Patient Guide Jan. 2017

Page 1

Patient Guide

Welcome to Houston Methodist Sugar Land Hospital

To learn more or to make a donation, visit houstonmethodist.org/sugarland and click on the red Donate Now button!

16655 Southwest Frwy. Sugar Land, TX 77479 houstonmethodist.org/sugarland

01.17


A TRADITION OF INNOVATION & COMPASSION THE DIFFERENCE BETWEEN PRACTICING MEDICINE AND LEADING IT. Houston Methodist MethodistSugar SugarLand LandHospital Hospitalbrings brings expertise, up-to-the-minute technology Houston thethe expertise, skillskill andand up-to-the-minute technology of of the world-renowned world-renowned Houston HoustonMethodist MethodisttoHospital to Fort and surrounding counties, the alleviating the Fort Bend and Bend surrounding counties, alleviating need the need to travel the Medical Texas Medical for high-quality and compassionate care. to travel to the to Texas CenterCenter for high-quality and compassionate care. We‘re changing changingwhat whatititmeans meanstotobe beaacommunity communityhospital, hospital,performing performing most advanced surgical We’re thethe most advanced surgical andand diagnostictechniques techniquesavailable available in Fort Bend County, including surgery, opensurgery heart surgery diagnostic in Fort Bend County, including brain brain surgery, open heart and jointand joint replacementsurgery, surgery,totoname name a few —backed all backed a healing on compassion, hands-on care and replacement a few—all by a by healing focusfocus on compassion, hands-on care and outstandingservice. service. outstanding The physicians physiciansand andstaff staffofofHouston Houston Methodist Sugar Land Hospital deliver the world-class medical The Methodist Sugar Land Hospital deliver the world-class medical care care you and and your yourfamily familydeserve—with deserve — with convenience desire. you thethe convenience you you desire. Physician Scheduling: Visit houstonmethodist.org/appointments to schedule an appointment Physician Scheduling: Visit houstonmethodist.org/spg to schedule an appointment online,or orcall call281.274.7500 281.274.7500for foraareferral. referral. online Outpatient Imaging Visit houstonmethodist.org/online-scheduling 281.274.7170. Outpatient ImagingScheduling: Scheduling: Visit houstonmethodist.org/appointmentsororcall call 281.274.7170.

OUR OUR SERVICES SERVICES INCLUDE: • • • • • •• • • ••

Aquatic Therapy Aquatic Therapy Childbirth Center Birthing Center – Level II A&B NICU -Breast Level Care II A&B NICU Center Breast Care Center Cancer Center Cath LabCenter Cancer Diagnostic CardiologyImaging Emergency Cath Lab Department

• Diagnostic Imaging

houstonmethodist.org/sugarland 16655 16655 Southwest SouthwestFrwy. Freeway Sugar 77479 Sugar Land, Land, TX Texas 77479 281.274.7000 281.274.7000

• • • • • • • •

• Neuroscience & Spine Center Occupational Therapy • Occupational Therapy Physical Therapy • Physical Therapy Respiratory Therapy • Respiratory Therapy Speech Therapy • Speech Therapy • Surgical Spine Center Services – Robotics Surgical ServicesTechnology • Wound Care Program - Robotics Technology

• Endoscopy Emergency Department • Headaches and Migraines Endoscopy • Heart & Vascular Center Headache Migraines • Infusion & Center Infusion Center • Inpatient Services • Intensive Care Inpatient Services • Joint Center Intensive Care • Lab Joint Center

• • • • • •

Lab

• Wound Care Program

comprehensive therapy services The area’s finest and most experienced therapists staff our facilities, providing the latest and most effective treatments custom-tailored to deliver maximum effectiveness and quick return to full and pain-free function. Many of our therapists have completed clinical residency programs and fellowship programs within their subspecialty area of practice. In addition, many of our therapists hold national certifications, including:

• • • • •

Board Certification in Orthopedics Board Certification in Sports Physical Therapy Certified Hand Therapist Certified Strength and Conditioning Specialist LSVT BIG® and LSVT LOUD® Certification

Whether the goal is to get you back in the game, back to work, or back to your hobbies and passions, our therapists will be with you every step of the way.

Schedule Now: 281.274.0123 Three Convenient Locations: Houston Methodist Sugar Land Hospital Neuroscience & Spine Center 16605 Southwest Frwy. Medical Office Building 3, Suite 115 Sugar Land, TX 77479 Monday – Friday: 8 a.m. – 5 p.m. • Physical Therapy • Occupational Therapy • Speech Therapy • BIG and LOUD Therapy Houston Methodist Orthopedics & Sports Medicine at Sugar Land 16811 Southwest Frwy., Suite 100 Sugar Land, TX 77479 Monday – Thursday: 7 a.m. – 7 p.m. Friday: 7 a.m. – 6 p.m. • Physical Therapy • Occupational Therapy • Hand Therapy • Aquatic Therapy Houston Methodist Sienna Plantation Physical Therapy 8330 Hwy. 6, Suite 200 Missouri City, TX 77459 Monday – Friday: 8 a.m. – 5 p.m.

houstonmethodist.org/sugarland-therapy

• Physical Therapy


Welcome to Houston Methodist Sugar Land Hospital Mission To provide high quality, costeffective health care that provides for the comfort of our patients and delivers the best value to the community and people we serve in a spiritual environment of caring.

Vision I am pleased to welcome you to Houston Methodist Sugar Land Hospital. Houston Methodist Sugar Land Hospital has been serving Fort Bend and the surrounding counties since 1998. Residents have come to rely on us to deliver high-quality compassionate care and leading-edge technology that was once available only at Houston Methodist Hospital in the Texas Medical Center. During your time with us, you may have questions about the hospital, your stay or the many services we offer patients and guests. This patient information guide has been written and designed to help answer those questions. We understand that hospitalization can be a stressful time for patients and their families. Rest assured that we are here to assist you. Please feel free to contact our Guest Relations Department at 281.274.7806 to let us know how we can make your stay with us more comfortable. Thank you for choosing Houston Methodist Sugar Land Hospital. Sincerely,

Chris Siebenaler Chief Executive Officer

Houston Methodist Sugar Land Hospital is the premier hospital in the Fort Bend community that provides exemplary care through the loving hands and hearts of top-quality physicians and staff. We promise to cultivate a safe, spiritual and healing environment.


IN THIS GUIDE Welcome to Houston Methodist Sugar Land Hospital

1

Fire Safety

8

About Us

3

Electrical Appliances

8

Telephone Directory

4

Mail and Flowers

8

During Your Stay

5

Patient Meals

9

Visitors

5

Guest Trays

9

Admission

6

Starbucks

Calling Your Nurse

6

Patient Safety

Prevent Infections

21

Five Things You Can Do to Prevent Infection

21

Five Steps to Safer Health Care

24

9

What are Your Advance Directives?

25

Vending Machines

9

Spanish Advance Directives

28

6

Pharmacy

9

Your Privacy & Information

31

For the Hearing Impaired

6

Spiritual Care

9

Telephone

6

Gift Shop

9

Spanish Your Privacy & Information

36

Interpreters

6

Cafeteria

9

Stratus Language Services

7

Customer Service

10

Patient Notification of Data Collection

44

Valuables

8

Guest Relations/Concerns

10

Do You Have Pain?

45

ATM

8

Guest Relations in Spanish

10

Don’t Leave Until...

46

Security

8

Television Channel Listing

11

Preparing to Leave the Hospital

48

Cell Phones

8

Speak Up!

12

For the Caregiver

52

Wireless Internet Service

8

Rights & Responsibilities

13

Resources

53

Lost and Found

8

Spanish Rights & Responsibilities 14

Giving Back

55

Weapons

8

Stay Safe

Medication Tracker

56

Smoking

8

Nominate a Nurse

57

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About Us For more than a decade, Houston Methodist Sugar Land Hospital has been an integral part of the Fort Bend community, offering both state-of-the-art technology and excellent medical care in a unique, home-like environment. Our success begins with a patient-centric operational philosophy. That approach can be seen in things big and small — our dedication to providing the widest possible range of services; our significant capital investments in advanced technology; and the convenient design and comfortable décor of our facilities. But what really sets us apart is the quality of our people and their commitment to our patients’ well-being. Our healing mix of values-based personal care and service can be seen in our staff and within our commitment by truly living Houston Methodist I CARE values. Our employees display Integrity, Compassion, Accountability, Respect and Excellence in their daily interactions with patients, family members, our medical staff and one another. This dedication to serving others — along with innovative technology, training and expertise — is recognized by the many specialized designations we’ve achieved over the years. For example, Houston Methodist Sugar Land was named one of the nation’s 100 Top Hospitals two years in a row by Truven Health Analytics.™ The hospital also earned accreditation from DNV GL Healthcare, demonstrating that it meets or exceeds patient safety standards set forth by the U.S. Centers for Medicare and Medicaid Services. This commitment is also fully supported by our more than 900 top-quality physicians — representing the full range of medical specialties — who combine I CARE values with a level of expertise, knowledge and skill that is second to none.

Our Address 16655 Southwest Frwy. Sugar Land, TX 77479 281.274.7000

Values Statement: I CARE Integrity: We are honest and ethical in all we say and do. Compassion: We embrace the whole person and respond to emotional, ethical and spiritual concerns as well as physical needs. Accountability: We hold ourselves accountable for our actions. Respect: We treat every individual as a person of worth, dignity and value. Excellence: We strive to be the best at what we do and a model for others to emulate.

Your Opinion Counts Soon after you are discharged, you will receive a patient satisfaction survey in the mail. Please take the time to complete and return the survey. Your feedback is an important part of our goal to continually improve the care and services we provide.

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Telephone Directory MAIN NUMBER

281.274.7000

Brazos 5

346.901.2500

ICU — Brazos (Medical ICU)

346.901.2250

Brazos 6

346.901.2600

ICU — Main (Surgical ICU)

281.274.8050

Main 4 East

281.276.1927

Infusion Center

281.276.8201

Main 4 West

281.276.1900

Joint Center Coordinator

281.275.0685

Main 5 East

281.276.3027

Medical Records

2 8 1 . 2 74 . 7 8 1 4

Main 5 West

281.276.3000

Neuroscience & Spine Center

281.274.7979

Main 6 East

281.275.0670

Outpatient Scheduling

2 8 1 . 2 74 . 7 1 7 0

Main 6 West

281.275.0660

Outpatient Therapy

2 8 1 . 2 74 . 0 1 2 3

Billing

832.667.5900

Patient Food Services

281.274.8360

Breast Care Center

2 8 1 . 2 74 . 7 1 2 6

Patient Information

281.274.7000

Cafeteria

281.276.8537

Physician Referral

281.274.7500

Cancer Center

281.274.7800

Pre-admission Testing

2 8 1 . 2 74 . 7 0 5 1

Case Management

2 8 1 . 2 74 . 7 1 0 8

Radiology

2 8 1 . 2 74 . 7 1 7 1

Childbirth Center

281.274.7080

Receptionist

2 8 1 . 2 74 . 0 1 0 4

Diabetes Education

713.441.5975

Safety and Security

2 8 1 . 2 74 . 7 1 1 2

Directions to Hospital

281.274.7000

Social Services

2 8 1 . 2 74 . 7 1 0 8

Emergency Department

2 8 1 . 2 74 . 7 1 1 7

Speakers’ Bureau

281.794.0687

Gift Shop — Main Pavilion

2 8 1 . 2 74 . 0 1 3 5

Speech Therapy

281.274.7064

Gift Shop — Mom and Baby

281.274.8338

Spiritual Care

2 8 1 . 2 74 . 7 1 6 4

Guest Relations

281.274.7806

Support Groups

2 8 1 . 2 74 . 7 1 6 4

Wound Care Program

281.275.0770

Heart & Vascular Center 281.274.8378

Please visit us at houstonmethodist.org/sugarland Calling WITHIN the Hospital Dial the last five digits of the number. Local calling OUTSIDE the Hospital Press “9” and dial your number.

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During Your Stay We have guidelines in place to help you and your family members work with our doctors, nurses and staff to get the most from your hospital stay. Please take a few minutes to review these guidelines with your loved ones.

Visitation Policy Our visitation policy is designed to protect patients’ privacy, promote safety and meet the emotional needs of the patient. The purpose of this policy is to create a reasonable, enforceable standard that provides all patients with the opportunity to rest and recover in comfortable surroundings while enabling family, friends and other individuals to be involved in patient care. Visitation privileges will not be restricted, limited or otherwise denied on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity or disability. Overall, the policy reflects Houston Methodist’s commitment to provide a safe environment for all patients, visitors and employees. Visitors are welcome 24 hours a day in most areas of the hospitals. However, certain areas may have shorter visitation hours due to clinical necessity. Patients and visitors should check with staff in the patient care unit to confirm the policy for that area. Additional restrictions to the visitation policy may be initiated by an executive order due to a local or national crisis, pandemic or other special situation. Patients have the right to choose who may and may not visit them. Individual patient preferences regarding the hours and duration of visitation will be accommodated as clinically appropriate. The number of visitors per patient may be limited based on patient request, clinical necessity or in consideration of the other patients. Visitors may be requested to step out of the room so that the staff may provide care to the patient. All persons should refrain from visiting if they have a runny nose, cough or other symptoms of respiratory infection, diarrhea or any other suspected contagious disease. A visitor is permitted to remain overnight. Overnight sleeping in public waiting areas is not permitted. Patients are not authorized to remain in public waiting areas and should remain on their unit after hours. Houston Methodist is committed to providing a safe, healthy environment that is free from violence or threats of violence. Houston Methodist Sugar Land Hospital does not tolerate behavior, whether direct or through the use of hospital facilities, property or resources that: • Is violent • Threatens violence • Harasses or intimidates others • Interferes with an individual’s legal rights of movement or expression • Disrupts the workplace, the environment of care or the hospital’s ability to provide and deliver safe, quality care, service and treatment to the public

Visitors Visitors entering the hospital between 9 p.m. and 6 a.m. are required to sign in at the Emergency Department entrance or the Sweetwater Pavilion North entrance. After 10 p.m. the elevators require badge access.

Visitor Guidelines Please ask your friends and relatives to observe our visiting rules: • Visitors are asked to practice good hand hygiene. Hands should be sanitized or washed before and after all patient contact. Hand gel is located outside each room. • If the patient’s room has signage on the door for “Isolation,” for your protection, please follow all instructions and check with the patient’s nurse should you have any questions. • Visitors should ask the nurse for permission before bringing food to patients. Visitors are also discouraged from eating and drinking in the patient’s room. • Visitors should not visit if they have colds or any infectious diseases. • A “NO VISITORS” sign may be posted on the door upon request.

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During Your Stay Admission

Upon Admission

Most inpatients are pre-admitted to the hospital or admitted through the Emergency Department. If you have questions about the admitting process, call patient access services at 281.276.8621. For security reasons, the Main Pavilion, where admissions are handled, is closed to the public between 9 p.m. and 6 a.m. daily. During these hours the only public entrance to the hospital is through the Emergency Department.

Your admission and type of medical care are arranged by your physician. Upon admission to your room, you will be oriented regarding what to expect during your stay with us. A complete admission history and assessment will be completed by our nursing team. At that time, the plan of care and expected length of stay will be discussed. Each day, your nurse will review the plan of care with you, as well as your goals for that day. It is our goal to deliver excellent patient care and involve your family in your care, when possible.

