Patient Rights and Responsibilities

TeamMD Surgery Center is dedicated to providing the best healthcare services possible. To help accomplish this mission, TeamMD Surgery Center believes that all patients should know their rights and responsibilities.

Patient have:

 1. To be informed of these rights, as evidenced by the patient’s written acknowledgment, or by documentation by staff in the medical record, that the patient was offered a written copy of these rights and given a written or verbal explanation of these rights, in terms the patient could understand. The facility shall have a means to notify patients of any rules and regulations it has adopted governing patient conduct in the facility.

2. To be informed of services available in the facility, of the names and professional status of the personnel providing and/or responsible for the patient’s care, and of fees and related charges, including the payment, fee, deposit, and refund policy of the facility and any charges for services not covered by sources of third-party payment or not covered by the facility’s basic rate.

3. To be informed if the facility has authorized other health care and educational institutions to participate in the patient’s treatment. The patient also shall have a right to know the identity and function of these institutions and to refuse to allow their participation in the patient’s treatment.

4. To receive from the patient’s physician(s) or clinical practitioner(s), in terms that the patient understands, an explanation of his or her complete medical/health condition or diagnosis, recommended treatment, treatment options, including the option of no treatment, risk(s) of treatment, and expected result(s). If this information would be detrimental to the patient’s health, or if the patient is not capable of understanding the information, the explanation shall 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, shall be documented in the patient’s medical record. 

5. To participate in the planning of the patient’s care and treatment, and to refuse medication and treatment. Such refusal shall be documented in the patient’s medical record.

6. To be included in experimental research only when the patient gives informed, written consent to such participation, or when a guardian gives such consent for an incompetent patient in accordance with law, rule and regulation. The patient may refuse to participate in experimental research, including the investigation of new drugs and medical devices.

7. To voice grievances or recommend changes in policies and services to facility personnel, the governing authority, and/or outside representatives of the patient’s choice either individually or as a group, and free from restraint, interference, coercion, discrimination, or reprisal.

8. To 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 for the convenience of facility personnel.

9. To confidential treatment of information about the patient.

a. Information in the patient’s medical record shall not be released to anyone outside the facility without the patient’s approval, unless another health care facility to which the patient was transferred requires the information, or unless the release of the information is required and permitted by law, a third-party payment contract, or a peer review, or unless the information is needed by the Department for statutorily authorized purposes.

b. The facility may release data about the patient for studies containing aggregated statistics when the patient’s identity is masked.

10. To be treated with courtesy, 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 facility personnel are discussing the patient.

11. To not be required to perform work for the facility 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.

12. 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. 

13. To not be discriminated against because of age, race, religion, sex, nationality, or ability to pay, or deprived of any constitutional, civil, and/or legal rights solely because of receiving services from the facility. 

14. To expect and receive appropriate assessment, management and treatment of pain as an integral component of that person’s care in accordance with N.J.A.C. 8:43E-6.

These rights and responsibilities outline the basic concepts of service here at TeamMD Surgery Center, LLC. If you believe at any time, our staff has not met one or more of the statements during your care here, please ask to speak with the Medical Director or Nurse Manager. We will make every attempt to understand your complaint/concern. We will correct the issue you have if it is within our control, and you will receive a written response. 

Patient Responsibilities:

1. Provide accurate and complete information about their present complaints, past medical illnesses, hospitalizations, surgeries, medications, over-the-counter products, dietary supplements, allergies/sensitivities and other matters relating to their health.

2. Tell their health care providers whether they understand the treatment, plan of care, and what is expected of the patient.

3. Help the practitioners, nurses and other health personnel in their efforts to care for patients by following their instructions and medical orders.

4. Observe the Center’s no smoking policy, be considerate of other patients and of staff regarding noise and number of visitors, and respect the Center’s property and that of other persons.

5. If required by their practitioner, provide a responsible adult to transport/accompany him home and to remain with him for 24 hours aftercare at the Center.

6. Accept financial responsibility for any charges not covered by their insurance.

It is always best to make every effort to address patient/visitor complaints internally through discussion, investigation and potential action by/among Center personnel and the patient/visitor. Therefore, in accord with relevant Center policies any and all patient/visitor complaints should initially be brought to the attention of Center personnel such as the Medical Director, Director of Nursing or Administrator. 

If necessary, Medicare beneficiaries may contact the Medicare Ombudsman about the Center at: www.cms.hhs.gov/center/ombudsman.asp 

Presentation of a complaint will not compromise care. 

TeamMD Surgery Center ATTN:
Medical Director
1167 McBride Ave, Ste 4 Woodland Park, NJ 07424
T: 973-567-4162

NJ Department of Health & Senior Services
Division of Health Facilities Evaluation & Licensing
PO Box 367 Trenton, NJ 08625-0367
Complaint Hotline: 1-800-792-9770 www.state.nj.us/health/healthfacilities

Medicare Beneficiary
Visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) or use www.cms.hhs

The Joint Commission Website www.jointcommission.org
or for general questions, call Customer Service at 630-792-5800
or use the online form www.jointcommission.org/report_a_complaint.aspx

TeamMD Surgery Center

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TeamMD Surgery Center is an Out of Network facility. The Center accepts Commercial Insurance with Out-Of-Network (OON) Benefits, Auto Insurance and Workers Compensation Insurance (subject to pre-approval). TeamMD Surgery Center participates with Medicare.


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