Patient Rights & Responsibilities
POLICY: This is to ensure that all patients receiving care at Hamilton Endoscopy & Surgery Center shall have his/her rights observed, respected, and enforced by the healthcare providers of this center from clinical staff to business staff and any other personnel that has contact and/or provides services to the patient. The following are the rights of the patient receiving care in this ambulatory surgery center.
The patient shall be informed verbally and in writing of his/her rights before their procedure, and in terms that the patient can understand. A signature acknowledging receipt of verbal and written notification of these rights shall be obtained on the day of the procedure. This will be obtained by the patient and/or legal guardian, and placed in the patient’s chart as part of their permanent medical record.
The patient will be informed of the services offered at our ambulatory surgery center, the names of the professional staff, and the professional status of who is providing and/or responsible for their care, including information on the center’s provisions for after-hour and emergency care.
The patient will be provided with information, upon request, about fees and related charges, including payments, deposits, and our refund policy as well as any charges not covered by third-party payers or by the center for ambulatory surgery’s basic rate.
The patient will be informed of any other healthcare or educational institutions participating in the patient’s treatment.
The patient will be informed of the identity and the function of these institutions, and he/she has the right to refuse the use of such institutions.
The patient will be informed, in terms that the patient can understand, of his/her complete medical/health condition or diagnosis, as well as the recommended treatment, treatment options, risks of treatment, and expected results, including the option to refuse treatment. If this information would be detrimental to the patient’s health, or if the patient is not capable of understanding the information, then the information will be provided to the patient’s next of kin or guardian. This release of information to the next of kin or guardian, along with the reason for not informing the patient directly will be documented in the patient’s chart.
The patient will participate in the planning of his or her care and has the right to refuse such care and medication. Upon refusal, it will be witnessed and documented in the patient’s chart.
The patient will be included in experimental care if the patient has agreed to such and gives written and informed consent to such treatment, or when a guardian has consented to such treatment. The patient also has the right to refuse such experimental treatment, including the investigation of new drugs and medical devices.
The patient has the right to voice grievances or recommend changes in policies and services to the ambulatory surgery center personnel, the governing authority, and/or outside representatives of the patient’s choice, free from restraint, interference, coercion, discrimination, or reprisal.
The patient will be free from mental and physical abuse, free from exploitation, and free from the use of restraints unless they are authorized by a physician for a limited period of time to protect the patient or others from injury. Drugs and other medications shall not be used for the discipline of patients or the convenience of the ambulatory surgery center’s personnel.
The patient will be assured of confidential treatment of information about him/herself. Information in the patient’s medical record shall not be released to anyone outside the center for ambulatory surgery without the patient’s approval, unless another healthcare center to which the patient was transferred, requires this information, or unless the release of the information is required or permitted by law, a third party payment contract, or a peer review, or if the information is needed by the State Department of Health for statutorily authorized purposes. The ambulatory surgery center may release data about the patient for studies containing aggregated statistics when the patient’s identity is masked.
The patient will receive courteous treatment, consideration, respect, and recognition of the patient’s dignity, individuality, and right to privacy, including, but not limited to, auditory and visual privacy. The patient’s privacy shall also be respected when ambulatory surgery center personnel are discussing the patient.
The patient will not be required to work for the center for ambulatory surgery unless the work is part of the patient’s treatment and is performed voluntarily by the patient. Such work shall be in accordance with local, state, and federal laws and rules.
The patient has the right to exercise civil and religious liberties, including the right to independent personal decisions. No religious beliefs or practices, or any attendance at religious services, shall be imposed upon any patient.
The patient has the right to expect and receive appropriate assessment, management, and treatment of pain as an integral component of that person’s care.
The patient has the right to information regarding the credentialing process of healthcare professionals at the center for ambulatory surgery.