Outpatient Services If you are not admitted to the hospital, but receive outpatient services, you will be billed according to your insurance plan. If you have questions about outpatient billing, call patient billing services at 832.667.5900.

Calling Your Nurse To contact your nurse, call the number on the white board or press your call button on your bed or television remote. Each department has a unit secretary that answers the calls and will route your concerns to your nurse or patient care assistant.

Patient Safety — To Prevent Falls The hospital has an active safety program, and all personnel are trained to prevent accidents. You can help by using the call button whenever you need assistance. Unless you have been told it is all right to do so, do not try to get out of bed or a wheelchair without assistance. Bed or chair alarms may be used to keep you safe.

For the Hearing Impaired A TDD machine and amplification devices are available for the hearing impaired. They may be obtained by notifying your caregiver.

Telephone Friends and family can dial directly to all patient rooms. Your direct dial number is listed on your phone or on the dry-erase board in your room. There is no need to go through the hospital operator. Local calls are free. Just press “9” and dial the number. You are responsible for long-distance calls. To make a long distance call, press “9,” then “0,” then the area code and the number you are calling. The operator will ask you for your method of payment (collect or credit card) and will connect your call.

Interpreters Houston Methodist Sugar Land Hospital utilizes Stratus video and language services. If you need the help of an interpreter, tell your caregiver, and we will obtain the services of someone who speaks your language. We also offer translation services and tools for the hearing impaired. There is no fee for the service. We cannot use family members as interpreters.

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Languages Available Through Stratus

TM

Stratus Video — www.stratusvideo.com — 727.451.9766 — 33 N. Garden Ave., Suite 1000, Clearwater, FL 33755

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During Your Stay Leave Your Valuables at Home Please do not bring valuables with you to the hospital. If you have valuables, please entrust them to a family member. If there is not a family member available, please ask your nurse to have security take your belongings to the hospital safe. When you are discharged, remember to pick up any valuables stored in the safe. Please call security at 281.274.7112 for additional information. Houston Methodist Sugar Land Hospital is not responsible for replacement of personal belongings.

ATM

Cell Phones The use of cellular phones is allowed in all areas of the hospital, but for patient safety, their use is restricted within three feet of medical equipment. Additionally, certain departments may restrict the use of cell phones if it interferes with patient care. Please set the ring to vibrate to help promote a quiet, healing environment.

Wireless Internet Service Houston Methodist Sugar Land Hospital has free wireless internet access. Patients and visitors can bring their wireless devices to access the internet in the patient rooms, the cafeteria and in hospital waiting areas.

Lost and Found To inquire about lost and found items, call security at 281.274.7112.

Weapons Do not bring firearms into the hospital. State law prohibits the carrying of firearms on hospital property.

Smoking Smoking is not permitted anywhere in the hospital or on hospital grounds, including the medical office buildings and the parking areas.

For your convenience, an automated teller machine (ATM) is available in the atrium of the Main Pavilion and Sweetwater Pavilion.

Fire Safety

Security

Patient and visitor non-medical equipment is allowed to be used in the hospital as long as it does not interfere with the care of the patient. These items include electronic equipment such as computers, and personal grooming equipment such as electronic razors and hair dryers. Hospital staff may ask for the equipment to be removed or not used, if they feel it is unsafe or disruptive to patient care.

Security services are available 24-hours a day, seven days a week. For an escort to your car or other security related issues, call security at 281.274.7112.

We periodically conduct fire drills. If you hear an alarm, stay where you are. In the event of an actual emergency, hospital staff will notify you.

Electrical Appliances

Patients being admitted to the hospital with personal medical equipment will be provided hospital owned equipment to replace theirs while they are an admitted patient. An exception to this process will be allowed if there is a clinically significant compromise to the patient’s care by using hospital provided equipment and will require an accompanying physician’s order, supplies provided by the patient and the patient or family care provider demonstrates competency to safely operate the device.

Mail and Flowers Mail and flowers sent to you by loved ones will be delivered to your room upon arrival. Mail received after you have been discharged will be forwarded to your home address. Flowers received after you leave will be returned to the florist. Please be aware that live flowers or plants are not allowed in the intensive care unit; however, silk arrangements are permissible. Flowers can be ordered through the gift shop by calling 281.274.0135 (Main Pavilion Gift Shop) or 281.274.8338 (Mom and Baby Gift Shop). 8 | Physician Referral 281.274.7500


Patient Meals

Gift Shop

Houston Methodist Sugar Land Hospital offers a unique food service we call “Just For You” room service, which is available between the hours of 6:30 a.m. and 7 p.m., seven days a week. This service allows you to order your meal when you are hungry. Food arrival time is approximately 45 minutes. Please call extension 48360 for this service. A full-time dietitian is on staff to ensure that any special nutritional needs are met. For any questions or concerns regarding food service, please call the patient food services manager at extension 47919.

The hospital has two gift shops to help meet your needs.The Main Pavilion Gift Shop is located to the right of the main entrance at the end of the connector to the Brazos Pavilion. The gift shop in the Sweetwater Pavilion is located at the main entrance to the left of the information desk.

Guest Trays Guest trays are available for your visitors for the price of $12 per meal (breakfast, lunch, dinner). Guest trays are brought to the patient’s room and each guest tray consists of a standard regular service meal. Guest trays are not permitted in the ICU. Please call extension 48360 for this service.

Starbucks For your convenience, there are three Starbucks locations. Main Pavilion — First Floor (Garden Cafe Starbucks) Mon – Fri 7 a.m. – 7 p.m. Sat – Sun 7 a.m. – 2 p.m. Main Pavilion — Second Floor (near surgery waiting area) Mon – Fri 7 a.m. – 2 p.m. Sat – Sun Closed Sweetwater Pavilion — First Floor Mon – Fri 7 a.m. – 4 p.m. Sat – Sun Closed

Vending Machines The vending machine is available 24/7 and is located next to the Emergency Department.

Pharmacy The hospital pharmacy will provide the medications your doctor orders during your stay. The hospital has a closed formulary (list of medications stocked) and at times may not have all of the medications on your list. For your safety, non-FDA regulated herbals and supplements will not be dispensed or administered. In these instances, the pharmacist will work with your physician and nurse to determine the best alternative. It may be necessary for the hospital to administer medications you bring from home. A review of your home medications will be done upon admission, during your hospital visit and again when you are discharged to completely reconcile your medication lists across the care visit. At discharge, be sure to ask about which medications you should continue to take at home and if there are any medications you will no longer need to take. It is important that we partner together in meeting all of your medication needs, and we are here to answer any questions you may have about your prescribed medications.

Hours of Operation: Main Pavilion Gift Shop Mon – Fri 9 a.m. – 8 p.m. Sat – Sun 10 a.m. – 7 p.m. Mom and Baby Gift Shop Located in the Sweetwater Pavilion Mon – Fri 9 a.m. – 8 p.m. Sat – Sun 10 a.m. – 7 p.m.

Where’s the Cafeteria? The Garden Café is located in the atrium of the Main Pavilion and is open seven days a week, from 7 a.m. to 7 p.m. Monday through Friday and from 7 a.m. to 2 p.m. on Saturday and Sunday. Visitors are welcome to dine in the cafeteria.

Hours of Operation: Breakfast (Mon - Sun) 7– 10 a.m. Lunch/Dinner (Mon – Fri) 11 a.m. – 7 p.m. Lunch (Sat – Sun) 11 a.m. – 2 p.m.

Spiritual Care Our Department of Spiritual Care desires to provide you with excellent spiritual attention during your stay in our facility. Our staff chaplains, volunteer lay ministers, holy communion ministers and CanCare volunteers offer 24-hour pastoral support, as well as spiritual resources, including Bibles (in English, Spanish and six additional languages), scripture cards, prayer ministry, bereavement support and more. houstonmethodist.org/sugarland | 9


During Your Stay Customer Service Texas Department of State Health Services P.O. Box 149347 Austin, TX 78714 888.973.0022 customer.service@dshs.state.tx.us DNV GL Healthcare, Inc. 400 Techne Center Drive, Suite 100 Milford, OH 45150 1.866.496.9647 www.dnvglhealthcare.com KePRO 5700 Lombardo Center Drive Seven Hills, OH 44131 1.844.430.9504 www.keproqio.com Customer Service – CMS Region 6 (Servicio al Cliente) – Región 6 Quality of Care Complaints (Quejas sobre Calidad de Atención) 1301 Young St., Suite 714 Dallas, TX 75202 214.767.6423 RODALDora@cms.hhs.gov The Office for Civil Rights (Departamento de Derechos Civiles) (Temas de discriminación) Department of Health and Human Services (Departamento de Salud y Servicios Humanos) 1301 Young St., Suite 1169 Dallas, TX 75202

We can also assist you with biomedical ethics issues, including establishing a Medical Power of Attorney, an Out-of-Hospital-Do-Not-Resuscitate Order or Directive to Physicians, otherwise known as a Living Will. All three of these legal documents are known as different types of Advance Directives. (See pages 2530 for English and Spanish versions.) Regardless of your religion or faith, we strive to provide you with the resources you need to fulfill your spiritual needs with excellence. Our chapels, located on the first floor of the Brazos Pavilion near the patient elevators, and on the first floor of the Sweetwater Pavilion near the patient elevators, are open 24 hours. The Muslim Prayer Room is located on the first floor of Sweetwater Pavilion. If you are in need of pastoral assistance, please call 281.274.7164. For any emergencies after hours or during the weekend, please ask the hospital operator to contact the on-call chaplain.

Guest Relations/Concerns The Guest Relations Department is staffed by patient liaisons that are available to help patients with any questions or concerns that may arise during or after their admission. A patient liaison is available to all patients Monday – Friday, 8 a.m. – 10 p.m., and Saturday and Sunday, 10 a.m. – 6 p.m. If you have any special requests, questions or concerns about your care, please contact the Guest Relations Department at 281.274.7806. For a concern about care, treatment and services, including a complaint or grievance, you may also contact one of the organizations listed on this page under “Customer Service.” Quality health care is our priority. If you have a suggestion for improvement or a concern about your care, we ask you to make this known to the Quality Management Department. At Houston Methodist, our operations are tirelessly reviewed for ways to improve the care we offer our patients. The Guest Relations Department will send a resolution letter to you with the investigative results, date of completion and contact person. In some cases, investigations may take longer; however, we will keep you informed if this is the case.

Relaciones con el Paciente/ Inquietudes El Departamento de Relaciones con el Paciente cuenta con personal de enlace para ayudar a los pacientes ante cualquier duda o inquietud que pueda surgir durante o después de su ingreso al hospital. El servicio de enlace está disponible para todos los pacientes de Lunes a Viernes de 8 a.m. a 10 p.m. y Sábado a Domingo, 10 a.m. a 6 p.m. Si tiene algún pedido, pregunta o inquietud acerca del cuidado de su salud, póngase en contacto con el Departamento de Relaciones con el Paciente: 281.274.7806. Si usted eleva una inquietud, ésta será investigada por los departamentos pertinentes del hospital y se llevarán los resultados al Departamento de Control de Calidad. El Departamento de Relaciones con el Paciente le enviará una carta de resolución con los resultados de la investigación, la fecha de finalización y una persona de contacto. Sin embargo, en algunos casos la investigación puede llevar más tiempo; lo mantendremos informado si este fuera el caso. Si usted no estuviera satisfecho con el resultado de la investigación, podrá ponerse en contacto con las organizaciones listadas a la izquierda.

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Television Information All patient rooms are outfitted with flat screen televisions and a DVD player. If your room does not have a remote for the DVD player and you would like one, please let your nurse know. Please be considerate of others by keeping the TV volume down and turning off your TV at bedtime. Basic television and cable channels are available for you at no extra charge. 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34

CHANNEL GUIDE ACTION MOVIES FAMILY MOVIES Delirium information CHILDREN MOVIES RELAXING SCENESCAPES FOX 26 CW39 UPN MY20 CBS NBC ABC UNIVISION TELEMUNDO THE WEATHER CHANNEL CHRISTIAN TELEVISION NETWORK THE CHURCH CHANNEL IN-HOUSE SPIRITUAL CARE TRAVEL CHANNEL NEWBORN INFORMATION FOX NEWS CNN BREAKING NEWS CLUE TV/SLEUTH INVESTIGATION DISCOVERY NBA OR NFL IN SEASON ESPN ESPN 2 SEC NETWORK ROOT SPORTS HOUSTON FOX SPORTS SOUTHWEST AMERICAN HEROES HGTV GAME SHOW NETWORK

35 USA NETWORK 36 TNT 37 TBS 38 AMC (AMERICAN MOVIE CLASSIC) 39 CURRENTLY UNAVAILABLE 40 THE LEARING CHANNEL 41 ANIMAL PLANET 42 NATIONAL GEOGRAPHIC 43 PBS – LOCAL CHANNEL 8 44 NICKELODEON 45 DISCOVERY CHANNEL 46 BOOMERANG 47 THE OPRAH NETWORK 48 HALLMARK CHANNEL 49 OXYGEN 50 WOMEN’S ENTERTAINMENT 51 FOOD NETWORK 52 A&E 53 SCIENCE FICTION 54 TRU TV 55 SCIENCE CHANNEL 56 LIFETIME 57 REELZ 58 OVATION 59 FOX MOVIE CHANNEL 60 TV LAND 61 F/X 62 FYI 63 HISTORY CHANNEL 64 STARZ ENCORE FAMILY MOVIES 65 BRAVO 66 E! AUX/HDMI 1 IN-ROOM DVD/BLU-RAY PLAYER

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Speak Up! Remember: • Write down any questions you have • Choose a family member to communicate with the doctors and staff • Keep a list of doctors you see and their phone numbers • Keep a list of medications including name, dosage and frequency

Take charge of your care. During your stay, the doctors, nurses and staff of our hospital will treat you and your family as partners in your own care. One important way that you can be involved is to speak up. Ask questions, voice your concerns and don’t be afraid to raise any issues relating not only to your care and treatment, but also to overall hospital services. In the pages that follow, you’ll find a step-by-step guide to making the most of your hospital stay — how to remain safe, get the information you need, ask the right questions and interact effectively with your doctors, nurses and hospital staff.

Step Up and Speak Up Speak Up: Ask questions and voice concerns. It’s your body and you have a right to know. Pay Attention: Make sure you’re getting the right treatments and medicines. Educate Yourself: Learn about the medical tests you get and your treatment plan. Find an Advocate: Pick a trusted family member or friend to be your advocate. What Meds and Why: Know what medicines you take and why you take them. Check before You Go: Seek care at a hospital, clinic, surgery center or other type of health care organization that meets regulatory institution’s quality standards. Participate in Your Care: You are the center of the health care team.

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Rights & Responsibilities As a patient, you have the right to respectful and considerate care. In addition, there are specific rights and responsibilities you have during your hospital stay.

