive an itemized copy of your account statement, upon request;
- Be informed of the charges for services, eligibility for third-party reimbursements and, when applicable, the availability of free or reduced cost care;
- Approve or refuse the release or disclosure of the contents of your medical record to any health-care practitioner and/or health-care facility except as required by law or third-party payment contract;
- Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.
- Receive the information regarding credentialing of Health Care Professionals at the Center.
- Voice grievances and recommend changes in policies and services to the center’s staff, the operator and the New York State Department of Health without fear of reprisal.
- Express complaints about the care and services provided and to have the center investigate such complaints. The center is responsible for providing you or your designee with a written response within 30 days if requested by the you, indicating the findings of the investigation. The center is also responsible for notifying you or your designee that if you are not satisfied by the center response, you may complain to the New York State Department of Health’s Office of Health Systems Management.
As a patient receiving care at this center you have the responsibility to:
- Provide full cooperation by complying with the pre-procedure and post- procedure instructions given by your physician and anesthesiologist, including the provision of a responsible adult to transport you home from the facility.
- Inform your provider about any living will, medical power of attorney, or other directive that could affect your care.
- Provide the Center staff with all medical information that may have a direct impact on the care provided at the Center.
- Provide the Center with all information regarding third-party responsibility insurance coverage.
- Fulfill financial responsibility for all services received, as determined by your insurance carrier.
- Be respectful of all the health care providers and staff, as well as other patients and visitors.
If you or your loved one has any complaints or grievances, please contact the Island Ambulatory Surgery Administrator at 718.998.9400 or write to: Administrator, 2279-83 Coney Island Avenue, 1st Floor, Brooklyn, NY 11223.
You can voice complaints and recommend changes in policies and services to the facility staff, the governing authority, and the Office of Health Systems Management (OHSM) of the New York State Department of Health at 1.800.804.5447.
You may also call your Quality Improvement Organization if you have a complaint about the quality of Medicare-covered services at 1-800-331-7767 (or 1-866-446-3507 TTY for the hearing impaired) and describe your concern. You may also write to IPRO:
1979 Marcus Avenue
Lake Success, NY 11042
To get help with your Medicare-related questions or concerns, or help you need to understand your Medicare options and to apply your Medicare rights and protections, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If your inquiry requires a response from the Medicare Beneficiary Ombudsman, a 1-800-MEDICARE representative can direct your inquiry to the Medicare Beneficiary Ombudsman as needed. You can also visit the web site for the Office of the Medicare Beneficiary Ombudsman: http://www.medicare.gov/claims-and-appeals/medicare-rights/get-help/ombudsman.html