The patient shall be informed verbally and by written notice on the date of the procedure, of his/her physician/s financial interest or ownership in the ASC. The signed copy of the Patient Acknowledgement and notification of the physician’s financial interest or ownership will be placed in the patient’s chart as part of the permanent medical record.
The patient shall be informed verbally and offered written notice on the date of the procedure, information on the ASC’s policy on advance directives, including a description of applicable state and safety laws, and if requested, official state advance directive forms. The signed copy of the Patient Acknowledgment and notification of the ASC policy on advance directives will be placed in the patient’s chart as part of the permanent medical record.
The patient has the right to refuse any treatment and research, except as otherwise provided by law.
The patient will not be discriminated against because of age, race, religion, sex, nationality, or ability to pay, nor will they be deprived of any constitutional, civil, and/or legal rights solely because of receiving services from the center for ambulatory surgery.
The patient has the right to change their healthcare provider and reschedule their procedure as needed.
The patient has the right to be informed about the ambulatory surgery center’s procedures for expressing suggestions, including complaints and grievances, including those regulated by state and federal regulations.
The patient has the right not to be misled by marketing or advertising regarding the competence and capabilities of the center for ambulatory surgery.
The patient has the right to be provided with appropriate information regarding the absence of malpractice insurance coverage.
The patient has the right to receive care in a safe setting free from all forms of abuse and harassment.
A patient is responsible for reporting unexpected changes in his or her condition to the healthcare provider.
A patient is responsible for reporting to the healthcare provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
A patient is responsible for following the treatment plan recommended by the healthcare provider.
A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the healthcare provider or healthcare center.
A patient is responsible for his or her actions if he or she refuses treatment or does not follow the healthcare provider’s instructions.
A patient is responsible for assuring that the financial obligations of his or her healthcare are fulfilled as promptly as possible.
A patient is responsible for following ambulatory surgery center rules and regulations affecting patient care and conduct.
A patient is responsible to provide complete and accurate information about his/her health, any medications, including herbal and over-the-counter supplements, and any allergies or sensitivities.
A patient is responsible to follow the treatment plan prescribed by his/her provider.
A patient is responsible to provide a responsible adult to transport him or her home from the ambulatory surgery center (if the patient is receiving anesthesia) and remain with him/her for 24 hours if required by his/her provider.
A patient is responsible to inform his/her provider about any living will, medical power of attorney, or another directive that could affect his or her care.
A patient is responsible to be respectful of all the healthcare providers and staff, as well as other patients.
If a patient is judged incompetent under applicable state laws by a court of proper jurisdiction, the rights of the patient are exercised by the relevant party appointed under state law to act on the patient’s behalf.
If a state court has not adjudged a patient incompetent, any legal representative designated by the patient in accordance with state law may exercise the patient’s rights to the extent allowed by state law
The Administrator will provide upon request to all patients and/or their families, the names, addresses, and telephone numbers of the following offices where complaints may be lodged:
Division of Health Facilities
Evaluation and Licensing
The New Jersey Department of Health
PO Box 367
Trenton, NJ 08625-0367
Phone: 800-792-9770 – Complaint Hotline
State of New Jersey
Office of the Ombudsman for Institutionalized Elderly
PO Box 808
Trenton, NJ 08625-808
Phone: 877-582-6995 (toll-free)
Questions and Complaints
1235 Whitehorse-Mercerville Road, Suite 310
Hamilton, NJ 08619
Ph: (609) 581-6610
Fax: (609) 581-6620
The Administrator shall also provide all patients and/or their families, upon request, the names, addresses, and telephone numbers of offices where information concerning Medicare and Medicaid coverage may be obtained The Medicare Ombudsman is available to the public and the ambulatory surgery center’s patients to get information about the Medicare and Medicaid programs, prescription drug coverage, and how to coordinate Medicare benefits with other health insurance programs. Information about filing a grievance or complaint can be obtained from their website, by mail, or via phone.
CMS Medicare Contact Information
7500 Security Boulevard
Baltimore, MD 21244-1850