BEFORE YOUR ARRIVAL AND CHECKING IN

Admitting Procedures
Your admission to the hospital must be arranged by your physician in conjunction with the hospital's Admitting Department. Either your doctor and /or his staff or the Admitting Office will notify you of your admission time. Once you arrive at the hospital, you should enter through the Emergency Department entrance unless you are a maternity patient. If you need assistance, please ask for help at the Information Desk.

If you are a maternity patient in active labor, please report directly to the Labor and Delivery Unit. If you did not complete preadmission paperwork, a family member should go to the Admitting Office to complete registration forms. Women scheduled for a Cesarean delivery must report to Admitting.

When you register, please bring your social security number, the name and phone number of the person the hospital should notify in an emergency, your employer information and insurance identification forms, which the admitting registrar will photocopy. If you are not covered by any health insurance, the hospital may request a deposit or arrange a financial agreement. Many insurance companies now require preadmission authorization certification, so we recommend you check with your insurance carrier prior to your admission. Failure to do so might result in a reduction of your insurance benefits. You will also need to sign a guarantor statement and a release of information, which will be sent to your insurance company.

Once the admitting procedure is complete, your name band will be placed around your wrist and the admitting registrar will direct you to your room.

What to Bring
You will want to bring personal items, such as a robe, slippers, sleepwear, hair brush, tooth brush and tooth paste, shaving kit and other toiletry articles. Please do not bring valuables to the hospital. Send home any large sums of money, credit cards, jewelry, radios or other items you may have brought with you. If necessary, these can be secured in the Safety and Security Department until a family member takes them home for you.

Personal appliances, such as electric hair dryers, curling irons and razors, are not permitted unless they are inspected and approved by the hospital's Biomedical Engineering Department. The use of cellular phones is prohibited inside the building.

While you are here, please be careful with your dentures, hearing aids and eyeglasses. Don't wrap them in tissues or napkins or leave them on your meal tray where they may be inadvertently discarded. A denture cup is available from your nurse. The hospital will not assume responsibility for loss of money or valuable items that you have kept with you during your stay with us. This includes clothing, radios, wristwatches, rings, appliances, eyeglasses, contact lenses, dentures, hearing aids and any other personal belongings.

Medications
Good Samaritan Hospital provides comprehensive pharmacy services. Personal medications should not be used while you're an inpatient and should be sent home. Occasionally, our pharmacy may not stock a medication your physician orders for you so we may ask you to use your own supply. While you are here, your physician will prescribe any medications you require. It would be helpful for you to keep a list of medications you've been taking during the last three months, as well as any allergies to medications you have, so this information can be shared with our health care team. In many instances, a pharmacist will assist your physician in monitoring your medication regimen to help prevent drug interactions or the side effects of some drugs. We believe it is important that you know about the drugs being prescribed, including their names, possible side effects and how they should be taken. If you have any questions about your medication, please ask your physician or your nurse.

FOR YOUR COMFORT AND CONVENIENCE

Spiritual Care
The chaplains of the Pastoral Care Department are available to serve your spiritual and religious needs, as well as those of your family. Newly admitted patients of all faiths are visited by a chaplain. Catholic and Jewish chaplains are available during the day and are on call for emergencies. The Eucharistic Liturgy is offered in the chapel, located in the main lobby, Monday through Friday at noon, Saturday at 8:00 p.m. and Sunday at 10:30 a.m. You are welcome to attend Mass or visit the chapel or Jewish Meditation Room as long as your physician approves and you are accompanied by a nurse's aide or volunteer. The Mass can also be viewed on Channel 6.

Kosher food can be ordered from the Nutrition Services Department and electric Sabbath candles are available from the chaplain or by calling the Pastoral Care Department. In addition, there are a few rooms available at a nominal fee for relatives of critically ill patients whose religious tenets forbid traveling on the Sabbath.

Chaplains can be reached in the Pastoral Care Department at ext. 5171 or ask your nurse or patient representative to make the contact for you.

Barber / Beautician
If you would like the services of a barber or a beautician, ask your nurse for the telephone number or ask the patient representative to make the arrangements for you. The Patient Representative can be reached by dialing '0' and asking the hospital operator to page her.

Book Cart / Newspapers
A volunteer will bring a book cart stocked with books and magazines to your bedside. They can also take orders for newspapers.