Patient Rights:

3The right to a reasonable response to his/her requests and needs for treatment or service, within the hospital’s capacity, mission and applicable laws and regulations;

3The right to know how Houston Methodist is required and permitted by law to use and disclose his/her health information;

3The right to have his/her health information

safeguarded and to know his/her health information rights, including the right to access and request amendment of his/her health information and to obtain an accounting of disclosures regarding his/her health information as permitted under applicable law;

3The right to and need for effective communication; 3The right to considerate and respectful care, including the consideration of developmental age, sensory impairment, psychosocial, spiritual and cultural variables, and the comfort and dignity of dying patients;

3The right to know the name of the physician who has primary responsibility for coordinating the care and the names and professional relationships of other physicians and non-physicians who will see the patient;

3The right to receive information about the illness, including explanation of risks, benefits and alternatives needed in order to consent to a procedure or treatment, the course of treatment and prospects for recovery in terms that the patient can understand;

3The right, in collaboration with his/her physicians, to make decisions involving his/her health care, including the acceptance or refusal of treatment and the use of advance directives;

3The right to receive, at the time of admission, in a language or method that the patient understands, information about the hospital’s patient rights policy, and the mechanism for initiation, review, and when possible, resolution of patient complaints regarding quality of care;

3The right to voice a concern to the appropriate hospital personnel or to the Texas Department of State Health Services; (a list of contact information can be found on page 10)

3For concerns regarding health information privacy, the right to voice the concern to appropriate hospital personnel or the Secretary of the United States Department of Health and Human Services;

3The right to participate in, or have his/her qualified personal representative participate in, the consideration of ethical issues arising in his/her care;

3The right to participate or not to participate in any human experimentation, research or education projects;

3The right, within legal limits, to personal privacy and confidentiality of information. Case discussion, consultation, examination and treatment are confidential and should be conducted discreetly. The patient has the right to be told why any individual is present;

3The right to consent or refuse to consent to recording or filming (photographic, video, electronic or audio material) of him/her or any personal identifiable information for purposes other than the identification, diagnosis or treatment of the patient;

3The right, within legal limits and a reasonable timeframe, to access or have his/her qualified personal representative access information contained in his/her medical records;

3The right of his/her guardian, next of kin or qualified personal representative to exercise, to the extent permitted by law, the rights delineated on his/ her behalf if he/she is incapable of understanding treatment, unable to communicate his/her wishes, is judged incompetent or is a minor;

3The right to be informed, along with his/her family, when appropriate, of the outcomes of care including unanticipated outcomes;

3The right to have his/her pain managed effectively; 3The right to receive a high standard of quality care in a safe environment while in the hospital;

3The right to be free of all forms of abuse or harassment and access to protective and advocacy services;

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Rights & Responsibilities 3The right to be informed of continuing health care needs following discharge from the hospital; and

3The right to exercise the above rights without regard to sex, economic status, educational background, race, color, religion, ancestry, national origin, sexual orientation, marital status or the source of payment for care.

3The right to be free from restraint or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff. Restraint or seclusion may only be imposed to ensure the immediate physical safety of the patient, a staff member, or others and must be discontinued at the earliest possible time.

3The right to formulate advance directives, and to have hospital staff implement and comply with their advance directive. This right applies to both inpatients and outpatients. (See Advance Directives section in this guide for more information).

3The right to receive visitors while in the hospital and be informed of any reasonable restrictions or limitations due to clinical condition. Each patient (or representative, where appropriate) has the right, subject to his or her consent, to receive the visitors whom he or she designates, including, but not limited to, a spouse, a domestic partner (including a samesex domestic partner), another family member, or a friend, and his or her right to withdraw or deny such consent at any time. Visitors will not be restricted, limited, or otherwise denied visitation privileges on

the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability. All visitors designated by the patient (or representative, where appropriate) will have the opportunity to enjoy visitation privileges that are no more restrictive than those of immediate family members. (See page 6 for specific visitor guidelines.)

In turn, patients should accept certain responsibilities, including:

3The responsibility to identify himself/herself, for providing reasonably accurate and complete information about his/her medical history, unexpected changes in his/her current condition, and for asking questions when he/she does not understand medical information he/she has received;

3The responsibility for complying with the directions and instructions of his/her health care providers;

3The responsibility to recognize the effect of his/her lifestyle on health;

3The responsibility for respecting the rights of others, including, but not limited to, other patients and health care providers;

3The responsibility to know the extent and limitations of his/her health care benefits; and

3The responsibility for assuring that the financial obligations associated with his/her care are met in a timely fashion.

Poder legal permanente para atención médica Derechos de los pacientes:

3El derecho a obtener del hospital una respuesta razonable a los pedidos y necesidades de tratamiento o servicio que el hospital esté en apititud de aproporcionar, que coherente con la función del hospital y sea permitido por las leyes y reglamentaciones vigentes;

3El derecho a saber como el Houston Methodist require y sea permitido por las leyes usa y reveler su información medica; 14 | Physician Referral 281.274.7500

3El derecho a saber su información médica, incuyendo el derecho al acceso y a pedir enmendar su información médica y a obtener contabilidad de revelacion referente a su información medica como sea permitido por las leyes vigentes;

3El derecho de comunicacion necessaria y efectiva; 3El derecho al tratamiento benevolente y respectuoso, tomando en consideración la edad le carencia de capacidades sensoriales, factores sicosociales, espirituales y culturas, como asi tambien el consuelo y el trato digno a pacientes terminals;


Poder legal permanente para atención médica 3El derecho de saber el nombre de el medico principal que tendra la responsibilidad de coordinar su cuidado y saber los nombres de calquier otro medico o persona que vera al paciente;

3El derecho a la información sobre la enfermedad, el plan de tratamiento y posibilidad de recuperacion en terminos que pueda comprender el paciente;

3El derecho a tomar decisions, conjuntamente con sus médicos, cocermientos a su atencion medica, incluyendo la aceptacion o el rechazo de tratamientos y el uso de directivas anticipadas;

3El derecho a recibir, en el momento de admisión, en el idioma y metodo que el paciente comprenda, la información sobre la política del hospital concemiente a los derechos del paciente, y el mecanismo de presentación, evaluación y, cuando sea posible, resolución de quejas de pacientes concernientes a la calidad de la atención;

3El derecho de expresar su inquietud al personal apropriado del hospital o al Departamento de Salud del Estado de Texas (Texas Department of State Health Services);

3Para inquietudes referente a la privacidad sobre su informacion medica, el derecho de expresar su inquietud al personal apropriado del hospital o al Secretario del Departamento de Salud y Servicios Humanos de los Estados Unidos (Secretary of the United States Department of Health and Human Services);

3El derecho a participar, o hacer participar a su representante personal calificado, en el tratamiento de temas eticos emergentes del tipo de atencion medica necesaria;

3El derecho de participar or no participar in experimentos humanos, investigacion o proyectos educativo en el cual el paciente esta participando;

3El derecho, dentro de los límites legales, a la privacidad y confidencialidad de la información. Conversaciones, consultas, examenes, y tratamiento son confidencial y seran conducidos en discreto. El paciente tiene el derecho de saber cual individual esta presente.

3El derecho de dar consentimiento o no dar consentimiento de grabacion o pelicula (fotografia, video, electronico, o material audio) del paciente or de cualquier identificable información personal para cualquier otro motivo ademas de la identificación, diagnosis o tratamiento del paciente.

3El derecho, dentro de los límites legales, a tener acceso, o dejar acceder a su representante personal calificado, a la información contenida en sus registros de antecedentes médicos;

3El derecho de su tutor, familiar o representante personal calificado a ejercitar en su nombre los derechos expuestos, dentro de lo permitido por la ley, si el paciente fuera incapaz de comprender el tratamiento necesario, no pudiera comunicar su voluntad, fuera declarado incompetente o fuera menor de edad;

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Poder legal permanente para atención médica 3El derecho a ser informado, al igual que los familiares, cuando sea apropiado, sobre el resultado del cuidado del paciente, incluyendo situaciones no anticipadas;

3El derecho de tener su dolor controlado effectivamente;

3El derecho de recibir un estandar alto de seguridad mientras que el paciente esta en el hospital;

3El derecho al acceso de servicios de protection y de apoyo;

3El derecho de ser informado sobre la continación del cuidado médico despues de salir del hospital;

3El derecho hacer uso de todos los derechos antedichas sin tomar en cuenta su sexo, situacion economica, educacion, raza, color, religion, ascendencia, origin nacional, orientacion sexual, estado civil, o origin de pago por su cuidado.

A cambio, el paciente debe aceptar ciertas responsabilitades que incluyen:

3La responsabilidad de indentificarse, proveer

información correcta de su historia medica, cambios repentinos en su condición y hacer preguntas cuando no entiende la información médica recibida.

3La responsabilidad de cumplir con las directivas e instrucciónes de los proveedores de atencion médica;

3La responsabilidad de reconocer el efecto de su estilo de vida en coneccion a su salud;

3La responsabilidad de respetar los derechos de los demas, incluyendo, aumque no limitándose, a pacientes y proveedores de atención médica;

3La responsabilidad de saber el alcance y limitacion del beneficio con el cuidado de su salud y;

3La responsabilidad de asegurar el cumplimiento punctual de las responsabilidades financieras implicadas en su tratamiento médico.

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Prohibición de fumar Para ofrecer un ambiente sano para nuestros pacientes y visitantes, se prohíbe el uso de productos de tabaco dentro y fuera del Hospital Methodist.

Política sobre armas de fuego Por ley estatal, está prohibido portar armas de fuego en las instalciones del hospital. Si usted posee armas de fuego y debe ingresar al hospital durante una visita, sírvase llamar al departamento de Seguridad del hospital al número 713.441.4246, para depositar el arma en este departamento.

Teléfonos celulares No se permite prender o usar telefonos celulares en areas de cuidados intensivos, quirofanos, unidades de cuidados de anesthesia, departamento de cateterizacion, cuidado intermediario infantil, laboratorio, y sala de emergencias.

Quejas y Reclamaciones Si usted tiene una queja o reclamación relacionada con cualquier aspecto del cuidado de su salud o del servicio prestado, solicite hablar con el gerente del departamento o supervisor correspondiente. Si después de haber expuesto su queja o problema, siente que éste no fue tratado adecuadamente, favor de comunicarse con un coordinador de pacientes al 281.274.7806. Para después de horas de oficina, durante los fines de semana y los días festivos, podrá comunicarse también por medio de una operadora al 281.274.7000. Si su asunto continúa sin haberse resuelto, puede nortificarlo a la línea de quejas del Departamento de Servicios de la Salud del Estado de Texas [Texas Department of State of Health Services] al 1.888.973.0022, extensión 2613, enviar una queja o reclamación por escrito vía fax al 1.512-834.6653 (At’n: Quejas de Hospitales [Hospital Complaints]), o escribir una carta y enviarla a 1100 West 49th St., Austin, TX, 78756-3199.


Stay Safe You can contribute to health care safety. While you are in the hospital, many people will enter your room, from doctors and nurses to aides and technicians. The following information will help make your hospital stay safe and comfortable.

C H EC K I D

Employee ID All hospital employees wear identification badges. Feel free to ask any staff member for his or her name and job classification. If you do not see an ID badge on an employee, please call your nurse immediately.

Don’t Be Afraid to Ask… A number of people may enter your hospital room. Be sure to: • Ask for the ID of everyone who comes into your room. • Speak up if hospital staff do not ask to check your ID. • Ask if the person has washed his or her hands before they touch you. • If you are told you need certain tests or procedures, ask why you need them, when they will happen and how long it will be before you get the results.

Fighting Infections While you’re in the hospital to get well, there is the possibility of developing an infection. The single most important thing you can do to help prevent infections is to wash your hands and make sure that everyone who touches you — including your doctors and nurses — wash their hands, too. Upon admission, the housekeeping staff provided you with a small bottle of alcohol gel and a note. You, your family and friends should always wash hands:

Patient Identification Any time staff enters your room to administer medications, transport you or perform procedures and treatments, they must check your birth date and name before they proceed. At times, you may be asked the same questions repeatedly. We are aware that this may be annoying. Please understand, however, that this verification process is a critical component in our patient safety program in order to guarantee that all of our patients receive the correct medications and treatments.

Happy Birthday to You! Wash your hands with soap and warm water for 15 to 20 seconds. That’s about the same amount of time that it takes to sing the “Happy Birthday” song twice.

No Soap? No Problem. Alcohol-based hand cleaners are as effective as soap and water in killing germs 99 percent of the time. To use, apply the cleaner to the palm of your hand and rub your hands together. Keep rubbing over all the surfaces of your fingers and hands until they are dry. Your nurse will instruct you and your family to use soap and water only for indicated infections.

1. After touching objects or surfaces in the hospital room 2. Before eating 3. After using the restroom

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Stay Safe It is also important that your health care providers wash their hands with either soap and water or with an alcohol-based hand cleaner every time, both before and after they touch you. Health care providers know to practice hand hygiene, but sometimes they forget. You and your family should not be afraid or embarrassed to speak up and ask them to wash their hands.

Preventing Medication Errors By taking part in your own care, you can help the members of your health care team avoid medication errors. Here’s how: • Be sure that all of your doctors know what medications you have been taking, including prescription drugs, over-the-counter medications, herbal and vitamin supplements, natural remedies and recreational drugs. • Be sure that all of your doctors know of any allergies you may have to medications, anesthesia, foods, latex products, etc. • When you are brought medications or IV fluids, ask the person to check to be sure you are the patient who is supposed to receive the medications. Show that person your ID bracelet to double-check.

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Doctors, nurses and other health care providers come into contact with lots of bacteria and viruses, so before they treat you, ask them if they’ve cleaned their hands.

Know Your Meds While you are hospitalized, your doctor may prescribe medications for you. Be sure that you understand exactly what they are and why they are being prescribed. Use this checklist to help you get information you need about your medications: • What is the name of the medicine? • What is its generic name? • Why am I taking this medicine? • What dose will I be taking? How often and for how long? • When will the medicine begin to work? • What are the possible side effects? • Can I take this medicine while taking my other medications or dietary supplements? • Are there any foods, drinks or activities that I should avoid while taking this medicine? • Do I need to take the medicine on an empty stomach or with food or a whole glass of water? • What should I do if I forget to take the medicine and miss a dose? USE THE MEDICATION TRACKER ON PAGE 53 TO HELP YOU MONITOR YOUR MEDICATIONS.


a collaborative, innovative approach to neurological disorders and spine care. Disorders and diseases of the brain and spine require specialized expertise and a multidisciplinary approach to diagnosis and treatment. At Houston Methodist Sugar Land Hospital’s Neuroscience & Spine Center, our board-certified physicians work together to provide comprehensive, personalized care, designed to help patients return to a productive lifestyle. We offer expedited appointments, including second opinions, with our highly regarded specialists. to begin your personal treatment plan Call: 281.274.7979 email: neuroscience@houstonmethodist.org Our team of neurosurgeons, neurologists, orthopedic spine surgeons and interventional pain specialists treat a wide variety of disorders: • Alzheimer’s and Memory Disorders • Amyotrophic Lateral Sclerosis (ALS) • Back and Neck Pain • Brain and Spinal Tumors • Epilepsy and Seizures • Headaches and Migraines • Multiple Sclerosis (MS)

houstonmethodist.org/neuro-sl Please note, email is not a secure means to communicate personal identification, i.e. Social Security number, date of birth, financial information, etc.

