PATIENT RIGHTS & RESPONSIBILITIES
You have the right to personal privacy and care in a safe setting free from all forms of abuse, harassment, discrimination, or reprisal.
You have the right to accurate and easily understand information about your health plan, treatment, health care, professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just need to understand something, help should be given so you can make informed health care decisions prior to your treatment or procedure. Please ask for help.
You have the right to choose health care providers who can give you high-quality health care. If you do not feel you are receiving appropriate care from a provider, you have the right to change providers if other qualified providers are available.
If you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger, you have the right to be screened and stabilized using emergency services. You should be able to use these services whenever and wherever you need them, without needing to wait for authorization and without any financial penalty.
You have the right to treatment options and to take part in decisions about your care. Parents, guardians, family members, or surrogates that you select can represent you if you cannot make your own decisions according to state law. If you are judged incompetent under applicable state health and safety laws by a court of proper jurisdiction, your rights as a patient are to be exercised by the person appointed under state law to act on your behalf.
You have the right to refuse or opt out of care that is part of research or a teaching event.
You have a right to considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.
You have the right to talk privately with health care providers and to have your health care information protected. You also have the right to read and copy your own medical record.
You have the right to ask that your doctor change your record if it is not correct, relevant, or complete. Unless authorized by law, you have the right to approve or refuse record release.
You have the right to a fair, fast, and objective review of any complaint you have against
your health plan, doctors, hospitals or other health care personnel without fear of reprisal. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy (or lack of) of treatment or care.
ADVANCE DIRECTIVES: You have the right to present an Advance Directive; however, it is our policy not to honor all terms of an Advanced Directive at our surgery center, as lifesaving measures will be made in the event of an emergency. We will do everything to stabilize you, the patient, and arrange for immediate transfer to a nearby hospital. The Advanced Directive will be kept with your medical records in case you are transferred to another facility where it will be honored in the event of such an emergency.
Provide complete and accurate health information to the best of your ability about your health, any medications, including over- the-counter products and dietary supplements, and any allergies or sensitivities.
Ask for an explanation if you do not understand papers you are asked to sign or anything about your own or your child’s care.
Assure the financial obligations associated with your own or your child’s care is fulfilled.
Gather as much information as you need to make informed decisions. You are responsible to participate in your plan of care. Be available so staff can teach you how to care for yourself or your child.
You are responsible for following the treatment plan recommended; discharge instructions outlining your care will be reviewed with you prior to surgery and given to you to take home. If clarification is needed, please ask.
Follow the care prescribed or recommended for you or your child by the physicians, nurses, and other members of the health care team; remember, if you refuse treatment or do not follow instructions, you are responsible for your actions.
Respect the rights and privacy of others, and for the personal property of other persons in the ASC.
Take an active role in ensuring safe patient care for yourself, please state any concerns while in our care.
You are responsible for making known whether or not you clearly understand the medical treatment plan. If you don’t understand, please ask again.
You must have a responsible adult to provide your transportation home and assist with your care for the first 24 hours, if required by your provider.
PHYSCIAN OWNERSHIP: You understand and acknowledge that the ASC is owned in part by physicians. At the time of last revision of this document, physicians who have financial interest or ownership in the ASC facility include:
O. Alton Barron, MD
Karen Stierman, MD
Sean Gallagher, MD
Russell Briggs, MD
Trinity Mereau, DPM
David Cuellar, MD
Robert Graham, MD
Benjamin Amis, MD
Michael Trotter, MD
Brian Mazzarella, MD
Subir Chhikara, MD
Persons who have concerns or grievances regarding Pinnacle Surgery Center of Austin, including but not limited to, decisions regarding admission, treatment, discharge, denial of services, quality of services, courtesy of personnel or any other issue are encouraged to contact the Administrator or write a statement to:
Pinnacle Surgery Center of Austin
911 W 38th Street, Suite 400
Austin, TX 78705
Pinnacle Surgery Center of Austin is Medicare Certified. For more information about your Medicare patient rights, please call:
The Medicare Beneficiary Ombudsman 1-800-MEDICARE
Any complaints regarding services provided at Pinnacle Surgery Center of Austin can be directed in writing or by telephone to:
Health Facility Compliance Group (MC 1979) Texas Department of State Health Services
P.O. Box 149347 Austin, TX 78714-9347
Complaint Hotline: 888-973-0022
Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, acupuncturists, surgical assistants may be reported for investigation at the following address:
Texas Medical Board Attention:
Investigations 333 Guadalupe, Tower 3, Suite 610
P.O. Box 2018, MC-263
Austin, TX 78768-2018
Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353
For more information please visit our website at www.tmb.state.tx.us
Pinnacle Surgery Center of Austin is accredited through the Institute for Medical Quality. Complaints and concerns regarding services provided can also be sent to:
IMQ, Ambulatory Programs 180 Howard Street, Suite 210 San Francisco, CA 94105