Cafeteria
Visitors are welcome to use the hospital cafeteria located on the main floor behind the Dove Gift Shop. A variety of appetizing hot, cold and grilled entrees, sandwiches, a salad bar and an assortment of desserts are available daily. The Cafeteria is open as follows:

Monday - Friday 7:30 a.m. to 6:30 p.m. Holidays and Weekends 7:30 a.m. to 6:00 p.m.

A food vending service is available 24 hours a day, seven days a week in the area adjacent to the cafeteria cashier.

Flowers
Volunteers will deliver flowers to your room between 2:00 p.m. and
4:00 p.m. Flowers and balloons are not permitted on the Critical Care Unit (CCU). Patients in the Intermediate Care Unit, Rooms 271 to 279, may receive flowers.

Gift Shop
Personal care articles, infant wear, toys, candy, magazines, paperbacks, cards, flowers and gift items are on sale in the hospital's Dove Gift Shop in the main lobby. Staffed by volunteers, the shop is open daily from
9:00 a.m. to 8:30 p.m. and donates all revenues to the hospital.

Interpreters
Sign and foreign language interpreters are available through your patient representative and the MCI Language Line. If you need a sign interpreter, please alert the Patient Representative or the admitting registrar so arrangements can be made in advance.

Mail
Your mail is delivered to the nursing units four times daily, Monday through Saturday (excluding holidays). You may also receive express deliveries from Federal Express, UPS or other carriers. We will forward any mail that arrives after you leave to your home address. Tell your family and friends that your mail should be addressed as follows:

Your Name
Room and Bed Number
Good Samaritan Hospital
255 Lafayette Avenue
Suffern, NY 10901-4869

Notary Public
This service is available through your patient representative.

Television, Phone and Fax Service
You may rent television, telephone and fax services daily through Television Rental Company. Their rental hours are from 10:00 a.m. to 7:30 p.m., seven days a week. If you did not request these services when you were being admitted, you may request them by calling ext. 5289 or you may ask your nurse to assist you. The service will be turned on that day.

Television Rental Company will ask for advance payment, but you need not make a payment on your first day in the hospital to have services connected. The daily rate schedule is as follows:

• Television   $5/day
• Telephone $3.75/day (This fee includes local calls; calls made outside the local Suffern exchanges should be billed to your credit card, charged to your home phone or called collect.)
  Cellular phones are prohibited inside the hospital building.
• Fax Machine $5.50/day plus daily phone service rental.
• Please note: TV charges are not covered by hospitalization insurance. Payment for service must be made to Television Rental Company. The TV service is not run by Good Samaritan Hospital.

Telephone Service
For your convenience, bedside telephone service with your own direct-dial number is available in all areas, except the critical care units. The telephones are manufactured for use specifically at our facility and will not work in your home.

Receiving calls: Please make note of your number and let your family and friends know they can reach you without going through the hospital operator. Calls from outside the hospital can be directly connected to your extension by dialing 845-368 + 8 + room number for bed A (near the door) or 845-368 + 9 + room number for bed B (near the window). Remind your family and friends that calls are restricted between
10:00 p.m. and 7:00 a.m. to avoid disturbing other patients.

Placing calls: To make a local call, dial 7 + phone number. The following exchanges are considered local: 351, 352, 354, 356, 357, 362, 368, 425, 426, 574, 577, 578, 753.

To make a toll call within the 914 area code, dial 7 + 0 + phone number, then listen for further instructions from a New York telephone operator.

For toll calls outside the 914 area, dial 7 + area code + phone number. If you require assistance from a long distance MCI operator, dial 7 + 00. (Operator assisted calls from your phone to locations outside the dialing area are handled by MCI. You have the right, however, to access the long distance carrier of your choice. For AT&T, dial 7 + 102880; Sprint, dial 7 + 103330; or for Cable and Wireless, dial 7 + 102230.)

Fax Service
If you require a bedside fax machine, call Television Rental Company at ext. 5289.

Equipment for Special Needs
Specific aids, such as amplified telephone handsets, personal amplifiers, large button touch tone telephones, visual alerts or Text Telephones (TTY), are available to you without charge. Your patient representative will make the arrangements.

Public Telephones
Public telephones are located throughout the hospital for your visitors' convenience.