• Muscle and Nerve Injuries • Muscular Atrophy • Myasthenia Gravis • Neuromuscular Disorders • Parkinson’s Disease and Movement Disorders • Peripheral Neuropathy • Sleep Disorders • Stroke


Count on us when minutes count In a cardiac emergency, a fast, comprehensive response can be the difference between life and death. That’s why our Heart & Vascular Center offers the most advanced cardiac care program in the area. In fact, we’re the only hospital in the Fort Bend area to provide 24/7 interventional cardiology and cardiac surgery services. Also, because we consistently exceed national standards in the most critical components of cardiac care, we’re a nationally accredited chest pain center. In a cardiac emergency, there’s only one place you need to be — Houston Methodist Sugar Land Hospital. That’s the difference between practicing medicine and leading it.

Call 9-1-1 immediately if you experience any of the following: • Chest pain or pressure (may radiate down arm) • Shortness of breath

• Nausea, vomiting and/or severe indigestion • Breaking out in a cold sweat For more information or for a physician referral, visit houstonmethodist.org/sugarland or call 281.274.7500.


Prevent Infections Infection Prevention FAQs

Five Things You Can Do to Prevent Infection

Catheter-Associated Urinary Tract Infection

1. Wash your hands. Rub your hands with soap and warm water for 20 seconds.

A urinary tract infection (UTI) is an infection in the urinary system, which may include the bladder and kidneys. If you have a urinary catheter, germs can travel along the catheter and cause an infection in your bladder or your kidney.

Wash your palms, fingernails and in between your fingers. If your hands are not visibly soiled, you can use alcohol-based hand sanitizer. Rub the sanitizer all over your hands until your hands are dry. You should wash your hands before touching or eating food. You should wash after using the bathroom, changing a diaper or playing with a pet. Most importantly, wash or sanitize your hands after visiting someone who is ill.

2. Make sure health care providers wash their hands. Doctors, nurses, dentists and other

health care providers come in contact with many patients. So before they treat you, ask them if they have washed their hands.

3. Cover your mouth and nose. Many diseases

are spread through sneezes and coughs. When you sneeze or cough, the germs can travel three feet or more. Cover your mouth and nose to prevent the spread of infection to others. Use a tissue, or if you do not have a tissue, cover your mouth and nose with the bend of your elbow or hands. If you use your hands please don’t forget to wash or sanitize.

4. If you are sick, avoid close contact with others. If you are sick, stay away from other

people or stay home. Don’t shake hands or touch others to avoid germ transmission.

5. Get vaccinated to avoid disease and fight the spread of infection. Make sure your

vaccinations are current. Vaccinations are available to prevent illnesses such as flu and pneumonia and other childhood illnesses. Speak to your doctor regarding vaccinations.

What is a “catheter-associated urinary tract infection”?

What is a urinary catheter? A urinary catheter is a thin tube placed in the bladder to drain urine into a collection bag. A urinary catheter may be used: • If you are not able to urinate on your own • To measure the amount of urine that you make • During and after some types of surgery • During some tests of the kidneys and bladder

What are the symptoms of a urinary tract infection? • Burning or pain in the lower abdomen • Fever • Bloody urine may be a sign of infection, but is also caused by other problems • Burning during urination or an increase in the frequency or urgency of urination after the catheter is removed

Can catheter-associated urinary tract infections be treated? Yes, most catheter-associated urinary tract infections can be treated with antibiotics and removal or change of the catheter.

What are some of the things that hospitals are doing to prevent catheter-associated urinary tract infections? Catheter insertion: • Catheters placed only when necessary and they are removed as soon as possible • Only properly trained persons insert catheters using a sterile technique • The skin in the area where the catheter will be inserted is cleaned before inserting the catheter • Other methods can be utilized, such as external catheters in men • Intermittent urethral catheterization (putting in a catheter to drain the urine, then removing the catheter) houstonmethodist.org/sugarland | 21


Prevent Infections Catheter Care: • Health care providers wash their hands with soap and water or sanitize with alcohol-based gel before and after touching your catheter • Avoid disconnection of the catheter and drain tube. This helps to prevent germs from getting into the catheter tube • The catheter is secured to the leg to prevent pulling on the catheter • Avoid twisting or kinking the catheter • Keep the collection bag lower than the bladder to prevent urine from back flowing to the bladder • Empty the collection bag regularly

What do I need to do when I go home from the hospital? • If you will be going home with a catheter, your doctor or nurse should explain everything you need to know about taking care of the catheter. Make sure you understand how to care for it before you leave the hospital • If you develop any symptoms of infection, such as fever, pain with urination or abdominal pain, you should call your doctor immediately Surgical Site Infections

What is a surgical site infection (SSI)? A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. Some of the common symptoms of a surgical site infection are: • Redness, pain or tenderness around the area where you had surgery • Drainage of cloudy fluid from your surgical wound • Fever

Can a surgical site infection be treated? Yes, most surgical site infections can be treated with antibiotics. Sometimes patients with SSIs also need another surgery to treat the infection.

What are some of the things that hospitals are doing to prevent surgical site infections? To prevent SSIs, doctors, nurses and other health care providers: • Wash their hands and arms up to their elbows with an antiseptic agent just before the surgery

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• Wash their hands with soap and water or an alcoholbased gel before and after caring for each patient • May remove some of your hair immediately before your surgery using electric clippers; they should not shave you with a razor • Wear special hair covers, masks, gowns and gloves during surgery to keep the surgery area clean • Give you antibiotics before your surgery starts. In most cases, you should get antibiotics within 60 minutes before the surgery starts and the antibiotics should be stopped within 24 hours after surgery • Clean the skin at the site of your surgery with a special soap that kills germs • Bathe patients with bath wipes

What can I do to prevent surgical site infections? • Tell your doctor about other medical problems you may have such as allergies, diabetes and high blood pressure • Quit smoking • Do not shave near where you will have surgery

At the time of your surgery: • Speak up if someone tries to shave you with a razor instead of a clipper • Do not shave your surgical site at home • Ask if you will get antibiotics before surgery

After your surgery: • Make sure your health care providers wash their hands before examining you • Family and friends should wash their hands before and after visiting with you • Family and friends should not touch the surgical wound or dressing

What do I need to do when I go home from the hospital? • Before you go home your doctor or nurse should explain everything you need to know about taking care of your wound • Always wash your hands before and after caring for your wound • If you have any symptoms of an infection such as redness, pain, drainage or fever, call your doctor immediately


Catheter-Associated Bloodstream Infections

What is a catheter-associated bloodstream infection? A “central line” or “central catheter” is a tube that is placed into a patient’s large vein, usually in the neck, chest, arm or groin for the administration of fluids, antibiotics or other medications. It may be left in place for several weeks. A bloodstream infection can occur when bacteria or other germs travel down a “central line” and enter the blood. You may become ill with fevers and chills or the skin around the catheter may become sore and red.

Can a catheter-associated bloodstream infection be treated? Yes, it can be treated successfully with antibiotics.

What are some things hospitals are doing to prevent catheter-associated bloodstream infections? To prevent catheter-associated infections, the health care provider will: • Choose a vein where the catheter can be safely inserted with minimal risk of infection • Wash their hands with soap and water or alcohol-based gel before inserting the catheter • Wear a mask, cap, sterile gown and sterile gloves when inserting a central catheter • Clean the patient’s skin with an antiseptic cleanser before inserting the catheter • Wash their hands and wear gloves whenever handling the catheter and/or dressings • Evaluate every day if the patient still needs to have the catheter • Place caps on IV lines and ports

What can I do to help prevent a catheterassociated bloodstream infection? • Ask your doctor or nurse to explain why you need the catheter and how long you will need it; are they using all the precautions above • Monitor to make sure that all health care providers wash their hands with soap and water or sanitize with alcoholbased gel • If the bandage comes off or becomes wet or dirty, tell your nurse or doctor immediately • Inform your nurse or doctor if you notice signs of infection, such as a red or painful site • Do not let anyone other than your health care provider

touch your catheter

What do I need to do when I go home from the hospital? Some patients are sent home from the hospital with a catheter in order to continue their treatment. • Make sure you understand how to care for your catheter before you leave the hospital Clostridium Difficile

What is clostridium difficile infection? Clostridium difficile, also known as “C. diff ” is a germ that can cause diarrhea. Most cases of C. diff infection occur in patients taking antibiotics. Symptoms include: • Loss of appetite and watery diarrhea • Fever • Nausea and abdominal pain or tenderness

Who is most likely to get C. diff infection? The elderly and people taking antibiotics that lower the level of normal bacteria in the intestine. C. diff spores can live outside the human body for a long time and may be found on things in the environment such as bed linens, bed rails, bathroom fixtures and medical equipment.

Can C. diff infection be treated? Yes, there are antibiotics that can be used to treat C. diff.

What are some things hospitals are doing to prevent C. diff infections? • Health care providers wash their hands with soap and water before and after caring for patients • Health care providers instruct family and visitors to wash their hands with soap and water when leaving enteric precaution rooms • Alcohol sanitizers do not remove C. diff spores from hands. Everyone must wash their hands with soap and water to remove the C.diff spores. • Carefully clean all hospital rooms and medical equipment

Use enteric precautions: • Health care providers and visitors will wash their hands before and after visiting the patient with C. diff

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Prevent Infections • Patients wil be instructed to wash their hands with soap and water when leaving enteric isolation rooms for tests or procedures • Health care providers and visitors will wear gowns and gloves when in the patient’s room • Patients on enteric precautions are asked to stay in their rooms as much as possible. They should not go to common areas such as the gift shop or cafeteria • Only give patients antibiotics when it is necessary • Visitors may not have food or drinks when in the patient room

What do I need to do when I go home from the hospital?

medicine exactly as prescribed, and if you develop diarrhea call your doctor immediately

This information is from the following: • The Joint Commission (TJC) • Center for Disease Control (CDC) • American Hospital Association (AHA) • Society for Health Care Epidemiology of America (SHEA) • Infectious Diseases Society of America (IDSA) • Association for Professionals in Infection Control and Epidemiology (APIC)

• If you are given a prescription to treat C. diff, take the

Five Steps to Safer Health Care 1. Ask questions if you have doubts or concerns. Ask questions and make sure you understand the answers. Choose a doctor you feel comfortable talking to. Take a relative or friend with you to help you ask questions and understand the answers.

2. Keep and bring a list of ALL the medicines you take. Give your doctor and pharmacist a list of all the medicines that you take, including nonprescription medicines. Tell them about any drug allergies you have. Ask about side effects and what to avoid while taking the medicine. Read the label when you get your medicine, including all warnings. Make sure your medicine is what the doctor ordered and know how to use it. Ask the pharmacist about your medicine if it looks different than you expected.

3. Get the results of any test or procedure. Ask when and how you will get the results of tests or procedures. Don’t assume the results are fine if you do not get them when expected, be it in person, by phone or by mail. Call your doctor and ask for your results. Ask what the results mean for your care.

4. Talk to your doctor about which hospital is best for your health needs. Ask your doctor about which hospital has the best care and outcomes for your condition if you have more than one hospital to choose from. Be sure you understand the instructions you get about follow-up care when you leave the hospital.

5. Make sure you understand what will happen if you need surgery. Make sure you, your doctor and your surgeon all agree on exactly what will be done during the operation. Ask your doctor: “Who will manage my care when I am in the hospital?” Ask your surgeon: “Exactly what will you be doing?” “About how long will it take?” “What will happen after the surgery?” “How can I expect to feel during recovery?” Tell the surgeon, anesthesiologist and nurses about any allergies, bad reaction to anesthesia and any medications you are taking. Adapted from U.S. Department of Health and Human Services in partnership with American Hospital Association and American Medical Association

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What are Your Advance Directives? Advance Directives Act (see §166.033, Health and Safety Code)

Directive to Physicians (also known as a Living Will) This is an important legal document designed to help you communicate your wishes about medical treatment at some time in the future when you are unable to make your wishes regarding life-sustaining treatment known because of illness or injury. The Directive to Physicians comes into effect when you lack the ability to make or communicate your decisions regarding such treatment and are in a terminal or irreversible condition. You are encouraged to discuss your values and wishes with your family or chosen spokesperson, as well as your physician. Your physician, other health care provider or medical institution may provide you with various resources to assist you in completing your Directive to Physicians. Brief definitions are listed below and may aid you in your discussions and advanced care planning. Initial the treatment choices that best reflect your personal preferences. Provide a copy of your Directive to Physicians to your physician, hospital and family or spokesperson. Consider a periodic review of this document. By periodic review, you can best assure that the Directive to Physicians reflects your preferences. In addition to this Directive to Physicians, Texas law provides for two other types of Advance Directives that can be important to physicians during a serious illness. These are the Medical Power of Attorney and the Out-ofHospital-Do-Not-Resuscitate Order. You may wish to discuss these with your physician, family, hospital representative or other advisers. Hospital chaplains are available to assist you with understanding and completing these documents. To learn more about Advance Directives, you can watch the brief video “Life Conversations: Respecting My Journey, Honoring My Wishes” on Hospital Channel 19. Video Schedule English: 10 a.m., 1 p.m., 5 p.m., 8 p.m. Spanish: 10:30 a.m., 1:30 p.m., 5:30 p.m., 8:30 p.m.

What are Advance Directives? Advance Directives are the legal documents that allow you to give direction to medical personnel, family and friends concerning your future care when you cannot speak for yourself. You do not need a lawyer in order to complete Advance Directives. Your Directive to Physicians should be based on your personal values. In the event of a disagreement between family members or other caregivers concerning your wishes regarding life-sustaining treatment or other issues in connection with your Directive to Physicians, the biomedical ethics committee is available to hear such disputes. Contact 281.274.7164. To ensure we have the most updated copy, please bring a copy of your Directive to Physicians each time you are readmitted to the hospital.

You also may wish to complete a Directive related to the donation of organs and tissues. The existence or lack of an Advance Directive does not determine an individual’s access to care, treatment and services. For more information or for assistance with Advance Directives, please call 281.274.7164 or 281.274.7108.

