Altair Health Surgery Center
Patient Rights and Responsibilities

As a patient in a New Jersey Ambulatory Surgery Center, you have the right to:

Medical Care

  • Receive an understandable explanation from your physician of your complete medical condition including recommended treatment, expected results, risks and reasonable alternatives. If your physician believes that some of this information would be detrimental to your health or beyond your ability to understand, the explanation must be given to your next of kin or guardian.
  • Give informed written consent prior to the start of specified, nonemergency medical procedures or treatments only after your physician has explained—in terms you can understand—specific details about the recommended procedure or treatment, the risks, time to recover and reasonable medical alternatives.
  • Be informed of the facility’s written policies and procedures regarding life-saving methods and the use or withdrawal of life-support.
  • Refuse medication and treatment to the extent permitted by law and to be informed of the medical consequences of refusal.
  • Be included in experimental research only when you have given informed consent to participate.
  • Receive appropriate assessment and treatment for pain.

Transfers

  • Be transferred to an acute care facility only if the current facility is unable to provide the level of appropriate medical care or if the transfer is requested by you or your next of kin or guardian.
  • Receive from a physician in advance an explanation of the reasons for transfer including alternatives, verification of acceptance from the receiving facility, and assurance that the move will not worsen your medical condition.

Communication and Information

  • Be treated with courtesy, consideration and respect for your dignity and individuality.
  • Know the names and functions of all physicians and other health care professionals directly caring for you.
  • Expeditiously receive the services of a translator or interpreter, if needed, to communicate with the facility staff.
  • Be informed of the names, titles, and duties of other health care professionals and educational institutions that participate in your treatment. You have the right to refuse to allow their participation.
  • Be advised in writing of the facility’s rules regarding the conduct of patients and visitors.
  • Receive a summary of your rights as a patient, including the name(s) and phone number(s) of the facility staff to whom to direct questions or complaints about possible violations of your rights. If at least 10% of the facility’s service area speaks your native language, you can receive a copy of the summary in your native language.

Medical Records

  • Have prompt access to your medical records. If your physician feels that this access is detrimental to your health, your next of kin or guardian has a right to see your records.
  • Obtain a copy of your medical records for a reasonable fee within 30 days after submitting a written request to the facility.

Cost of Facility Care

  • Receive a copy of the facility charges, an itemized bill, if requested, and an explanation.
  • Appeal any charges and receive an explanation of the appeals process.
  • Obtain the facility’s help in securing public assistance and private health care benefits to which you may be entitled.

Discharge Planning

  • Be informed about any need for follow-up care and receive assistance in obtaining this care required after your discharge from the facility.
  • Receive sufficient time before discharge to arrange for follow-up care after surgery.
  • Be informed of the provisions for off-hour emergency coverage.

Privacy and Confidentiality

  • Be provided with physical privacy during medical treatment and personal hygiene functions unless you need assistance.
  • Be assured confidentiality about your patient stay. Your medical and financial records shall not be released to anyone outside the facility without your approval, unless you are transferred to another facility that requires the information, or release of the information is required and permitted by law.
  • Have access to individual storage space for your private use and to safeguard your property if unable to assume that responsibility.

Freedom from Abuse and Restraints

  • Be free from physical and mental abuse.
  • Be free from restraints unless authorized by a physician for a limited period of time to protect your safety or the safety of others.

Civil Rights

  • Receive treatment and medical services without discrimination based on race, age, religion, national origin, sex, sexual preferences, handicap, diagnosis, ability to pay or source of payment.
  • Exercise your constitutional, civil and legal rights.

Questions, Complaints and Appeals

  • Ask questions or file grievances about patient rights with a designated facility staff member and receive a response within a reasonable period.
  • Be provided, by the facility, with contact information for the New Jersey Department of Health and Senior Services unit that handles questions and complaints.

Complaints and Concerns can be Expressed in any of the Following Ways:

Call the New Jersey Department of Health complaint hotline at: 800-792-9770 or write to:

New Jersey State Department of Health
Centralized Hospital Intake Program
Mailstop: CA/DCS
P.O.Box 360, Trenton, NJ 08625

Discuss with the Center’s Administrator at (973) 695-8300 or write to:

Hanover Hills Surgery Center
83 Hanover Rd, Ste 100, Florham Park, NJ 07932

Call the Medicare Beneficiary Hotline at 1-800-MEDICARE (1-800-633-4227) or write to:

Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland 21244-1850

Or contact the Medicare Ombudsman via the world wide web at:

https://www.cms.gov/center/special-topic/ombudsman/medicare-beneficiary-ombudsman-home

Patient Responsibilities:

  1. The patient is responsible for providing accurate and complete information regarding their health status, medical history, and current medications.
  2. The patient is responsible for reporting any change in their condition during the present course of treatment and recovery.
  3. The patient is responsible for participating in care decisions and for asking questions when they do not understand the information provided.
  4. The patient has the responsibility to be considerate of others, including health care professionals and staff, as well as other patients, and to respect their rights, privacy, and property.
  5. The patient is responsible for adhering to the plan of treatment by following instructions, participating in his/her care, keeping appointments, and cooperating with care providers who assist with carrying out the plan(s) of care.
  6. The patient and/or patient representative is responsible for disposition of patient valuables.
  7. The patient is responsible for his/her actions should he/she refuse treatment or not follow the physician’s orders.
  8. The patient is responsible for providing a responsible adult to transport him/her home from the facility and remain with him/her for twenty-four (24) hours, if required by his/her provider.
  9. The patient is responsible for recognizing the effect of lifestyle choices on their personal health.
  10. The patient is responsible to be respectful of all healthcare professionals and staff, as well as other patients.
  11. The patient is responsible for providing complete and accurate third-party payer information and meeting any outstanding financial obligations related to the services received. Collaboration and agreement of payment policies and fees for services will be documented.
  12. In the case of a pediatric patient, a parent or guardian is responsible for remaining in the facility for the duration of the patient’s stay in the facility. The parent or legal guardian is responsible for participating in decision-making regarding the patient’s care.