MEALTIME
To offer you a varied diet, we provide menus from which you may order your meals for the following day. Each morning on your breakfast tray, you will find a menu consistent with the type of diet prescribed by your doctor. Complete the menu by placing a check next to the items you would like (remember to include appetizer, entree, vegetable, dessert and beverage) and leave the menu on your tray stand -- do not leave it on your tray. A nutrition assistant will pick up your completed menu after 9:00 a.m., review your selection to be sure it reflects your prescribed diet and, if necessary, arrange for a dietitian to meet with you. Kosher meals are available upon request.

Mealtime Hours
Your meals are served between the following hours:

If you have any questions during your stay, please contact the Nutrition Office at ext. 6041 between 6:30 a.m. and 5:30 p.m.

Guest Trays
Guest trays are available for visitors who would like to eat in the room with a patient. There is an additional charge for a guest tray and your visitor will need to pay the cafeteria cashier in advance. The cashier will then direct your visitor to the Nutrition Office where he or she can make a menu selection. Your visitor's tray will be delivered to your room at meal time.

AMBULATORY SURGERY
Ambulatory surgery is a safe and convenient alternative to conventional hospitalization when an overnight stay is not required. These instructions are specifically for patients scheduled for ambulatory surgery.

Preparing At Home For Your Surgery
Your surgeon will order preoperative testing, which is usually scheduled within seven days of your surgery. On the day of your testing, you should register at the first floor Admitting Office, where you will be asked to complete personal and insurance information. Our staff will give you specific pre-operative instructions about eating, drinking and taking medication and they will direct you to the laboratory, radiology or other areas for your pre-surgical tests.

If you develop a cold, virus, sore throat or if you are not feeling well the week before your surgery, please contact your physician, who may postpone your procedure, if necessary.

It is very important that you follow the preoperative instructions your physician or preadmission nurse gives you. In addition, please follow these basic rules:

• Get a good night's rest
• Do not eat or drink after midnight
• Come to the hospital dressed in casual, comfortable clothing and do not wear make up or hair accessories.
• Have at least one finger of each hand free of nail polish.
• Do not bring any jewelry or valuables with you. Wedding and engagement rings can be taped to your finger, if necessary.

If you're taking daily medication, discuss whether you should continue with your physician. If you're taking medication such as blood pressure pills, cardiac or diabetic medication, take them with no more than 1/4 ounce of water. Please note that aspirin, one of the most commonly used medications available, can, in some individuals, produce an unwanted side effect, namely prevention of normal blood clotting, which can result in abnormal bleeding. If you are having surgery, please inform your doctor if you have taken aspirin, Bufferin*, Alka Selzer*, Excedrin*, Anacin*, Pepto Bismol*, Bayer*, Midol*, or any other prescription or over the counter medication. Please call your doctor's attention to the medication(s) in question before your surgical procedure. (* Trademark Registered).
It is very important that you arrive at the Admitting Office at your appointed time so that scheduling may move along quickly.

For your safety, have a family member or friend accompany you after surgery, as you will not be allowed to drive yourself home.

Going To Surgery
Before you are taken to the operating suite, the floor nurse will ask you questions about your medical history and may need to shave or prep your operative site. Sometimes you may have additional lab work, x-rays or tests performed at this time. You will be asked to change into a hospital gown and to remove your eyeglasses, contact lenses, hearing aids, dentures or prostheses. If you have a severe hearing impairment, you may request to keep your hearing aid, which you can give to a nurse before you enter the operating room. Your doctor may order preoperative mediation to help you relax.

Your family is welcome to stay with you until you are taken to the operating room. At that time, they should wait in the Ambulatory Waiting Room where your doctor will meet with them after surgery.

In the holding area of the operating room, you will meet your nurses and anesthesiologists and will be able to talk with your surgeon. The staff will make any additional preparations for surgery and will start an IV.

After Your Surgery
Following surgery, you will be taken to the recovery room, where nurses will check your pulse, blood pressure and other vital signs, encourage deep breathing and check your operative site. Your doctor will prescribe pain medication if you need it. Pain tolerance is individual and it is important to communicate your needs to your nurse.

Once your vital signs are stable and you're responsive, the anesthesiologist will discharge you from the recovery unit. If you received spinal or epidural anesthesia for your surgery, the anesthesiologist will make sure that you have sensation and movement in your lower extremities before discharging you. They will give you postoperative instructions about diet, activity, rest and medication, as well as a phone number to call if you experience any problems while at home.