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Directive to Physicians Form I, _________________________(insert your name), recognize that the best health care is based upon a partnership of trust and communication with my physician. My physician and I will make health care decisions together as long as I am of sound mind and able to make my wishes known. If there comes a time that I am unable to make medical decisions about myself because of illness or injury, I direct that the following treatment preferences be honored: If, in the judgment of my physician, I am suffering with a terminal condition from which I am expected to die within six months, even with available life-sustaining treatment provided in accordance with prevailing standards of medical care: _______ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR _______ I request that I be kept alive in this terminal condition using available life-sustaining treatment. (This selection does not apply to hospice care.) If, in the judgment of my physician, I am suffering with an irreversible condition so that I cannot care for myself or make decisions for myself and I am expected to die without life-sustaining treatment provided in accordance with prevailing standards of care: _______ I request that all treatments other than those needed to keep me comfortable be discontinued or withheld and my physician allow me to die as gently as possible; OR _______ I request that I be kept alive in this terminal condition using available life sustaining treatment. (This selection does not apply to hospice care.) Additional requests: (After discussion with your physician, you may wish to consider listing particular treatments in this space that you do or do not want in specific circumstances, such as artificial nutrition and fluids, intravenous antibiotics, etc. Be sure to state whether you do or do not want the particular treatment.) ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ After signing this directive, if my representative or I elect hospice care, I understand and agree that only those treatments needed to keep me comfortable would be provided and I would not be given available life-sustaining treatments. If I do not have a Medical Power of Attorney and I am unable to make my wishes known, I designate the following person(s) to make treatment decisions with my physician that are compatible with my personal values: 1. ______________________________________________________ 2. _____________________________________________________ (If a Medical Power of Attorney has been executed, then an agent already has been named and you should not list additional names in this document.) If the above persons are not available or if I have not designated a spokesperson, I understand that a spokesperson will be chosen for me following standards specified in the laws of Texas. If, in the judgment of my physician, my death is imminent within minutes to hours, even with the use of all available medical treatment provided within the prevailing standard of care, I acknowledge that all treatments may be withheld or removed except those needed to maintain my comfort. I understand that under Texas law this directive has no effect if I have been diagnosed as pregnant. This directive will remain in effect until I revoke it. No other person may do so. Signed ____________________________________________________ Date __________________ City, County, State of Residence _______________________________________________________ Two competent adult witnesses must sign below, acknowledging the signature of the declarant. The witness designated as Witness 1 may not be a person designated to make a treatment decision for the patient and may not be related to the patient by blood or marriage. This witness may not be entitled to any part of the estate and may not have a claim against the estate of the patient. This witness may not be the attending physician or an employee of the attending physician. If this witness is an employee of a health care facility in which the patient is being cared for, this witness may not be involved in providing direct patient care to the patient. This witness may not be an officer, director, partner or business office employee of a health care facility in which the patient is being cared for or of any parent organization of the health care facility. Witness 1 _____________________________________________ Witness 2 ________________________________________________

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What are Your Advance Directives? Definitions • “Artificial Nutrition and Hydration” means the provision of nutrients or fluids by a tube inserted in a vein, under the skin in the subcutaneous tissues or in the stomach (gastrointestinal tract). • “Irreversible Condition” means a condition, injury or illness: (1) that may be treated, but is never cured or eliminated; (2) that leaves a person unable to care for or make decisions for himself/herself; and (3) that, without life-sustaining treatment provided in accordance with the prevailing standard of medical care, is fatal. Explanation: Many serious illnesses such as cancer, failure of major organs (kidney, heart, liver or lung) and serious brain disease, such as Alzheimer’s dementia may be considered irreversible early on. There is no cure, but the patient may be kept alive for prolonged periods of time if the patient receives life-sustaining treatments. Late in the course of the same illness, the disease may be considered terminal when, even with treatment, the patient is expected to die. You may wish to consider which burdens of treatment you would be willing to accept in an effort to achieve a particular outcome. This is a very personal decision that you may wish to discuss with your physician, family or other important people in your life. • “Life-sustaining Treatment” means treatment that, based on reasonable medical judgment, sustains the

life of a patient and without which the patient will die. The term includes both life sustaining medications and artificial life support, such as mechanical breathing machines, kidney dialysis treatment and artificial hydration and nutrition. The term does not include the administration of pain management medication, the performance of a medical procedure necessary to provide comfort care or any other medical care provided to alleviate a patient’s pain. • “Terminal Condition” means an incurable condition caused by injury, disease or illness that, according to reasonable medical judgment, will produce death within six months, even with available life-sustaining treatment provided in accordance with the prevailing standard of medical care. Explanation: Many serious illnesses may be considered irreversible early in the course of the illness, but they may not be considered terminal until the disease is fairly advanced. In thinking about terminal illness and its treatment, you again may wish to consider the relative benefits and burdens of treatment and discuss your wishes with your physician, family or other important people in your life. The existence or lack of an Advance Directive does not determine an individual’s access to treatment and services. For more information call 281.274.7164 or 281.274.7108.

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Directiva a Los Médicos Y a Familiares o Substitutos Ley de Directivas Anticipadas (ver §166.033 del Código de Salud y Salubridad)

Instrucciones Para Completar Este Documento Las leyes de Texas autorizan el uso de instrucciones anticipadas escritas, lo que incluye una instrucción de acuerdo con el siguiente formulario: Este es un documento legal importante conocido como Instrucción anticipada. Está diseñado para ayudarlo a comunicar sus deseos sobre tratamiento médico en algún momento en el futuro cuando no pueda dar a conocer sus deseos debido a enfermedad o lesión. Por lo general, estos deseos se basan en valores personales. En particular, es recomendable que tenga en cuenta qué cargas o difi cultades del tratamiento estaría dispuesto a aceptar por la obtención de una cierta cantidad de benefi cio si estuviera gravemente enfermo. Se lo alienta a que analice sus valores y deseos con su familia o vocero elegido, así como con su médico. Su médico, otro proveedor de atención de la salud o institución médica pueden brindarle diversos recursos

para ayudarlo a completar sus instrucciones anticipadas. A continuación se incluyen defi niciones breves y pueden ayudarlo en sus análisis y en la planifi cación anticipada. Consigne sus iniciales en las opciones de tratamiento que mejor refl ejan sus preferencias personales. Proporcione una copia de sus instrucciones a su médico, hospital habitual y familiar o vocero. Tenga en cuenta una revisión periódica de este documento. Con la revisión periódica, puede asegurarse de que las instrucciones refl ejan sus preferencias. Además de estas instrucciones anticipadas, las leyes de Texas estipulan otros dos tipos de instrucciones que pueden ser importantes durante una enfermedad grave. Estas son el Poder médico y Pedido de no resucitación fuera del hospital. Le recomendamos que analice estas opciones con su médico, familia, representante del hospital u otros asesores. También le recomendamos que complete una instrucción relacionada con la donación de órganos y tejidos.

Directivas Yo, __________________________________, reconozco que la mejor atención de la salud se basa en una sociedad de confianza y comunicación con mi médico. Mi médico y yo tomaremos juntos las decisiones sobre atención de la salud mientras tenga pleno uso de mis facultades mentales y pueda dar a conocer mis deseos. Si llega un momento en el que no pueda tomar decisiones relacionadas con mi atención de la salud debido a enfermedad o lesión, ordeno que se respeten las siguientes preferencias de tratamiento: Si, según el criterio de mi médico, tengo una afección terminal debido a la cual se prevé que muera dentro de un período de seis meses, incluso con tratamiento de soporte vital disponible administrado de conformidad con los estándares imperantes de atención médica: ______ Solicito que se interrumpan o se retengan todos los tratamientos, excepto aquellos necesarios para mantenerme aliviado, y que mi médico me permita morir lo más cuidadosamente posible; O ______ Solicito que se me mantenga con vida con esta afección terminal utilizando tratamiento de soporte vital disponible. (ESTA SELECCIÓN NO SE APLICA A LOS CUIDADOS PALIATIVOS). Si, según el criterio de mi médico, sufro una afección irreversible por la cual no puedo cuidarme a mí mismo ni tomar decisiones por mí mismo y se prevé que moriré sin tratamiento de soporte vital administrado de conformidad con los estándares imperantes de atención médica: ______ Solicito que se interrumpan o se retengan todos los tratamientos, excepto aquellos necesarios para mantenerme aliviado, y que mi médico me permita morir lo más cuidadosamente posible; O ______ Solicito que se me mantenga con vida con esta afección irreversible utilizando tratamiento de soporte vital disponible. (ESTA SELECCIÓN NO SE APLICA A LOS CUIDADOS PALIATIVOS). Solicitudes adicionales: (Después de analizarlo con su médico, le recomendamos que tenga en cuenta incluir en este espacio tratamientos particulares que usted desea o no desea en circunstancias específi cas, como nutrición y líquidos artifi ciales, antibióticos intravenosos, etc. Asegúrese de indicar si desea o no el tratamiento en particular). ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ 28 | Physician Referral 281.274.7500


Después de fi rmar esta instrucción, si mi representante o yo elegimos cuidados paliativos, comprendo y acepto que solo se me administrarán los tratamientos necesarios para mantenerme aliviado y no se me administrarán tratamientos de soporte vital disponibles. Si no cuento con un Poder médico, y no puedo dar a conocer mis deseos, designo a la(s) siguiente(s) persona(s) para tomar decisiones de tratamiento con mi médico compatibles con mis valores personales: 1. _________________________________________________________________________________________________________ 2. _________________________________________________________________________________________________________ (Si se ha ejecutado un Poder médico, entonces ya se ha nombrado un agente y no debe incluir nombres adicionales en este documento). Si las personas mencionadas anteriormente no están disponibles, o si no he designado un vocero, comprendo que se elegirá un vocero para mí siguiendo los estándares especifi cados en las leyes de Texas. Si, según el criterio de mi médico, mi muerte es inminente dentro de minutos u horas, incluso con el uso de tratamiento médico disponible proporcionado dentro del estándar de atención imperante, reconozco que todos los tratamientos pueden retenerse o eliminarse, excepto aquellos necesarios para mantenerme aliviado. Comprendo que en virtud de la ley de Texas esta instrucción no tiene ningún efecto si se me ha diagnosticado un embarazo. Esta instrucción seguirá teniendo efecto hasta que la revoque. Ninguna otra persona puede hacerlo. Firmado _____________________________________________ Fecha _________________ Ciudad, Condado y estado de residencia __________________________________________ Esta instrucción no tiene validez a menos que sea fi rmada en presencia de dos testigos adultos competentes [OPCIÓN 1], o, en lugar de fi rmar en presencia de testigos, el/la declarante puede fi rmar la instrucción y presentarla ante un notario público para su reconocimiento [OPCIÓN 2].

Opción 1 Dos testigos adultos competentes deben fi rmar a continuación y reconocer la fi rma del declarante. El testigo designado como Testigo 1 no puede ser una persona designada para tomar una decisión relacionada con el tratamiento en nombre del paciente y no puede estar relacionada con el paciente por sangre o matrimonio. El testigo no puede tener derecho a ninguna parte de su patrimonio y no puede tener un reclamo del patrimonio del paciente. Este testigo no puede ser el médico que atiende al paciente o un empleado del médico que atiende al paciente. Si este testigo es un empleado de un establecimiento de atención de la salud en el cual el paciente está recibiendo atención, este testigo no puede estar brindando atención directa al paciente. Este testigo no puede ser un funcionario, director, socio o empleado de ofi cina comercial de un establecimiento de atención de la salud en el cual está recibiendo atención el paciente para o de cualquier organización matriz del establecimiento de atención de la salud. Testigo 1 __________________________________________________________ Testigo 2 __________________________________________________________

Opción 2 RECONOCIMIENTO Estado de Texas Condado de _______________________ Ante mí, el notario público que suscribe, en el día de la fecha compareció (declarante) ______________________________________, y reconoció ante mí que él/ella fi rmó dicho documento a los efectos allí expresados. Firmado ante mí el (fecha) _________________________________ . _____________________________________ Notario Público (Sello) houstonmethodist.org/sugarland | 29


Directiva a Los Médicos Y a Familiares o Substitutos Definiciones • “Nutrición e hidratación artificiales” signifi ca la administración de nutrientes o líquidos a través de un tubo insertado en una vena, debajo de la piel en los tejidos subcutáneos o en el estómago (tubo gastrointestinal). • “Afección irreversible” signifi ca una afección, lesión o enfermedad: (1) que puede tratarse, pero no puede curarse ni erradicarse; (2) que deja a una persona incapaz de cuidarse o tomar decisiones por el propio bien de la persona; y (3) que, sin tratamiento de soporte vital administrado de conformidad con el estándar de atención médica imperante, es mortal. Explicación: Muchas enfermedades graves, como cáncer, insufi ciencia de los órganos principales (riñón, corazón, hígado o pulmones), y enfermedades cerebrales graves, como enfermedad de Alzheimer, pueden ser consideradas irreversibles desde un primer momento. No tienen cura, pero se puede mantener al paciente con vida durante períodos prolongados si el paciente recibe tratamientos de soporte vital. Más avanzada la misma enfermedad, esta puede considerarse terminal cuando, incluso con tratamiento, se prevé que el paciente muera. Le recomendamos que analice qué cargas de tratamiento estaría dispuesto a aceptar en un esfuerzo por alcanzar un resultado en particular. Esta es una decisión muy personal que le recomendamos que analice con su médico, familia u otras personas importantes en su vida

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• “Tratamiento de soporte vital” qsignifi ca tratamiento que, según un criterio médico razonable, mantiene la vida de un paciente y sin el cual el paciente muere. El término incluye tanto medicamentos de soporte vital y soporte vital artifi cial, como respiradores mecánicos, tratamiento de diálisis renal e hidratación y nutrición artifi ciales. El término no incluye la administración de analgésicos, la realización de un procedimiento médico para proporcionar atención de alivio o cualquier otra atención médica proporcionada para aliviar el dolor de un paciente. • “Afección terminal” signifi ca una afección incurable causada por una lesión, enfermedad o dolencia que, según criterio médico razonable, producirá la muerte dentro de un período de seis meses, incluso con tratamiento de soporte vital disponible administrado de conformidad con el estándar de atención imperante. Explicación: Muchas enfermedades graves pueden ser consideradas irreversibles al comienzo de la enfermedad, pero pueden no serconsideradas terminales hasta que la enfermedad está bastante avanzada. Al pensar en las enfermedades terminales y su tratamiento, es recomendable que analice los benefi cios y cargas relativos del tratamiento y que analice sus deseos con su médico, familia, u otrapersona importante en su vida. La existencia o no de una directiva anticipada no determina el acceso de una persona tratamiento y servicio. Para obtener más información, llame al 281.274.7164 o 281.274.7108.


Your Privacy & Information What it means to be a “No Information” patient If you request the status of “No Information” at the time of registration, this means NO information will be given to any visitor or caller who asks for you by name while you are in the hospital. The hospital will not even indicate that you are currently a patient. Electing the “No Information” status means: • You will not receive a delivery of flowers unless the person who places the order for flowers gave the florist your room number. • Family and friends will not be told that you are in the hospital and will not be able to find you in the hospital directory unless you have previously given them your room number and telephone number. If you wish to change your status from “No Information” during your hospitalization or have questions, call patient access services at 281.274.0104 and speak to the supervisor on call.

How do I get copies of my medical records? You have the right to review and obtain a copy of your health information. Requests for medical records for continuing care will be processed free of charge. Copies of medical records for personal reasons can be obtained from our Medical Records Department for a fee as authorized by Texas state law. You must complete an authorization form. For additional information regarding release of medical records, please visit or call: HIM/Medical Records Department Houston Methodist Sugar Land Hospital 16655 Southwest Freeway Medical Office Building Two, Suite 529 Sugar Land, TX 77479 281.274.7814

Notice of Privacy Practices This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. This Joint Notice of Privacy Practices (Notice) applies to the following organizations: Houston Methodist Sugar Land Hospital and its medical staff This Notice identifies the general ways your protected health information can be used or disclosed. Protected health information refers to your personal health information found in your medical and billing records. This includes information, whether oral, written or recorded in electronic form, that is created or received by us and relates to your past, present, or future physical or mental health conditions or the payment for health care services. This information can be transmitted or maintained in any form by Houston Methodist.

