PATIENT BILL OF RIGHTS

1. To be treated with consideration, respect and full recognition of the patient’s dignity and individuality, including privacy in treatment and in the care of the patient’s personal needs.
2. To be fully informed, as evidenced by the patient’s written acknowledgment of their rights and all the rules and regulations governing patient conduct.
3. To know the name of the clinicians responsible for their care including physicians, nurses, therapists, assistants, and aides.
4. To be fully informed by a physician and/or therapist of his/her medical condition related to therapy services, unless medically contraindicated, in terms that can be reasonably understood. This information may include but is not limited to diagnosis, treatment, prognosis and medically significant alternative to care.
5. To obtain the necessary information from the therapist to be able to give informed consent before the start of any treatment. This information should include, but is not limited to, 

1. The specific treatment/procedure
2. Goals of therapy and  the probable duration of the services
3. Benefits of therapy program
4. Medically significant risks 
5. Provision for emergency care
6. Alternatives to therapy

1. To be assured confidential treatment of his personal and medical records and to approve or refuse their release to any individual outside the facility, except in the case of his/her transfer to another health facility, or as required by law or third-party payment contract.
2. To expect every consideration for privacy throughout the medical/therapy care experience including but not limited to confidentiality and discreet conduct during care discussions, consultations, examinations and treatments. Those not directly involved in the patient’s care must have the permission of the patient to be present.  All communications and records pertaining to the patient’s care will be treated as confidential.
3. To expect therapy services to provide evaluation, services and/or referrals as indicated to address an emergency situation and that the physician and responsible party will receive complete information of this emergency situation and the need for alternative care.
4. To refuse treatment to the extent permitted by law and to be informed of the medical consequences of such refusal.
5. To obtain any information about any financial and/or professional relationships that exist between NY Homeside Rehab PT OT SLP, PLLC and any other organizations and/or individuals who are involved in therapy treatment. 
6. To be informed of NY Homeside Rehab PT OT SLP, PLLC’s engagement in any research that may involve his/her care and to have the right to refuse participation in any such research projects.
7. To expect reasonable continuity of care including but not limited to, knowing in advance the appointment time and the clinician who will provide the service, information regarding continued care following discharge and a contact number for questions and emergency care.
8. To access and review an explanation of patient bill regardless of source of payment.
9. To know what rules and regulations apply to the patient’s and/or responsible party’s conduct during all phases of treatment.
10. To be informed of the extent to which charges will or will not be covered by Medicare, Medicaid, or other payer known to the care provider which includes:
11. To be informed of charges for which the patient may be liable. 
12. To be made aware of any changes in the charges in a timely manner
13. To be informed of all items and services furnished by NY Homeside Rehab PT OT SLP, PLLC for which payment may or may not be made by the Medicare Program.

 PATIENT RESPONSIBILITIES 

1. To be responsible for providing, to the best of his/her knowledge, accurate and complete information about present complaints, past illnesses and hospitalizations, medications, and other matters relating to his health.
2. To provide the name and contact information of a responsible party in case of emergency and to ensure that a person is available when advised to do so.
3. To be responsible for reporting unexpected changes in his or her condition to the responsible practitioner.
4. To be responsible for making it known whether he/she clearly comprehends a contemplated course of action and what is expected of him/her.
5. To be responsible for following the treatment plan recommended by the practitioner primarily responsible for his/her care.
6. To participate fully in decisions involving their own health care which includes being responsible to make it known if he/she does not clearly comprehend a course of action and to accept the consequences of their decisions if complications arise.
7. To be responsible for their actions if they refuse treatment or do not follow the practitioner’s instructions.
8. To be responsible for assuring that the financial obligations of his/her health care are fulfilled as promptly as possible.

NONDISCRIMINATION POLICY: 

As a recipient of Federal financial assistance, NY Homeside Rehab PT OT SLP, PLLC (may alternatively be referred to as NY Homeside Rehab) does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of race, color, national origin, disability, age, sex, sexual orientation, gender identity, religion, and creed in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, and in staff and employee assignments to patients, whether carried out by NY Homeside Rehab directly or through a contractor or any other entity with which NY Homeside Rehab arranges to carry out its programs and activities.

This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (nondiscrimination on the basis of race, color, national origin), Section 504 of the Rehabilitation Act of 1973 (nondiscrimination on the basis of disability),  the Age Discrimination Act of 1975 (nondiscrimination on the basis of age), regulations of the U.S. Department of Health and Human Services issued pursuant to these three statutes at Title 45 Code of Federal Regulations Parts 80, 84, and 91, and other federal, state, or agency regulations and policies.

Additionally, in accordance with Section 1557 of the Patient Protection and Affordable Care Act of 2010, 42 U.S.C. § 18116,  NY Homeside Rehab does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of sex (including gender identity) in admission to, participation in, or receipt of the services and benefits under any of its health programs and activities, and in staff and employee assignments, whether carried out by NY Homeside Rehab directly or through a contractor or any other entity with which NY Homeside Rehab arranges to carry out its programs and activities.

In case of questions, please contact:
Provider Name: U.S. Department of Health and Human Services
Contact Person/Section 504 Coordinator: Linda Colon, Regional Manager
Telephone number: (800) 368- 1019
TDD or State Relay number: (800) 537- 7697