Patient Rights & Responsibilities

Patient's Rights Statement

The patient has the right:

To be treated with courtesy, respect, and consideration with appreciation of his or her individual dignity and with protection and provision of personal privacy as appropriate
To receive service(s) without regard to age, race, color, sexual orientation, religion, marital status, sex, national origin or sponsor
To an environment that is respectful, safe and secure for self/person and property without being subjected to discrimination or reprisal
To confidentiality of information gathered during treatment
To prompt and reasonable response to questions and requests
To know who is providing and is responsible for his or her care and their credentials
To know what patient support services are available, including whether an interpreter is available if he or she does not speak English
To know what rules and regulations apply to his or her conduct
To be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis
To refuse treatment to the extent permitted by law and to be fully informed of the medical consequences of his/her actions
To be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care
To know upon request and in advance of treatment, whether the health care provider or health care Facility accepts their Advance Directives
To receive upon request, prior to treatment, a reasonable estimate of charges for medical care
To receive a copy of reasonably clear and understandable, itemized bill and, upon request, to have charges explained
To receive impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap, or source of payment
To make known his/her wishes in regard to anatomic gifts. This can be documented in the Health Care Proxy or on a donor card.

To change their healthcare provider if other qualified providers are available
To be informed of the provision of off hour emergency care
To receive treatment for any emergency medical condition that will deteriorate from failure to provide treatment
To know if medical treatment is for purposes of experimental/research and to give his or her consent or refusal to participate in such experimental research
To make informed decisions regarding his or her care
To receive from his/her 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
To be fully informed about a treatment or procedure and the expected outcome before it is performed
To approve or refuse their release of confidential disclosures and records, except when release is required by law
To express grievances regarding their treatment or care that is or fails to be furnished or regarding any violation of his or her rights.
To participate in all aspects of health care decisions, unless contraindicated for medical reasons
To appropriate assessment and management of pain
If the patient has been adjudged incompetent under applicable state laws by a court of proper jurisdiction, the rights of the patient will be exercised by the person appointed under state law to act on the patient’s behalf
If a state court has not adjudged a patient incompetent, any legal representative or surrogate designated by the patient in accordance with state law may exercise the patient’s rights to the extent allowed by state law
To be free from all forms of abuse or harassment

To express a grievance, the patient may contact the facility by telephone at 718-629-5590 ext 9088 or 347-417-9088, or write a letter to Stephanie Gass, Privacy Officer, 1903 Utica Avenue Brooklyn NY 11234.

Patients may call the New York State Department of Health toll-free number at 1-800-804-5447 or by mail at: New York State Department of Health, Centralized Hospital Intake Program, Mailstop: CA/DCS, Empire State Plaza, Albany, NY 12237. You may also file a facility complaint form on the DOH website: https://apps.health.ny.gov/surveyd8/facility-complaint-form.

Medicare patients may complain to the Medicare program by contacting the Office of the Medicare Ombudsman on their website: https://www.cms.gov/Center/Special-Topic/Ombudsman/Medicare-Beneficiary-Ombudsman-Home.

Patient's Responsibilities

Provide complete and accurate information to the best of his/her ability about his/her health, any medication, including over-the-counter products and dietary supplements and any allergies or sensitivities.
Follow the treatment plan prescribed by his/her provider.
Provide a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider.

Inform his/her provider about any living will, medical power of attorney, or other directive that could affect his/her case.
Accept personal financial responsibility for any charges not covered by his/her insurance.
Be respectful of all the health care providers and staff, as well as other patients.

Patient Rights & Responsibilities

Patient's Rights Statement

Patient's Responsibilities

Call: (718) 932-1234

Visit: 23-25 31st St, Queens, NY 11105