Autologous Blood Donor Program and Transfusion
Although most patients undergoing surgery do not require blood during their operations, blood will be available should the need arise. The safest blood transfusion a patient can receive is his or her own blood - an autologous donation. Check with your doctor to see if you may participate in this program. If you have made an autologous donation and you require blood during your hospital stay, your own blood will be transfused to you. Advanced notice and written permission from your doctor are required. Your physician can explain the likelihood of transfusion and the risks and benefits associated with it.

VISITOR INFORMATION
Visiting
All visitors should stop at the Information Desk for information and directions. Visitors are welcome to use the cafeteria or wait in the hospital's lobby area at any time during visiting hours. Family and friends of surgical patients may wait in the ambulatory waiting area, in the hospital lobby or in the surgical waiting room after 4:00 p.m. House phones are available in the lobby to contact patient rooms.

Visiting Hours

Medical Surgical Areas
11am-8:30pm  (two visitors per patient)

Critical Care Unit(icu &ccu)
10:00 am—8:30pm  (two visitors,immediate family only)

Pediatrics
11am-8:30pm (parents and two visitors per patient.
visiting is unlimited for parents

Maternity
11am-8:30 pm (4 visitors per patient.  Siblings under 12 must be accompanied by an adult)

Frawley Unit
Monday through Friday: 3:30 to 4:30pm and 6:30 to 8:00pm
Weekends and major holidays are 2:30 to 4:30pm and 6:30 to 8:00pm
Visitors must be at least 16 years old.

Guidelines:

• In order to protect the health and well-being of our patients and their visitors, the following will apply:
• No infant(less than 1 year) will be allowed in patient care areas
• All children(1-12yrs) must be accompanied by an adult
• Visitng children should be in good health ,in order to protect them and our patients from further illness.
• Siblings(brother&sister) are the only children permitted in maternity unit
• All visitors are asked to leave the building at 8:30pm
• No”sitter” under 18 will be allowed to remain overnight 
• It is the expectation and responsibility of accompanying adults to:
• Monitor and control behavior of any child brought to hospital
  If other patient’s rights are being compromised, the child and the adult will be asked to leave the unit by a hospital representative

Exceptions: will be made only through the clinical directors or nursing supervisors. Written permission in the form of a special pass will be given and must be presented at information desk.

Thank you for your cooperation in helping us maintain a quiet, therapeutic environment for  our patients and your loved ones.                                

Children's Restriction
No infant (less than one year) will be allowed in patient care areas. This is to protect their health and well being as well as that of our patients.

All children (1-12 years) must be accompanied by an adult.

It is the expectation of and responsibility of the accompanying adult to monitor and control the behavior and demeanor of any child brought into the institution. If the rights of other patients are being compromised, the child and adult will be asked to leave the floor by a hospital representative.

It is the responsibility of the accompanying adult to assure that all visiting children are free of illness or contagious disease for the health and safety of our patients as well as the child.

Maternity - Siblings (brother and sister) of the baby are the only children under 12 permitted on the unit.

No "sitter" under 18 will be allowed to remain overnight or be left in charge of younger children while they are visiting in the hospital.

Exceptions will be made only through the clinical managers of the nursing unit or the administrative supervisor. The clinical manager will give written permission to a family member if an exception to visiting hours has been made.

All visitors will leave the building at 8:30 p.m.

Telephone Hours
The hours between 10:00 a.m. - 11:00 a.m. and 9:00 p.m. - 10:00 p.m. have been designated as the time for families to call the unit for an update on the patient's condition. Calls will not be accepted outside of these hours.One spokesperson from each family should be designated to call. This individual may then inform other concerned family members and friends.

Families are encouraged to contact their physician during their office hours for information regarding tests and results.

The hospital staff is bound by strict federal and state confidentiality regulations. They can not and will not reveal any information to telephone callers other than patient condition. Please use the patient's physician as your main contact.

Visitor Parking
Visitor parking is available on the hospital property and accessible from Hillcrest Road.

Patient Information
Family and friends may call the Information Desk in the main lobby to obtain a room number or telephone extension. The Information Desk is open daily from 8:00 a.m. - 8:00 p.m. The hospital operator, who can be reached by dialing 845- 368-5000, will transfer outside callers to the Information Desk.

Lodging for Visitors
There are many hotels and motels in the area offering discounted rates to families of Good Samaritan Hospital patients. If your family needs assistance with accommodation arrangements, contact the patient representative by dialing '0' and asking the hospital operator to page her.

