Kingwood Endoscopy
Patient Rights and Responsibilities
I. Each patient treated at the Center has the right to:
A. Be treated with respect, consideration and dignity.
B. Respectful care given by competent personnel with consideration of their privacy concerning their medical care.
C. Receive care in a safe setting and free from all forms of abuse or harassment.
D. Be given the name of their attending physician, the names of all other physicians directly assisting in their care, and the names of functions of other health care persons having direct contact with the patient.
E. Be given the opportunity to participate in decisions involving their health care, except when such participation is contraindicated for medical reasons.
F. Have records pertaining to their medical care treated as confidential and, except where authorized by law, patient shall be given the opportunity to approve or refuse their release.
G. Know what Center rules and regulations apply their conduct as a patient.
H. Expect emergency procedures to be implemented without necessary delay.
I. Be informed of the Center’s Policy on Advanced Directives.
J. Absence of clinically unnecessary diagnostic or therapeutic procedures.
K. Expedient and professional transfer to another facility when medically necessary and to have the responsible person and the facility that the patient is transferred to notified prior to transfer.
L. Treatment that is consistent with clinical impression or working diagnosis.
M. Good quality care and high professional standards which are continually maintained and reviewed. An increased likelihood of desired health outcomes.
N. Full information in non-technical language concerning appropriate and timely diagnosis, treatment, prognosis and preventive measures; if it is not medically advisable to provide this information to the patient, the information should be given to the responsible person on his/her behalf.
O. Receive a second opinion concerning the proposed surgical procedure, if requested.
P. Accessible and available health services; information on after-hour and emergency care.
Q. Give an informed consent to the physician prior to the start of a procedure.
R. Be advised of participation in a medical care research program or donor program; the patient should give consent prior to participation in such a program; a patient may also refuse to continue in a program that has previously given informed consent to participate in.
S. Receive appropriate and timely follow-up information of abnormal findings and tests.
T. Receive appropriate and timely referrals and consultations.
U. Receive information regarding “continuity of care”.
V. Refuse drugs or procedures and have a physician explain the medical consequences of the drugs or procedures.
W. Appropriate specialty consultative services made available by prior arrangement.
X. Medical and nursing services without discrimination based upon age, race, color, religion, sex, national origin, handicap, disability, or source of payment.
Y. Have access to an interpreter whenever possible.
Z. Be provided with, upon written request, access to all information contained in their medical record.
AA. Accurate information regarding the competence and capabilities of the organization.
BB. Receive information regarding methods of expressing suggestions or grievances to the organization.
CC. Appropriate information regarding the absence of malpractice insurance coverage.
DD. Change primary or specialty physicians if other qualified physicians are available.
EE. Health Services provided are consistent with current professional knowledge.
FF. Information regarding fees for services and payment policies.
II. Each patient treated at Center has the responsibility to:
A. Provide full cooperation with regards to instructions given by his/her surgeon, anesthesiologist, and operative care (pre and post). Behave respectfully towards healthcare professions, staff, patients, and family/friends.
B. Provide complete and accurate information to the best of his/her knowledge regarding health, medications, allergies, etc.
C. Provide Center staff with all medical information that may have a direct effect on the provider at the Center.
D. Provide Center with all information regarding a third-party insurance coverage.
E. Fulfill financial responsibility, for all services received, as determined by the patient’s insurance carrier.
F. Follow the treatment plan given by his/her provider.
G. Provide a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required.
To report a patient rights concern, if you need access to services or to report a concern regarding discrimination in access to services, or help to file a grievance please contact the following:
Center Administrator: Katherine Jimenez
310 Kingwood Executive Dr. Suite A
Kingwood, TX 77339
PH(832)344-4008 Fax(832)344-4009
Email: Katherine.jimenez@kingwoodendoscopy.com
You can File a grievance in person, mail, fax, or email.
State Reporting Agency: Texas Department of State Health Service
P.O. Box 149347
Austin, TX 78714-947
Compliance Hotline 1-888-973-0022
http://www.tdh.state.tx.us
Medicare Ombudsman: 1-800-Medicare
https://www.cms.hhs.gov/ombudsman/resources.asp
AAAHC:AAAHC 5250 Old Orchard Road, Suite 250
Skokie, IL 66007
Phone (847) 853-6060
Texas State Medical Board Attention: Investigations
333 Guadalupe, Tower 3 Suite 610
P.O. Box 2018, MC-263
Austin, TX 78768-2018
Main 1-800-248-4062
Complaint Line 1-800-201-9353
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office of Civil Rights Complaint Portal, available at: https://ocrportal.hhs.gov/ocr/portal/lobby.isf or by mail or phone at:
US Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 2021
1-800-368-1019 or 1-800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html