Adapted from U.S. Department of Health & Human Services Office for Civil Rights

If you believe your health information privacy rights have been violated, you can file a complaint with Houston Methodist, your provider, your health insurer or with the Secretary of the United States Department of Health and Human Services. There will be no penalty or retaliation against you for making a complaint. You can also go online to hhs.gov/ocr/hipaa. A separate law provides additional privacy protections to patients of alcohol and drug treatment programs. We will not disclose information identifying an individual as a patient or provide any medical information relating to the patient’s substance abuse treatment unless: the patient consents in writing; a court order requires disclosure; medical personnel need the information to meet a medical emergency; or in other cases where it is absolutely necessary. For more information, go online to samhsa.gov.

This Notice describes your legal rights regarding your health information. It also informs you of our legal duties and privacy practices. If you receive services by your physician or a health care provider at a different location, there may be different health information privacy policies or notices, and there will be different contact information.

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Your Privacy & Information Houston Methodist organizations and their medical staffs participate in an Organized Health Care Arrangement under HIPAA for the purpose of sharing protected health information for treatment, payment, and health care operations. Houston Methodist hospitals and their respective Medical Staff members are independently responsible for complying with this Notice.

Our Legal Duties We are required, by law, to keep your identifiable health information private; provide you with this Notice of our legal duties and privacy practices with respect to your health information; and follow the terms of the Notice as long as it is in effect. If we revise this Notice, we will follow the terms of the revised Notice, as long as it is in effect.

How we may use and disclose your health information The following information describes how we are permitted, or required by law, to use and disclose your health information. Not every use or disclosure in a category will be listed. Treatment: We may use or disclose your health information to a physician or other health care provider in order to provide care and treatment to you. For example, a physician treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Different departments at Houston Methodist also may share information about you in order to coordinate the different services you receive, such as lab work, X-rays, and prescriptions. We also may disclose health information about you to those who may be involved in your health care outside of Houston Methodist, such as physicians and others who provide you with follow-up care and medical equipment or product suppliers. We may contact you to coordinate care after discharge, provide appointment reminders and to provide you with information about health-related benefits and services at Houston Methodist, or treatment alternatives that may be of interest to you. Payment: We may use or disclose your health information to obtain payment for services we provide to you. We may disclose your health information to another health care provider or entity. For example, Houston Methodist may need to provide your health plan with information about surgery you received so your health

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plan will pay Houston Methodist or reimburse you for the surgery. Houston Methodist also will tell your health plan about a treatment you are going to receive to obtain the health plan’s prior approval for this treatment or to determine whether your plan will cover the treatment. Health Care Operations: We may use or disclose health information about you to support the programs and activities of Houston Methodist such as quality and service improvement; health care delivery review; staff performance evaluation; competence or qualification review of health care professionals; education and training of physicians and other health care providers; and business planning and development, business management and general administrative activities. We use this information to continuously improve the quality of care for all patients we serve. For example, we may combine health information about many patients to evaluate the need for new services or treatments. We may disclose information for educational purposes to doctors, nurses, and other students. And we may combine health information we have with that of other facilities to see where we can make improvements. Additionally, we may share your health information with other health care providers and payors for certain of their business operations if the information is related to a relationship the provider or payor currently has or previously had with you, and if the provider or payor is required by federal law to protect the privacy of your health information. Houston Methodist Connect Health Information Exchange (HIE): We may make your health information available electronically through an information exchange network to other providers such as hospitals, laboratories, and physicians involved in your care who request your electronic health information. The purpose of this information exchange is to support the delivery of safer, better coordinated patient care. Participation in the information exchange is voluntary. If you do not want your Houston Methodist health information to be accessible to authorized health care providers through Houston Methodist Connect, you may submit a signed opt-out (non-participation) form, available from your registration representative or www.houstonmethodist.org. If you decide not to participate, health care providers will not be able to access your health information through Houston Methodist Connect.


Electronic Disclosures: Houston Methodist creates, receives, maintains, and in some instances, discloses your protected health information in an electronic format. We will obtain your written authorization prior to electronically disclosing your protected health information for any reason other than treatment, payment, health care operations, or as otherwise authorized or required by law. Authorization for Other Disclosures: We will not use or disclose your health information, except as described in this document, unless you authorize us, in writing, to do so. You may give us written authorization to disclose your medical information to anyone for any purpose. Houston Methodist may use electronic or other means to satisfy your request for the authorized disclosure. You can revoke an authorization at any time, in writing. If you revoke an authorization, we will no longer use or disclose your health information for the purpose covered by the authorization. However, we are unable to take back any uses or disclosures already made with your authorization. Specific examples of uses or disclosures requiring authorization include: use of psychotherapy notes, marketing activities, the sale of your health information, and most uses and disclosures for which we are compensated.

phone number and other contact information, and information related to the department of your service, your treating physician, outcome information, health insurance status, and the dates you received treatment or services at Houston Methodist would be released. You have the right to opt out of fundraising communications at any time by calling 713.790.3333 and your request must be honored. Any such communication will have clear and conspicuous instructions on how to opt out of future fundraising communications. Future Communications: We may use or disclose your information to communicate with you via newsletters, mailings or other means regarding treatment options, health related information, disease-management programs, wellness programs, or other community based initiatives or activities in which Houston Methodist participates. If we receive any financial compensation for such communications (with limited permitted exceptions), we will obtain your authorization prior to sending the communication and your authorization can be revoked at any time.

Hospital Directory: Unless you instruct otherwise, we may disclose your name, general condition, and location in the hospital to your friends, family, and others who ask for you by name. Unless you instruct otherwise, we will provide your name, location in the hospital, and religious affiliation to clergy members of your faith or tradition upon their request. Family and Friends: We may use or disclose information to notify or assist in notifying a family member, personal representative, or other person responsible for your care, of your location and general condition. We will also disclose health information to a family member, other relative, close personal friend, or any other person you identify, if the information is relevant to that person’s involvement with your care or payment for your care. Fundraising: We may use or disclose health information about you to contact you in an effort to raise money for our organization and its operations. We may disclose this information to The Methodist Hospital Foundation to assist us in our fundraising activities. Only demographic information such as your name, date of birth, address,

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Your Privacy & Information Public Health and Safety: We may use or disclose health information, as authorized or required by local, state or federal law, for the following purposes deemed to be in the public interest or benefit: • To report certain diseases and wounds, births and deaths, and suspected cases of abuse, neglect, ordomestic violence; • To help identify, locate, or report criminal suspects, crime victims, missing persons, suspiciousdeaths, or criminal conduct on Houston Methodist’s premises; • To respond to a court order, subpoena, or other judicial process; • To assist federal disaster relief efforts; • To enable product recalls, repairs, or replacements; • To respond to an audit, inspection, or investigation by a health-related government agency; • To assist in federal intelligence, counterintelligence, and national security issues; • To facilitate organ and tissue donations; • To assist coroners, medical examiners, and funeral directors; • To respond to a request from a jail or prison regarding an inmate’s health or medical treatment; • To respond to a request from your military command authority (if you are a member or veteran of the armed forces); • To provide information to a workers’ compensation program. Business Associates: There are some services provided at Houston Methodist through contracts with business associates. When these services are contracted, we will disclose your health information to the business associate so they can perform the job we have asked them to do. However, business associates are required by federal law to appropriately safeguard your information. Research: We will disclose information to researchers after approval by an Institutional Review Board (IRB) in preparation for a research study, to recruit research subjects, or for a research study. The IRB reviews research proposals and establishes protocols to protect your safety and the privacy of your health information.

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Special Privacy Protections for Alcohol and Drug Abuse Information: Alcohol and drug abuse information has special privacy protections. We will not disclose any information identifying an individual as being a patient or provide any health information relating to the patient’s substance abuse treatment unless the patient consents in writing; a court order requires disclosure of the information; medical personnel need the information to meet a medical emergency; qualified personnel use the information for the purpose of conducting scientific research, management audits, financial audits, or program evaluation; or it is necessary to report a crime or a threat to commit a crime, or to report abuse or neglect as required by law.

Your Health Information Rights Your medical record is the property of Houston Methodist (the health care practitioner or facility that compiled it). You have the following rights, with certain exceptions, regarding the health information that is created about you at Houston Methodist. You have the right to a paper copy of this Notice. In addition, a copy of this Notice also may be obtained at our web site, www.houstonmethodist.org. Confidential Communications: You have the right to request that we communicate health information to you by an alternate means or location other than your home address and telephone number. Your request must be made in writing to Houston Methodist’s contact person, and must specify how or where you wish to be contacted. We will try to accommodate your request for alternate communications. If you request an alternate means of communication, that request also should be communicated by you to all of your physicians, including your private physician. Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information to a family member about a surgery you had. To request


a restriction, you must make your request in writing to the contact person listed below. We are not required to agree to your request. If we do agree, our agreement must be in writing, and we will comply with your request unless the information is needed to provide you emergency treatment. Additionally, you have the right to request that we not use or disclose information to a health plan for purposes of payment or health care operations (not for treatment) if the health information pertains solely to a health care item or service that has been paid for out-of-pocket and in full. Your request for restriction must be submitted in writing to our listed contact person. In this case, Houston Methodist must honor your request. However, you should be aware that such restrictions may have unintended consequences, particularly if other providers need to know that information (such as a pharmacy filling a prescription). It will be your obligation to notify any such other providers of this restriction. Additionally, such a restriction may impact your health plan’s decision to pay for related care that you may not want to pay for out of pocket (and which would not be subject to the restriction). Access: You have the right to review and obtain a copy of your health information, with certain exceptions. Usually, this includes medical and billing records, but does not include psychotherapy notes. Your request to review or obtain a copy of your health information must be in writing to our listed contact person. You will be charged fees as authorized by law. To the extent your information is held in an electronic health record, you may be able to receive the information in an electronic format. Amendment: If you feel that the health information we have about you is incorrect or incomplete, you have the right to ask for an amendment of that information. You have the right to request an amendment for as long as the information is kept by or for us. Your request for an amendment must be made in writing to our listed contact person, and include a reason that supports your request.

request for an accounting must be in writing to our listed contact person, and must state a time period for which you want an accounting. You may request one accounting free of charge within a 12-month period. A fee will be charged for additional lists within this same time period. Breach Notification: In certain instances, you have the right to be notified in the event that we, or one of our Business Associates, discover an inappropriate use or disclosure of your health information. Notice of any such use or disclosure will be made in accordance with state and federal requirements. Revisions of this Notice: We reserve the right to change this Notice, and the right to make the new provisions effective for all health information we currently maintain, as well as any information we receive in the future. If we make a major change to this Notice, the revised Notice will be posted at Houston Methodist and on our web site. In addition, a paper copy of the revised Notice will be available upon request. To Report a Complaint: If you believe your health information privacy rights have been violated, you can file a complaint with us or with the Secretary of the United States Department of Health and Human Services. There will not be any penalty or retaliation against you for making a complaint to us or to the Department of Health and Human Services. Contact Person: If you have any questions or need information regarding our legal duties and privacy practices, or how to exercise any of your health information rights listed in this Notice, please contact: Business Practices Officer Houston Methodist Sugar Land Hospital 16655 Southwest Frwy. Sugar Land, TX 77479 281.274.7000

Accounting of Disclosures: You have the right to receive a list of certain disclosures that we have made within the last six years of your health information. Your

houstonmethodist.org/sugarland | 35


Notificación de Prácticas de Privacidad Esta notificación describe el modo en que su información médica puede ser utilizada y divulgada y cómo usted puede tener acceso a esa información. Por favor léala atentamente. Esta notificación conjunta de prácticas de privacidad (notificación) se aplica a las siguientes organizaciones: Houston Methodist Sugar Land Hospital y su personal médico Esta notificación identifica las formas generales en que la información protegida sobre su salud puede utilizarse o divulgarse. La información protegida sobre su salud se refiere a su información de salud personal que se encuentra en sus expedientes médicos y de facturación. Esto incluye información, ya sea oral, escrita o grabada en formato electrónico, que es creada o recibida por nosotros, y se relaciona con su estado de salud físico o mental pasado, presente o futuro, o con el pago de los servicios de cuidado de la salud. Esta información puede ser transmitida o mantenida en cualquier formato por Houston Methodist. Esta notificación describe los derechos que le otorga la ley con respecto a la información sobre su salud. También le informa nuestros deberes legales y prácticas de privacidad. Si recibe servicios de su médico o de un proveedor de cuidado de la salud en otro lugar, puede haber otras políticas y notificaciones sobre la privacidad de la información de salud, así como otra información de contacto. Las organizaciones de Houston Methodist y su personal médico participan en un acuerdo de cuidado de la salud organizada en virtud de la Ley de Transferencia y Responsabilidad de los Seguros de Salud (HIPAA) para compartir información de salud protegida con fines de tratamiento, pago y operaciones de cuidado de la salud. Los hospitales de Houston Methodist y sus respectivos miembros del personal médico son responsables, de manera independiente, de cumplir lo establecido en esta notificación.

Nuestras Obligaciones Legales Por ley, estamos obligados a mantener la confidencialidad de la información sobre su salud identificable; a proporcionarle esta notificación sobre nuestras obligaciones legales y prácticas de privacidad con respecto a la información sobre su salud; y a cumplir los

36 | Physician Referral 281.274.7500

términos de la notificación en tanto tenga vigencia. Si realizamos una revisión a esta notificación, respetaremos los términos de la nueva versión en tanto tenga vigencia.

Formas De Utilizar Y Divulgar La Información Sobre Su Salud La siguiente información describe cómo podemos o debemos utilizar y divulgar la información sobre su salud, según lo permita o requiera la ley. No se enumerarán todos los usos o divulgaciones posibles de cada categoría. Tratamiento: Podemos utilizar la información sobre su salud o divulgarla a un médico u otro proveedor de cuidado de la salud para que le brinden atención y tratamiento. Por ejemplo, es posible que un médico que lo esté tratando por una pierna fracturada necesite saber si tiene diabetes, ya que esta enfermedad puede retrasar el proceso de curación. Distintos departamentos de Houston Methodist también pueden compartir su información a fin de coordinar los diferentes servicios que usted recibe, como análisis de laboratorio, radiografías y recetas. Asimismo, podemos divulgar su información de salud a aquellas personas que puedan estar involucradas en el cuidado de su salud fuera de Houston Methodist, como médicos y otras personas que le proporcionan cuidado de seguimiento, y proveedores de equipos o productos médicos. Podemos contactarnos con usted para coordinar su atención médica después del alta, recordarle citas médicas y brindarle información sobre beneficios y servicios relacionados con la salud de Houston Methodist, o alternativas al tratamiento que podrían interesarle. Pagos: Podemos utilizar o divulgar la información sobre su salud para obtener el pago de los servicios que le brindamos. Podemos divulgar la información sobre su salud a otro proveedor o entidad de cuidado de la salud. Por ejemplo, es posible que Houston Methodist necesite proporcionar a su plan de salud información sobre una cirugía que se realizó, a fin de que el plan de salud pague a Houston Methodist o le reembolse a usted el costo de la cirugía. Houston Methodist también informará a su plan de salud acerca de un tratamiento que usted deba recibir, a fin de obtener su aprobación previa de dicho tratamiento o para determinar si lo cubrirá. Operaciones de cuidado de la salud: Podemos utilizar o divulgar su información de salud para apoyar programas y actividades de Houston Methodist, como mejoras en la


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ADVANCED CANCER CARE IN SUGAR LAND Houston Methodist Cancer Center at Sugar Land is proud to be the home of the most advanced TrueBeamTM system in Fort Bend County. TrueBeam delivers powerful cancer treatments with pinpoint accuracy and precision, which helps protect nearby healthy tissue and critical organs. This new technology provides treatment options for even the most challenging cancer cases in the lung, prostate, breast, head and neck, brain, liver and other regions. To learn more about our cancer program, visit houstonmethodist.org/sugarland-cancer or call 281.242.CURE (2873). 16655 Southwest Frwy.