GOING HOME

When you leave the hospital
Your doctor will notify you and your family regarding the day and time of your discharge. Please do not leave the hospital before being formally discharged by your attending physician. If you cannot arrange for transportation home before 9:00 a.m., you are welcome to wait in the patient lounge on your floor. Should you remain in your room past 10:00 a.m., reimbursement policies require us to charge you the full day's room rate. Since these charges would not be covered by your insurance carrier, please ask the family member taking you home on discharge day to be at the hospital as early as possible. Late departure charges do not apply to patients awaiting transportation by a local or private volunteer ambulance service.

Family members or friends picking you up on your day of discharge should settle any outstanding financial matters at the cashier's office in the main lobby. Once the discharge forms are completed, the cashier will issue a release slip, which should be presented to the nurse on your unit for final clearance. You may then leave the unit. Before leaving the hospital, present the discharge clearance slip to the volunteer at the Information Desk.

Reminder: Before leaving your room, please check your closet and all drawers for personal items. Also at this time, please reclaim any valuables left with us for safekeeping.

ABOUT YOUR BILL

Because we understand that hospital bills can be confusing, we have included the following information to help you understand the process. If you have any questions or need to make arrangements for paying your bill, you may contact the representative who will handle your inpatient account during your stay. He or she can be reached Monday through Friday from 8:00 a.m. to 4:00 p.m. by dialing ext. 5120. For questions pertaining to your outpatient bills, call 845- 368-5152.

Who decides how you will be charged?
You may be surprised to learn that the answer is not Good Samaritan Hospital. In most cases, the amount you will be charged for services is determined, not by the Hospital, but by governmental regulations and contractual agreements with insurance companies. Medicare, Medicaid, No-fault and Workers Compensation all determine both the amount the hospital will be paid and the amount a patient will be responsible for paying, based on the patients DRG. In the case of HMOs, co-payments and deductibles are determined by a patient's particular contract.

How the DRG system works
All illnesses and injuries are categorized into more than 500 diagnosis related groups (DRGs). The State has determined a payment rate and length of stay for each DRG, based on the average amount of services used by all of our patients in the same category. While rates vary from DRG to DRG depending on the severity of the condition, all patients in one DRG must be charged the same amount.

During your stay, Good Samaritan Hospital's Case Managers review your records, as required by law, to make sure all federal and state guidelines for continued hospitalization are met. They will also work with your physician to assure the best use of our services.

Financial Information
As a service to you, Good Samaritan Hospital will submit your claim for payment directly to Blue Cross, Medicare, Medicaid, no-fault carriers, workmen's compensation carriers and all commercial insurance companies, provided you give the necessary insurance information at the time of your registration or admission.

If your insurance company requires completed claim forms, please be prepared to provide these upon registration or, if necessary, arrange for a family member to bring these forms, along with your insurance ID cards, to our inpatient or outpatient representatives as soon as possible.

Many insurance companies now require pre-admission authorization certification, referrals and second surgical opinions. We recommend that you check with your insurance company before scheduling an elective admission. Failure to do so might result in a reduction of your insurance benefits. If your insurance carrier does not cover you at 100% , you will receive a bill for the portion due.

Hospital Charges
Your final hospital bill will include fees for patient care charges and personal items. Patient care charges include your room, daily meals, around-the-clock general nursing care and many behind the scenes services, such as pharmaceuticals and care-related supplies. These services are included in the DRG rate, which is the amount billed to your insurance company.

Personal items, which are not covered by your insurance, include private room differential and daily telephone service. Payment for these services is due upon discharge.

Not included in your hospital bill are fees for private duty nurses, or your attending physician's or any other specialists' fees. These providers will bill you independently of Good Samaritan Hospital.

You may also receive separate bills from physician specialists who interpret any test performed during your stay. Some examples are:

• Radiologist
• Pathologist
• Nuclear Medicine Specialist
• Oncologist
• Emergency Room Physician Group
• Cardiologist
• Neurologist
• Anesthesiologist

When Medicare is Your Primary Insurance
If you are covered by Medicare insurance, you will need to complete a Medicare questionnaire. In many instances, you may believe that Medicare is your primary insurance, when in fact, it is not. If you have other insurance, it would benefit you to have this carrier billed first for your hospital services. Medicare will then become the secondary carrier.