We Respect your rights to:

1. Expect quality treatment within the scope of our mission.
2. Be treated with personal dignity. Your care will not be affected by your race, religion, beliefs, cultural values, sex, age or financial status.
3. Ask all personnel involved in your care to introduce themselves, state their role in your care and explain what they are going to do for you.
4. Have a response to your request and needs for treatment.

The patient has the right to access, request amendment to and receive an accounting of disclosures regarding his/her health information as permitted under applicable law. Your healthcare team will describe your proposed treatment to you. You can expect the team to explain:

1. A description of your medical condition.
2. The alternatives of treatment.
3. The prognosis and any problems related to recuperation.
4. The benefits and risks of each alternative.
5. Provide a list and information about any medications your physician orders; per your request.

It is your right to be informed of any experimental, research, educational or training activities that may be involved in your treatment. You will be asked if you wish to participate in these activities and have the right to refuse to participate in such activities.

If limited English language skills, hearing or vision problems inhibit your ability to communicate, assistance will be provided for you. If you need this service please let your nurse know.

We respect your right:

1. To informed consent. In partnership with your physician, you can choose to agree to treatment based on a full explanation of your disease, the risks and benefits of the proposed treatment and the alternative treatments; and
2. To refuse a diagnostic procedure or treatment. It is your right to decide whether you wish to be treated and if so, by which method of treatment. If you elect to refuse treatment, you will be informed of the medical consequences of your decision. If you are a minor, your family and/or legal guardian will be involved in all your treatment planning decisions. If you are unable to exercise these rights, Good Shepherd Medical Center will extend these same rights to your legally designated representative.

You have the right to prepare an Advance Directive (a Directive to Physician and/or a Durable Power of Attorney for healthcare). These documents allow you to give directions about your future medical care or to legally designate another person or persons to make medical decisions for you if you are temporarily or permanently incapable of doing so.

Your guardian, next of kin or legally authorized responsible person may make decisions, to the extent permitted by law, if you have been declared incompetent in the legal system; found to be medically incapable to understand the proposed treatment or procedure; or unable to communicate wishes if you are a minor.

You will be asked if you have an Advance Directive when you register as a patient at Good Shepherd Medical Center. If you have such a document, a copy will be placed in your medical record and shall be reviewed periodically with you or your surrogate decision maker.

You have the right to change, delete or add to your Advance Directive at any time. You will have access to care whether or not you have an Advance Directive.

You or your legally designated representative have the right to request the withholding of resuscitative services or the initiation or withdrawal of life-sustaining treatment (to the extent provided by law).

At your request, assistance will be provided to you in formulating an Advance Directive. However, most Good Shepherd Medical Center employees cannot witness an Advance Directive. Contact the Social Work Department at 903-315-2443 for these forms and information.

While you are a patient at Good Shepherd, we understand that you and your family may be faced with difficult treatment choices. We respect your right to make an individual decision based on your personal beliefs and values as well as on available medical information. You or your legally designated representative have the right to be personally involved in the consideration of all ethical issues involving your care.

To assist you with the decision making process, we suggest you consider the following issues:

1. Do you have all the information you need to make a decision about your care?
2. In case you are unable to speak for yourself, have you formulated an Advance Directive such as a Living Will or Durable Power of Attorney for Healthcare?

Various healthcare professionals at Good Shepherd Medical Center, such as social workers, chaplains, nurses, physicians and a patient representative are available to help you discuss concerns you may have. Good Shepherd Medical Center's Ethics Committee can also assist patients, families and staff in thinking about these issues. For assistance with any of these resources, contact your nurse.

This facility does not routinely provide mental health services. However, in accordance with federal law, it is the policy of this facility to provide written information to all adult inpatients on admission regarding their right to formulate a declaration for mental health treatment. People who present to this facility who need inpatient mental health services will be screened to determine whether an emergency medical condition exists, will be provided appropriate stabilizing treatment and then transferred, as appropriate, to a facility that provides inpatient mental health services.

The hospital respects and supports the right of patients to pain management. Good Shepherd Medical Center’s nursing staff along with your physician will be monitoring any pain you may experience. They will ask for your feedback to assess treatment. Your cooperation will help assure the best course in managing relief of pain.