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OUR 3TWIDE WIDE MRI OPEN MRI OUR 3T MRI OPEN MRI OUR 3T WIDE MRI OPEN MRI want to reconsider. Houston Methodist Sugar Land OUR 3T WIDE MRI OPEN MRI OUR 3T WIDE MRI OPEN MRI OUR 3T WIDE MRI OPEN MRI Convenient Imaging Hours: Convenient Imaging Hours: Convenient Imaging Hours: Hospital's spacious MRI holds up to 500 pounds. It Convenient Imaging Hours: ConvenientImaging Imaging Hours: IMAGE QUALITY Superior —3—3Tesla Poor —0.7 0.7Tesla Tesla Convenient Hours: IMAGE QUALITY Superior 3Tesla Tesla Poor Tesla IMAGE QUALITY Superior — Poor — IMAGE QUALITY Superior — 3 Tesla Poor — 0.7 Tesla IMAGE QUALITY Superior — 3 Tesla Poor — 0.7 Tesla also offers better images and more room, so you can feel IMAGE QUALITY Superior — 3 Tesla Poor — 0.7 Tesla Monday Friday: Monday -- -Friday: Monday Friday: Monday Monday -Friday: Friday: Monday Friday: comfortable even if you’re claustrophic. Plus, there 77a.m. - -8 8p.m. a.m. p.m. 7 p.m. Nearly 28" (about a foot 77a.m. a.m. - 8-88 p.m. a.m. p.m. Nearly28" 28"(about (abouta afoot foot Nearly 7 p.m. Nearly 28" (about a foot Nearly 28" (about a foot Actual image to show new spacious MRI is no additional cost. The better the MRI image, more room than open MRI) the Nearly 28" (about a MRI) foot more room than open more room than open MRI) AVERAGE AVERAGE Saturday: more room than open MRI) more room than open MRI) AVERAGE Saturday: About 15.5"toto 17.5" Saturday: more room than open MRI) AVERAGE AVERAGE About 15.5" to 17.5" 15.5" 17.5" Saturday: Saturday: HEADROOM AVERAGE easier it is for your doctor to diagnose and treat you.About About 15.5" to 17.5" About 15.5" to 17.5" HEADROOM Saturday: HEADROOM *Option to go in feet About 15.5" to 17.5" *Option to go in feet 77a.m. a.m. p.m. HEADROOM HEADROOM *Option to go in feet a.m. -4 p.m. HEADROOM 7 --- 4 4 p.m. *Option to99% gogo inofin feet *Option to feet first for exams *Option to go in feet 77a.m. a.m. p.m. a.m. -444 p.m. Actual image to show our spacious MRI 7 p.m. first for 99% of exams first for 99% of exams first firstforfor99% 99%ofofexams exams first for 99% of exams

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To schedule, visit To schedule, visit To visit To schedule, visit Toschedule, schedule, visit To schedule, visit houstonmethodist.org/ houstonmethodist.org/ houstonmethodist.org/ houstonmethodist.org/ houstonmethodist.org/ houstonmethodist.org/ appointments Convenient Imaging Hours: appointments appointments appointments appointments appointments or call 281.274.7170. call 281.274.7170. Monday - Friday: or 281.274.7170. oror call 281.274.7170. orcall call281.274.7170. 281.274.7170. 7 a.m. - 8 p.m.

Saturday: 7 a.m. - 4 p.m. To schedule, visit

Long — head may or may not be inside machine depending on scan

houstonmethodist.org/

Exam will last longer and continuous repositioning may be required

or call 281.274.7170.

*Houston Methodist Sugar Land Hospital has three 3T MRIs. If you are claustrophobic, be sure to request the Wide Bore MRI upon scheduling.

appointments


Notificación de Prácticas de Privacidad calidad y el servicio; revisión de la prestación de servicios de cuidado de la salud; evaluación del desempeño del personal; revisión de competencias o calificaciones de los profesionales del cuidado de la salud; educación y capacitación de médicos y otros proveedores de cuidado de la salud; planificación y desarrollo empresariales, administración de negocios y actividades administrativas en general. Utilizamos esta información para mejorar de manera continua la calidad del cuidado para todos los pacientes que atendemos. Por ejemplo, podemos combinar información de salud de muchos pacientes para evaluar la necesidad de nuevos servicios o tratamientos. Podemos divulgar información a médicos, enfermeras y otros estudiantes con fines educativos. También podemos combinar la información de salud que tenemos con datos de otras instituciones para determinar las mejoras que podemos realizar. Asimismo, podemos compartir la información sobre su salud con otros proveedores de cuidado de la salud y personas responsables de pagos para algunas de sus operaciones comerciales, si la información está asociada con una relación que ellos tengan o hayan tenido previamente con usted y si, según lo requiera la ley federal, dicho proveedor o persona debe proteger la privacidad de la información sobre su salud. Intercambio de información de salud (HIE) de Houston Methodist Connect: Es posible que la información sobre su salud quede a disposición de otros profesionales que participan en su cuidado —tales como hospitales, laboratorios y médicos— y que la solicitan en formato electrónico, por medio de una red de intercambio de información. El propósito de este intercambio de información es lograr que el cuidado médico del paciente sea más seguro y esté mejor coordinado. La participación en el intercambio de información es voluntaria. Si usted no desea que la información de Houston Methodist sobre su salud esté a disposición de los proveedores de cuidado de la salud autorizados a través de Houston Methodist Connect, usted puede presentar un formulario de rechazo (no participación) firmado, que puede solicitar a su representante de registro o en www. houstonmethodist.org. Si usted decide no participar, los proveedores de cuidado de la salud no podrán tener acceso a la información sobre su salud a través de Houston Methodist Connect.

Divulgación electrónica: Houston Methodist crea, recibe, mantiene y, en algunos casos, divulga su información protegida sobre la salud en un formato electrónico. Obtendremos su autorización por escrito antes de divulgar electrónicamente su información protegida sobre la salud por cualquier motivo que no sea con fines de tratamiento, pago, operaciones de cuidado de la salud, o según lo autorizado o requerido por la ley. Autorización para otras divulgaciones: No utilizaremos ni divulgaremos la información sobre su salud, excepto en los casos descritos en este documento, a menos que usted nos autorice por escrito a hacerlo. Usted puede autorizarnos por escrito a divulgar su información médica a cualquier persona y por cualquier motivo. Houston Methodist puede usar medios electrónicos o de otro tipo para satisfacer su pedido de divulgación autorizada. Usted podrá revocar una autorización en cualquier momento, por escrito. Si usted revoca una autorización, ya no utilizaremos ni divulgaremos la información sobre su salud para el objetivo cubierto por la autorización. Sin embargo, no podremos impedir cualquier uso o divulgación ya realizado con su autorización. Algunos ejemplos específicos de usos o divulgaciones que requieren autorización incluyen: el uso de notas de psicoterapia, las actividades de comercialización, la venta de la información sobre su salud y la mayoría de los usos y divulgaciones por los cuales recibimos una remuneración económica. Directorio de hospitales: A menos que nos indique lo contrario, podemos divulgar su nombre, estado general y ubicación en el hospital a sus amigos, familiares y otras personas que pregunten por usted por nombre. Asimismo, a menos que nos indique lo contrario, daremos su nombre, ubicación en el hospital y afiliación religiosa a miembros del clero de su fe o tradición, si así lo solicitaran. Familiares y amigos: Podemos utilizar o divulgar información para notificar o ayudar a notificar a un familiar, representante personal u otra persona responsable de su cuidado, su ubicación y su estado general. También divulgaremos información médica a un familiar, otro pariente, amigo personal cercano o a otra persona que usted conozca, en caso de que la información sea relevante para la participación de esa persona en su cuidado o para el pago de su cuidado.

houstonmethodist.org/sugarland | 39


Notificación de Prácticas de Privacidad Recaudación de fondos: Podemos utilizar o divulgar su información de salud para contactarlo como una medida para recaudar dinero para nuestra organización y sus operaciones. Podemos divulgar esta información a The Methodist Hospital Foundation para que nos ayude con nuestras actividades de recaudación de fondos. Sólo se divulgará información demográfica, tal como su nombre, fecha de nacimiento, dirección, número de teléfono y otra información de contacto e información relacionada con el departamento donde recibió servicios, su médico tratante, información de resultados, estado de seguro de salud y las fechas en que recibió tratamiento o servicios en Houston Methodist. Usted tiene derecho a dejar participar en las comunicaciones de recaudación de fondos en cualquier momento llamando al 713.790.3333 y debemos respetar su solicitud. Estas comunicaciones tendrán instrucciones claras y precisas sobre cómo debe proceder para quedar excluido de futuras comunicaciones de recaudación de fondos. Comunicaciones futuras: Podemos utilizar o divulgar su información para comunicarnos con usted a través de boletines, por correo u otro medio sobre opciones de tratamiento, información relacionada con la salud, programas de manejo de enfermedades, programas de bienestar u otras iniciativas o actividades comunitarias en las que Houston Methodist participa. Si recibimos alguna compensación económica por estas comunicaciones (con limitadas excepciones permitidas), obtendremos su autorización antes de enviar la comunicación y usted podrá revocar su autorización en cualquier momento. Salud y seguridad pública: Podemos utilizar o divulgar información de salud, según lo autorice o requiera la ley local, estatal o federal, para los siguientes propósitos, considerados de interés o beneficio público: • Informar ciertas enfermedades y lesiones, nacimientos y fallecimientos, y sospechas de casos de abuso,abandono o violencia doméstica; • Ayudar a identificar, ubicar o denunciar a los sospechosos de un delito, a las víctimas de un delito,personas desaparecidas, muertes sospechosas o conducta delictiva en las instalaciones de HoustonMethodist; • Responder a una orden judicial, citación u otro proceso judicial; • Ayudar en actividades federales de rescate en casos de desastre;

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• Permitir el retiro, la reparación o el reemplazo de productos; • Responder a una auditoría, inspección o investigación realizada por un organismo gubernamentalrelacionado con la salud; • Colaborar en cuestiones de inteligencia federal, contrainteligencia y seguridad nacional; • Facilitar las donaciones de órganos y tejidos; • Ayudar a médicos forenses, examinadores médicos y directores funerarios; • Responder a la solicitud de una cárcel o prisión sobre la salud o el tratamiento médico de un preso; • Responder a la solicitud de una autoridad militar (en caso de ser miembro o veterano de las fuerzasarmadas); • Brindar información a un programa de indemnización laboral. Socios comerciales: Algunos de los servicios ofrecidos en Houston Methodist son proporcionados a través de contratos con socios comerciales. Cuando estos servicios sean contratados, divulgaremos la información sobre su salud al socio comercial a fin de que este pueda llevar a cabo el trabajo que le solicitemos. Sin embargo, la ley federal exige a los socios comerciales proteger su información de una manera apropiada. Investigación: Divulgaremos información a investigadores cuando así lo autorice una Junta de Revisión Institucional (IRB) para la preparación de un estudio de investigación, para reclutar sujetos de investigación, opara un estudio de investigación. La IRB analiza las propuestas de investigaciones y establece protocolospara proteger su seguridad y la privacidad de la información sobre su salud. Protecciones especiales de confidencialidad de la información sobre el abuso de alcohol y drogas: La información sobre el abuso de alcohol y drogas cuenta con protecciones especiales de confidencialidad. No divulgaremos información que identifique a una persona como paciente ni brindaremos información de salud relacionada con el tratamiento por abuso de sustancias del paciente, a menos que preste su consentimiento por escrito; que una orden judicial exija la divulgación de esta información; que el personal médico necesite la información en caso de una emergencia médica; que el personal calificado utilice la información para una investigación científica, auditorías de administración o


financieras, o una evaluación del programa; o cuando sea necesario para denunciar un delito o una amenaza de cometerlo, o para denunciar abuso o abandono, según lo requiera la ley.

Restricciones: Usted tiene derecho a solicitar una restricción o limitación sobre la información de su salud que utilicemos o divulguemos para el tratamiento, pago u operaciones de cuidado de la salud. También tiene

Derechos Relacionados Con Su Información Sobre Su Salud

derecho a solicitar que limitemos la información sobre su salud que divulgamos a una persona que esté involucrada en su cuidado o el pago de su cuidado, como un familiar o un amigo. Por ejemplo, puede solicitar que no utilicemos ni divulguemos información a un familiar sobre una cirugía que usted se realizó. Para solicitar una restricción, usted debe presentar una solicitud por escrito a la persona de contacto indicada a continuación. No estamos obligados a aceptar su solicitud. Si la aceptamos, nuestro acuerdo debe presentarse por escrito, y cumpliremos su solicitud, a menos que la información sea necesaria para brindarle tratamiento de emergencia.

Su expediente médico es propiedad de Houston Methodist (el profesional de cuidado de la salud o institución que la recopiló). Usted tiene los siguientes derechos con respecto a la información sobre su salud recopilada en Houston Methodist, con algunas excepciones. Tiene derecho a recibir una copia impresa de esta notificación. Asimismo, también puede obtener una copia en nuestro sitio web, www.methodisthealth.com. Comunicaciones confidenciales: Usted tiene derecho a solicitar que le comuniquemos su información de salud por un medio alternativo o en una ubicación que no sea su domicilio o el número telefónico de su hogar. Deberá presentar su solicitud por escrito y entregarla a la persona de contacto de Houston Methodist. Dicha solicitud deberá especificar el medio de comunicación o el lugar en donde usted desea que se le contacte. Intentaremos ajustarnos a su solicitud de comunicación alterna. Si solicita un medio de comunicación alterna, también deberá entregar esa solicitud a todos sus médicos, incluido su médico particular.

