Baylor Scott & White Medical Center – Trophy Club recognizes your rights while receiving medical care and tasks. You respect our right to expect certain behavior on the part of our patients. You may request a copy of the full text of this law from our admission representative or any employee of this facility. A summary of your rights and responsibilities follows:

Patient Rights:

The right

• To be treated with courtesy and respect, with an appreciation of his or her dignity, and with the protection of his or her need for privacy.
• To a prompt and reasonable response to questions and
• To know who is providing medical services and who is responsible for his or her
• To know what patient support services are available, including whether an interpreter is available if he or she does not speak
• To have a support individual present with a patient unless
• To know what rules and regulations apply to his or her
• To be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and
• To refuse any treatment except as otherwise provided by
• To be given, upon request, complete information and necessary counseling on the availability of known financial resources for his or her care.
• To know (A patient eligible for Medicare), upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.
• To receive, upon request, prior to treatment, a reasonable estimate of charges for medical
• To receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have the charges
• To impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of
• To treatment for any emergency medical condition that will deteriorate from failure to provide
• To know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.
• To express grievances regarding any violation of his or her rights, as stated in Texas law, through the grievance procedure of the health care provider or health care facility, which served him or her, and to the appropriate state-licensing agency.
• To effective management of pain
• To formulate, review and revise their Advanced Directives, including psychiatric
• To file complaints about the Advanced Directive Policy with the State Survey and Certification Agency
• To have family and patient’s physician MD/DO promptly notified of the patient’s admission to the hospital

Patient’s Pediatric Parent’s or Guardian’s Responsibilities:

• To provide the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.
• To report unexpected changes in his or her condition to the healthcare
• To report to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.
• To follow the treatment plan recommended by the healthcare
• To keep appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care
• To know that the existence or lack of Advanced Directives does not determine the patients right to access care, treatment, and services
• To assume responsibility for his or her actions if he or she refuses treatment or does not follow the health care provider’s
• To assure that the financial obligations of his or her health care are fulfilled as promptly as
• To follow healthcare facility rules and regulations affecting patient care and conduct.

NOTICE TO PATIENTS CONCERNING COMPLAINTS / GRIEVANCES

For Hospital Concerns, Complaints, or Grievances:

Baylor Scott & White Medical Center – Trophy Club hopes that the information provided here assists patients in answering many of their most common questions. It is happy to provide you with a full copy of your rights and responsibilities under the federal program.

NOTICE TO PATIENTS CONCERNING COMPLAINTS / GRIEVANCES

For Hospital Concerns, Complaints, or Grievances:

Baylor Scott & White Medical Center – Trophy Club is committed to providing quality health care. Your opinions regarding the care you receive are important to us. If you have concerns during your stay, please contact your nurse or speak with the Department Director or CNO. You may also dial “0” from any hospital phone to contact the Operator. They will get the Department Director or CNO.

We assure you that expressing a concern or complaint will not affect the care received or further access to care and services at Baylor Scott & White Medical Center – Trophy Club.

If you should have a problem after you leave the hospital, or if you are not satisfied with the resolution of your situation, you may contact/write the following:

Chief Nursing Officer
Baylor Scott & White Medical Center – Trophy Club
2850 E Highway 114
Trophy Club, TX 76262 (817) 837-4662

You may also file complaints with the Texas Department of Health at the following:

Texas Department of Health
1301 South Bowen, STE 200
Mail Code 1905
Arlington, TX 76013

Phone: (817) 264-4500

Fax: (817) 264-4506

TDD: (817) 264-4505

www.dshs.state.tx.us (opens in new tab)

Medicare patients:

Formal complaints about the care they receive at the hospital can be submitted to the Medicare Ombudsman at: http://www.medicare.gov/navigation/help-and-support/ombudsman.aspx (opens in new tab).

Medicare phone number: 1-800-MEDICARE

For Physician Concerns or Complaints:

If you have a concern or complaint regarding your physician, we encourage you to contact your physician and explain your circumstances. Suppose you are not satisfied with the resolution. In that case, you may file complaints about physicians, as well as other licensees and registrants of the Texas Board of Medical Examiners, including Physician Assistants may be reported for investigation at the following:

Texas State Board of Medical Examiners Investigations Department, MC-263
PO BOX 2018
Austin, TX 78768-2018

(800) 248-4062

www.tmb.state.tx.us (opens in new tab)

Joint Commission: Report a complaint about a Healthcare Organization

Do you have a complaint about the quality of care at a Joint Commission-accredited healthcare organization? The Joint Commission wants to know about it. Submit your complaint online or send it to us by mail, fax, or email. Summarize the issues in one to two pages and include the healthcare organization’s name, street address, city, and state.

When submitting a complaint to The Joint Commission about an accredited organization, you may either provide your name and contact information or submit your complaint anonymously. Providing your name and contact information enables The Joint Commission to inform you about the actions taken in response to our complaint and contact you should additional information be needed.

Our policy is to treat your name as confidential information and not disclose it to any other party. However, it may be necessary to share the complaint with the subject organization during a complaint investigation.

The Joint Commission policy forbids accredited organizations from taking retaliatory actions against employees for having reported quality of care concerns to The Joint Commission.

Email: complaint@jointcommission.org Website: www.jointcommission.org (opens in new tab) Phone:

(800) 944 – 6610 or main line (630) 792 – 5000

Fax:

(630) 792-5636

Mail:

Office of Quality Monitoring The Joint Commission

One Renaissance Boulevard Oakbrook Terrance, IL 60181o