PATIENT RIGHTS

• Receive equal medical treatment and accommodations regardless of race, creed, sex, national origin, religion, or payment sources for care.
• Be fully informed and have complete information, to the extent known by the physician, regarding diagnosis, treatment, procedure, and prognosis, as well as the risks and side effects associated with treatment and procedure before the
• Exercise his or her rights without being subjected to discrimination or
• Voice grievances regarding treatment or care that is (or fails to be)
• Personal
• Receive care in a safe
• Be free from all forms of abuse or
• Receive the care necessary to regain or maintain his or her maximum health and, if necessary, cope with death.
• Expect personnel who care for the patient to be friendly, considerate, respectful, and qualified through education and experience, as well as perform the services for which they are responsible with the highest quality of
• Be fully informed of the scope of services available at the facility, provisions for after‐hours care, and related fees for services rendered.
• Be a participant in decisions regarding the intensity and scope of. If the patient cannot participate in those decisions, the patient’s rights shall be exercised by the patient’s designated representative or other legally designated person.
• Make informed decisions regarding his or her.
• Refuse treatment to the extent permitted by law and be informed of the medical consequences of such. The patient accepts responsibility for his or her actions should he or she refuse treatment or not follow the physician’s or facility’s instructions.
• Approve or refuse the release of medical records to any individual outside the facility or as required by law or third-party payment contracts.
• Be informed of any human experimentation or other research/educational projects affecting his or her care or treatment and can refuse participation in such experimentation or research without compromising the patient’s usual.
• Express grievances/complaints and suggestions at any
• Access to and/or copies of his/her medical.
• Be informed as to the facility’s policy regarding advance directives/living.
• Be fully informed before any transfer to another facility or organization and ensure the receiving facility has accepted the patient transfer.
• Express those spiritual beliefs and cultural practices that do not harm or interfere with the patient’s planned course of medical therapy.
• Expect the facility to agree to comply with Federal Civil Rights Laws that assure it will provide interpretation for individuals who are not proficient in English.
• Have an assessment and regular assessment of
• Education of patients and families, when appropriate, regarding their roles in managing pain.
• To change providers if other qualified providers are

Suppose a patient is adjudged incompetent under applicable state health and safety laws by a court of proper jurisdiction. In that case, the patient’s rights are exercised by the person appointed under State law to act on the patient’s behalf.

Suppose a state court has not adjudged a patient incompetent. In that case, any legal representative designated by the patient by state laws may exercise the patient’s rights to the extent state law allows.

Patient Responsibilities

• Be considerate of other patients and personnel and for assisting in the control of noise, smoking, and other distractions.
• Respecting the property of others and the
• Reporting whether he or she clearly understands the planned course of treatment and what is expected of him or her.
• Keeping appointments and, when unable to do so for any reason, notifying the facility and physician.
• Providing caregivers with the most accurate and complete information regarding present complaints, past illnesses and hospitalizations, medications, unexpected changes in the patient’s condition, or any other patient health
• Observing prescribed rules of the facility during his or her stay and treatment and, if instructions are not followed, forfeiting care at the facility.
• Participate in the “Speak Up” program that encourages participation in decision-making, asking questions, and voicing concerns.
• Promptly fulfilling his or her financial obligations to the facility.

ADVANCE DIRECTIVE NOTIFICATION

In the State of Texas, all patients have the right to participate in their own health care decisions and to make Advance Directives or to execute Powers of Attorney that authorize others to make decisions on their behalf based on the patient’s expressed wishes when the patient is unable to make decisions or unable to make decisions or unable to communicate decisions. Baylor Surgicare at Oakmont respects and upholds those rights. However, unlike in an acute care hospital setting, Baylor Surgicare at Oakmont does not routinely perform “high-risk” procedures. While no surgery is without risk, most procedures performed in this facility are considered minimal risk. You will discuss the specifics of your procedure with your physician, who can answer your questions about its risks, expected recovery, and care after your surgery. Therefore, it is our policy, regardless of the contents of any Advance Directive or instructions from a health care surrogate or attorney-in-fact, that if an adverse event occurs during your treatment at this facility, we will initiate resuscitative or other stabilizing measures and transfer you to an acute care hospital for further evaluation. At the acute care hospital, further treatments or withdrawal of treatment measures already begun will be ordered by your wishes, Advance Directive, or health care Power of Attorney. Your agreement with this facility’s policy will not revoke or invalidate any current health care directive or health care power of attorney.

If you wish to complete an Advance Directive, copies of the official State forms are available at our facility.

If you disagree with this facility’s policy, we will be pleased to assist you in rescheduling your procedure.

DISCLOSURE OF OWNERSHIP

Baylor Surgicare at Oakmont is proud to have several quality physicians invested in our facility. Their investment enables them to have a voice in the administration of policies of our facility. This involvement helps ensure the highest surgical care quality for our patients. Your physician does/does not (circled as appropriate) have a financial interest in this facility. For a current list of physician investors, please call 817-732-3300.

PATIENT COMPLAINT OR GRIEVANCE

Our Center strives to exceed your needs and make your stay a safe, comfortable, and pleasant experience for you, your family, and visitors. If you are pleased with your care, please let us know, and if you have concerns, please call the administrator at 817-732-3300.

If you feel you must direct your concern or complaint further, you may contact:

Texas Department of State Health Services
Facility Licensing and Compliance Division
1100 West 49^th Street
Austin, TX 78756

1-888-973-0022 (Toll-Free)

1-512-834-6653 (Fax)

http://hfc.complaints@dshs.state.tx.us

Medicare Division of Survey and Certification Operations

Office of the Regional Administrator
1301 Young Street, Suite 714
Dallas, TX 75202

214 767 6301

rodaldsc@cms.hhs.gov

The Joint Commission

One Renaissance Blvd
Oakbrook Terrace, IL 60181

1-800-994-6610

complaint@jointcommission.org

All Medicare beneficiaries may also file a complaint or grievance with the Medicare Beneficiary Ombudsman. Visit the Ombudsman’s webpage on the web at: www.cms.hhs.gov/center/ombudsman.asp