Your self report of pain is the single most reliable way for the nurse to know about your pain. Your nurse will ask you about your pain history and whether you are having pain when you are admitted to the hospital. Your pain will be assessed by each nursing shift. You will be asked to rate your pain on a 0 to 10 scale. 0 is no pain, 5 is moderate pain and 10 is the highest level of pain

Pain Management

Good Shepherd Medical Center supports the limitation of restraint to be used only in clinically appropriate and adequately justified situations. Our goal is to reduce the use of restraint through preventative and alternative strategies that protect the patient's health and safety and preserve his/her dignity, rights and well-being. We are committed to moving toward a restraint free environment by identifying opportunities for growth and change in regard to the use of restraints. We encourage the development of strategies that identify, create and promote a reduction in restraint use and the development of alternative interventions.

Terminally ill patients have the right to:

1. Comfort and dignity
2. Treatment of primary and secondary symptoms
3. Effective pain management
4. Response to patient/family psychosocial, spiritual and cultural needs

The staff at Good Shepherd Medical Center strives to respect the privacy of all patients. Discussions, examinations and treatment are confidential and will be discreetly conducted. In addition, you have the right to:

1. Close the curtain around your bed, or close the door anytime you want privacy;
2. Request no visitors;
3. Request confidential status to protect your identity as a hospitalized patient; and
4. Request a transfer to another room if you are unreasonably disturbed by another patient and/or visitor. Every effort will be made to accommodate you depending on availability of another equally suitable room.

Patients are assured confidential treatment of their medical records and may approve or refuse their release to any individual outside the Medical Center. We respect your right as a patient and that of your legally designated representative to personal access to your medical record and assure you that it will be accessed only by those involved in your care and treatment.

You have the right to considerate and respectful care within the scope of our mission.

Should you need a service not provided by the Medical Center, you have the right to be assisted in transferring to another healthcare facility that can provide the needed service. Authorization by an accepting physician and Medical Center must first be obtained.

At any time during your hospitalization you have the right to ask for estimated charges.

The effectiveness and safety of care, treatment and services does not depend on the patient's ability to pay.

You have the right to voice complaints regarding the quality of care and services you receive, and you are assured that the presentation of a complaint will in no way compromise your access to care. Whenever you are admitted to the hospital, you will be informed of your rights, including the right to state complaints. You may voice your complaints to any staff member or by calling the Guest Relations Specialist at 903-315-2630, or the Customer Service Representative at 903-315-5276.

You have a right to file a complaint with the Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756-3199, 888-973-0022 regardless of whether you have first used the hospital complaint process.

If at anytime during your care at Good Shepherd Medical Center you disagree with the quality of care you are receiving or disagree with premature discharge of your care, you may immediately request a Medicare beneficiary initiated Peer Review of the facts in your case. You may make this request through the hospital or directly to the Peer Review Organization by contacting the Texas Medical Foundation, 800-725-9225.

The Joint Commission on Accreditation of Healthcare Organizations is an independent, not-for-profit, national body that oversees the safety and quality of healthcare and other services provided in accredited organizations.

Concerns about accredited organizations may be provided directly to the Joint Commission at 800-994-6610.

Concerns regarding accreditation and the accreditation performance on individual organizations can be obtained through the Joint Commission website at www.jointcommission.org.

For questions about services or procedures covered by your insurance carrier or for any problems with your insurance, call the toll-free number listed on the back of your insurance identification card.

Throughout your hospital stay you will be evaluated for post hospital needs. This may result in referrals to community agencies to assist the Medical Center in meeting your discharge needs.

Provide, to the best of your knowledge, accurate and complete information about your present health status and your complete medical history including illnesses, hospitalizations, medications, Advance Directives and other matters related to your health.

If the explanation of your diagnosis or treatment is not clear, ask for the information you need. Patient education is an integral part of your treatment plan. You should receive clear instructions and education during hospitalization and for post-hospital care.

Because you are responsible for the decisions you make about your care, you have the right to as much information as you need to make your decisions. Once you and your physician have decided on a plan for treatment, be sure to advise your physician if you feel unable to follow the plan. Any plan, or change of plan, will be documented in your medical record.

If you are not fully able to participate in your care, urge a family member or friend to help you ask questions, receive instructions and make suggestions.

You may be asked to consent in writing to certain tests, procedures or operations. Ask as many questions as you need to fully understand each document you are asked to sign.

Be familiar with your health problems in order for your treatment plan to succeed. If you do not understand your illness or your treatment, ask your healthcare team to explain it.

Tell your physician about any changes in your health.

Ensure that your financial obligations are fulfilled as promptly as possible.

It is important to be considerate of other patients by observing their right to privacy, limiting your visitors in multi-bed rooms and maintaining a quiet atmosphere. Telephones, televisions, radios and lights should be used in a manner agreeable to others.

Patients and their families must be considerate of the hospital’s staff and property as well as other patients and their property.

Your healthcare provider will assist you with any questions concerning these policies.