Patients Bill of Rights

As a patient in an Ambulatory Surgery Center in New York State, you have the right, consistent with law, to:

1. Understand and use these rights. If for any reason you do not understand or you need help, the Ambulatory Surgery Center MUST provide assistance, including an interpreter.
2. Receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation, or source of payment.
3. Receive considerate and respectful care in a clean and safe environment free of unnecessary restraints.
4. Receive emergency care if you need it.
5. Be informed of the name and position of the doctor who will be in charge in the Ambulatory Surgery Center.
6. Know the names, positions, and functions of any Ambulatory Surgery Center Staff involved in your care and refuse their treatment, examination, or observation.
7. A non-smoking room.
8. Receive complete information about your diagnosis, treatment, and prognosis.
9. Receive all 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.
10. Receive all the information you need to give informed consent for an order not to resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. If you would like additional information, please ask for a copy of the pamphlet “Do Not Rsuscitate Others – A Guide for Patients and Families.”
11. Refuse treatment and be told what effect this may have on your health.
12. Refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
13. Privacy while in the Ambulartory Surgery Center and confidentiality of all information and records regarding your care
14. Participate in all decisions about your treatment and discharge from the Ambulatory Surgery Center. The Ambulatory Surgery Center must provide you with a written discharge plan and written desciption of how you can appeal your discharge.
15. Review your medical record with charge. Obtain a copy of your medical record for which the Ambulatory Surgery Center can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
16. Receive an itemized bill and explanation of all charges.
17. Complain without fear of reprisals about the care and services you are receiving and to have the Ambulatory Surgery Center respond to you and if you request it, a written response. If you are not satisfied with the Ambulatory SurgeryCenter, you can complian to the New York State Health Department. The Abulatory Surgery Center must provide you with the Health Department telephone number.
18.
Authorize those family members and other adults who will be given priority to visit consistent with your ability to receive visitors.

19. Make known your wishes in regard to anatomical gifts.  You may document your wishes in your health care proxy or on a donor card, available from the hospital.

PATIENTS’ RESPONSIBILITIES

1. The patient has the responsibility to provide accurate and complete information concerning his/her present complaints, past medical history and other matters relating to his/her health.
2. The patient is responsible for making it known whether he/she clearly comprehends the course of medical treatment and what is expected of him/her.
3. The patient is responsible for following the treatment plan established by his/her physician, including the instructions of the nurses and other health care professionals, as they carry out the physician’s orders.
4. The patient is responsible for keeping appointments and for notifying the Facility of physician when he/she is unable to do so.
5. The patient is responsible for his/her actions should he/she refuse treatment or not follow the physician’s orders.
6. The patient is responsible for assuring that the financial obligations of his/her care are fulfilled as promptly as possible.
7. The patient is responsible for following facility policies and procedures.
8. The patient is responsible for being considerate of the rights of other patients and facility personnel.
9. The patient is responsible for being respectful of his/her personal property and that of other persons in the facility.

New York State Departmentof Health
300 Motor Parkway, Suite 301, Hauppauge, New York 11788
Tel: 631-385-8677