Asimismo, tiene derecho a solicitar que no utilicemos ni divulguemos información a un plan de salud con fines de pago u operaciones de cuidado de la salud (no de tratamiento), si esta información se refiere únicamente a un artículo o servicio de cuidado de la salud que pagó de su bolsillo y en su totalidad. Debe presentar su solicitud de restricción por escrito a la persona de contacto indicada. En este caso, Houston Methodist debe respetar su solicitud. Sin embargo, debe tener en cuenta que estas restricciones pueden tener consecuencias no intencionadas, especialmente si otros proveedores necesitan tener acceso a esa información (como una farmacia al dispensar una receta). Será su obligación

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Notificación de Prácticas de Privacidad notificar a otros proveedores sobre la restricción. Además, esta restricción puede afectar la decisión de su plan de salud de pagar cuidados relacionados que usted no desea pagar de su bolsillo (que no estarían sujetos a la restricción). Acceso: Usted tiene derecho a revisar y recibir una copia de la información sobre su salud, con ciertas excepciones. Por lo general, esta información incluye expedientes médicos y de facturación, pero no incluye notas de psicoterapia. Su solicitud para revisar o recibir una copia de la información sobre su salud debe presentarse por escrito a la persona de contacto indicada. Se le cobrarán las tarifas autorizadas por ley. En la medida en que su información sea guardada en un expediente de salud electrónico, usted podrá recibir la información en formato electrónico. Modificaciones: Si considera que la información sobre su salud es incorrecta o se encuentra incompleta, tiene derecho a solicitar que se la modifique. Usted tiene el derecho de solicitar una enmienda mientras la información sea conservada por nosotros o para nosotros. Debe presentar su solicitud de modificación por escrito a la persona de contacto indicada y debe incluir un motivo que respalde este pedido. Detalle de las divulgaciones: Usted tiene derecho a recibir una lista de ciertas divulgaciones que hayamos realizado durante los últimos seis años con respecto a la información sobre su salud. Debe presentar su solicitud de un detalle por escrito a la persona de contacto indicada y especificar el período del cual desea el detalle. Puede solicitar un detalle sin cargo en un período de 12 meses. Se cobrará una tarifa por listas adicionales solicitadas en un mismo período. Notificación de incumplimiento: En determinadas circunstancias, usted tiene derecho a ser notificado en caso de que nosotros, o uno de nuestros socios comerciales, descubramos un uso o divulgación

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inadecuados de la información sobre su salud. La notificación de dicho uso o divulgación se realizará de conformidad con los requisitos estatales y federales. Revisiones de la notificación: Nos reservamos el derecho a modificar esta notificación y el derecho a hacer que las nuevas disposiciones sean válidas para toda la información de salud que mantenemos actualmente, así como para cualquier información que recibamos en el futuro. Si realizamos una modificación importante, la notificación revisada será publicada en Houston Methodist y en nuestro sitio web. Además, dispondremos de una copia impresa de la notificación revisada si así lo solicita. Para reportar una queja: Si considera que sus derechos de privacidad relacionados con su información sobre la salud han sido violados, puede presentar una queja ante San Jacinto Methodist Hospital o el Secretario del Departamento de Salud y Servicios Humanos de los Estados Unidos. No se aplicarán sanciones ni habrá represalias en su contra por presentar una queja ante nosotros o el Departamento de Salud y Servicios Humanos. Persona de contacto: Si tiene alguna pregunta o necesita información sobre nuestros deberes legales y prácticas de privacidad, o sobre cómo ejercer cualquiera de sus derechos relacionados con la información de salud indicados en esta notificación, por favor comuníquese con el funcionario de prácticas de negocios del centro de interés: Houston Methodist Sugar Land Hospital Business Practices Officer 16655 Southwest Frwy. Sugar Land, TX 77479 Línea principal: 281.274.7000


Houston Methodist Notificación Conjunta de Prácticas de Privacidad Acuse de Recibo Usted ha recibido la notificación de prácticas de privacidad de Houston Methodist. Esta notificación explica sus derechos legales en relación con la información sobre su salud y le informará sobre las obligaciones legales y las prácticas de privacidad de Houston Methodist con respecto a la información de salud creada por los servicios brindados por ellos. Si recibe los servicios de su médico u otro proveedor de cuidado de la salud en otro lugar, usted debe averiguar acerca de las políticas de privacidad y notificaciones con respecto a la información sobre salud de esa oficina o clínica, puesto que podrían ser diferentes. Las organizaciones de Houston Methodist y su personal médico participan en un acuerdo de cuidado de la salud organizada en virtud de la Ley de Transferencia y Responsabilidad de los Seguros de Salud (HIPAA) para compartir información de salud protegida con fines de tratamiento, pago y operaciones de cuidado de la salud. Además, le proporcionan esta notificación de prácticas de privacidad en un único documento para su comodidad. Los hospitales de Houston Methodist y sus respectivos miembros del personal médico son responsables, de manera independiente, de cumplir lo establecido en esta notificación. Su nombre y su firma al pie indican que usted ha recibido una copia de esta notificación de prácticas de privacidad. Si rechaza una copia de esta notificación, por favor coloque sus iniciales aquí y firme más abajo: ____________________ Si usted tiene alguna pregunta con relación a la información presentada en esta notificación de prácticas de privacidad, por favor no dude en llamar al funcionario de prácticas de negocios del centro de interés o al 713.383.5129.

Nombre del paciente: _____________________________________________________________________________________________ Firma del paciente o representante personal calificado del paciente: __________________________________ Fecha ______________ Nombre en letra de imprenta del Representante Personal Calificado: ________________________________________________ Autoridad legal para actuar en nombre del paciente: ____________________________________________________________________ Nota: En los casos de pacientes obstétricos, este acuse de recibo firmado de la notificación de prácticas de privacidad también sirve como acuse de recibo de la notificación de prácticas de privacidad en nombre de los recién nacidos.

Para uso del personal únicamente Fecha de acuse de recibo en el sistema de administración de paciente: ____________________________________________________ Comentarios, si no se ha proporcionado la notificación o no se ha obtenido el acuse de recibo: _________________________________ ___________________________________________________________________________________

Procesado por: ___________________________________ Departamento: _________________________________________ (Nombre en letra de imprenta)

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Your Privacy & Information

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Do You Have Pain? Manage your pain so your hospital stay is as comfortable as possible. One of the most common fears about hospitalization is the issue of pain. One of our main goals during your hospital stay is to ensure that you are as comfortable as possible. However, some degree of pain is normal after surgery. You can expect to receive information about pain and pain relief measures, a commitment to pain prevention and a quick response to reports of pain. You are the expert about how you are feeling. Therefore, be sure to tell your doctor or nurse when you have any kind of pain.

Use the Pain Rating Scale to tell your doctor or nurse how severe your pain is. Pain Rating Scale

0 No Hurt

2 Hurts Little Bit

4 Hurts Little More

6 Hurts Even More To help describe your pain, be sure to report: • When the pain began. • Where you feel pain.

8 Hurts Whole Lot

• How the pain feels — sharp, dull, throbbing, burning, tingling. • If the pain is constant, or if it comes and goes. • What, if anything, makes the pain feel better. • What, if anything, makes the pain feel worse.

10 Hurts Worst

• How much, if any, pain your medicine is taking away. • If your medicine helps with the pain, how many hours of relief do you get?

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Don’t Leave Until… Being Discharged If you have questions regarding the timing of when you will be discharged, please contact your case manager at 281.274.7108 or guest relations at 281.274.7806. Our goal is to discharge by 11 a.m. If you are a Medicare patient, be sure you are given “An important Message from Medicare” from the hospital’s case manager or social worker. This details your rights and provides information on who to contact to appeal a discharge decision.

Be sure to meet with the hospital’s case manager early in your stay to ensure a smooth discharge process later on.

Five things to know before you walk out that hospital door. When it’s time to be released from the hospital, your physician will authorize a hospital discharge. This doesn’t necessarily mean that you are completely well — it only means that you no longer need hospital services. Before you can leave the hospital, there are several things that you or your caregiver must attend to. The first step is to know who will be involved in your discharge process. This starts with the hospital’s case manager or social worker. You and your caregiver should meet this person relatively early in your hospital stay; if not, find out who this person is and be sure to meet with them well before your expected discharge date.

Make sure you have the following information before you leave the hospital: 1. Follow-up care instructions. Make sure you have paperwork that tells you: • what, if any, dietary restrictions you need to follow and for how long • what kinds of activities you can and can’t do and for how long • how to properly care for any incisions you may have • what follow-up tests you may need and when you need to schedule them • what medicines you must take, why and for how long • when you need to see your physician • any other home-care instructions for your caregiver, such as how to get you in and out of bed, how to use and monitor any equipment and what signs and symptoms to watch out for • telephone numbers to call if you or your caregiver have any questions pertaining to your after-hospital care 2. Medications list. This is a listing of what medications you are taking, why, in what dosage and who prescribed them. Having a list prepared by the hospital is a good way to double-check the information you should already have been keeping track of. 3. Rx. Please be sure to fill your prescriptions promptly, so you don’t run out of needed medications. For your convenience, Walgreens is located on the first floor of Medical Office Building Three. Please bring your correct pharmacy insurance card with you. As an additional service, bedside prescription delivery service is available upon discharge. If you are interested in taking advantage of this service, please contact your nurse or call Walgreens at 281.980.0293.

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4. Other services. When you leave the hospital, you may need to spend time in a rehabilitation facility, nursing home or other institution. Or you may need to schedule tests at an imaging center, have treatments at a cancer center or have in-home therapy. Be sure to speak with your nurse or physician to get all the details you need before you leave. 5. Community resources. You and your caregiver may feel unprepared for what will happen after you are discharged. Make sure your case manager provides you with information about local resources, such as agencies that can provide services like transportation, equipment, home care and respite care.

Home Health Care Part-time health care provided by medical professionals in a patient’s home to maintain or restore health. It includes a wide range of skilled and non-skilled services, including part-time nursing care, therapy and assistance with daily activities and homemaker services, such as cleaning and meal preparation. Medicare defines home health care as intermittent, physician-ordered medical services or treatment.

Durable Medical Equipment (DME) Medical equipment that is ordered by a doctor for use in a patient’s home. Examples are walkers, crutches, wheelchairs and hospital beds. DME is paid for under both Medicare Part B and Part A for home health services.

Nursing Home A residential facility for people with chronic illness or disability, particularly elderly people who need assistance for most or all of their daily living activities, such as bathing, dressing and toileting. Nursing homes provide 24-hour nursing care and are also called convalescent homes or long-term care facilities. Many nursing homes also provide short-term rehabilitative stays for patients recovering from an injury or illness. Some facilities also have a separate unit for residents with Alzheimer’s disease or memory loss.

Hospice A licensed or certified program that provides care for people who are terminally ill and for their families. Hospice care can be provided at home, in a hospice or other freestanding facility or within a hospital. Palliative care is symptom management of chronic conditions. Symptom management includes managing shortness of breath, pain, constipation, fatigue as well as addressing the physical, spiritual, emotional, psychological, financial and legal needs of the patient and his or her family.

Respite Care provides a temporary break for caregivers. Patients spend time in programs such as adult daycare or in week-long or month-long stays in a care facility.

Independent Living Communities for seniors who are very independent and have few medical problems. Residents live in private apartments. Meals, housekeeping, maintenance and social outings and events are provided.

Assisted Living An apartment in a long-term care facility for elderly or disabled people who can no longer live on their own but who don’t need a high level of care. Assisted-living facilities provide assistance with medications, meals in a cafeteria or restaurant-like setting and housekeeping services. Nursing staff is on site. Most facilities have social activities and provide transportation to doctors’ appointments, shopping, etc.

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Preparing to Leave the Hospital When You Are Discharged

Going Home

Your physician determines when you are ready to be discharged. Your physician and nurse will give you discharge instructions and answer any questions you have about managing your treatment and medications once you are home. If you are confused or unsure about what you need to do, what medications you must take or if you have to restrict your diet or activities, don’t be afraid to ask and take notes.

When your doctor determines that you are ready to leave the hospital, he or she will write your discharge order. You will then be given instructions regarding special diets, medication, any limitations on your activities and your follow-up appointment. If you need assistance once you are discharged from the hospital, such as additional community resources, support groups, convalescent care, medical equipment, rehabilitation centers or nursing home care, please contact your physician’s office.

Be sure you understand any instructions you have been given before you leave the hospital.

Commercial Insurance As a service to our customers, we will forward a claim to your commercial insurance carrier based on the information you provide at the time of registration. It is very important for you to provide all related information such as policy number, group number and the correct mailing address for your insurance company.

Here are a few tips to make the discharge process run smoothly: • Be sure you and/or your caregiver have spoken with a case manager and that you understand what services you may need after leaving the hospital. • Verify your discharge date and time with your nurse or doctor. • Have someone available to pick you up. • Check your room, bathroom and bedside table carefully for any personal items. • Ask your nurse to return any medications you brought from home for use during your hospital stay. • Make sure you or your caregiver has all necessary paperwork for billing, referrals, prescriptions, etc.

Schedule Your Follow-Up Appointments Following up with your primary care and specialty physicians is important to continue your care and better your health. Houston Methodist Sugar Land Hospital wants to ensure the appointment process is simple and convenient. To help you select a physician and schedule your follow-up appointment for you, please call 281.274.7500.

Affiliate Billing Upon admission or services rendered by Houston Methodist Sugar Land Hospital, the patient or legal representative of the patient must assume some or all of the following responsibilities: The patient or legal representative of the patient can accrue billing from the Hospital, the physicians and affiliated entities such as Houston Methodist Pathology Associates for labs, Houston Radiology Associated for diagnostics (e.g. X-rays), Emergigroup Physician Associates for the emergency center physicians, Greater Houston Anesthesiology for the anesthesiologists, MASTOS Imaging for breast services, Texas Children’s Physician Services Organization for neonatal physicians and Houston Methodist for the hospital. If the patient has surgery, the patient can accrue billing from the surgeon and an independent surgical assistant. The affiliates listed are contracted with various insurance plans and may not be covered under a patient’s individual plan. Please check with affiliates to determine if they are contracted. Below is contact information for some of the affiliated entities and Houston Methodist Hospital. Houston Methodist Hospital P.O. Box 4315 Houston, TX 77210-4315 832.667.5900 or 1.877.493.3228

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Houston Methodist Pathology Associates P.O. Box 4701 Houston, TX 77210-4701 1.800.874.1705


Houston Radiology Associated 2190 N. Loop West, Suite 250 Houston, TX 77018 281.206.9050

MASTOS Imaging P.O. Box 4109 Houston, TX 77210-4109 713.426.4010

Emergigroup Physician Associates P.O. Box 24125 Forth Worth, TX 76124-1125 1.800.378.4134 or 817.451.4208

Texas Children’s Physician Services Organization P.O. Box 4984 Houston, TX 77210-4984 832.824.2300 or 1.800.722.2570

U.S. Anesthesia Partners P.O. Box 301838 Dallas, TX 75303 713.620.4040

Billing What is included in a hospital bill? The hospital bill includes the cost of your room, meals, 24-hour nursing care, laboratory work, tests, medication, therapy and the services of hospital employees. You will receive a separate bill for professional services including physicians, radiologists, pathologists and any other professional fees incurred during your stay. The hospital is responsible for submitting bills to your insurance company and will do everything possible to expedite your claim. You should remember that your policy is a contract between you and your insurance company and that you have the final responsibility for payment of your hospital bill.

Coordination of Benefits (COB) Coordination of Benefits, referred to as COB, is a term used by insurance companies when you are covered under two or more insurance policies. This usually happens when both husband and wife are listed on each other’s insurance policies or when both parents carry their children on their individual policies or when there is eligibility under two federal programs. Most insurance companies have COB provisions that determine who is the primary payer when medical expenses are incurred. This prevents duplicate payments. COB priority must be identified on admission in order to comply with insurance guidelines. Your insurance may request a completed COB form before paying a claim, and every attempt will be made to notify you if this occurs. The hospital cannot provide this information to your insurance company. You must resolve this issue with your insurance carrier in order for the claim to be paid.

Where to Settle Your Bill Before you leave, we ask that you pay your co-payment, deductible and/or coinsurance. If you have not been cleared by patient access services, please check on your account by stopping by the cashier’s office before you leave: Main Pavilion, first floor, 8 a.m. to 4 p.m., Monday through Friday; 281.274.0108. Payment can be made by cash, personal check, MasterCard, Visa, American Express, Discover or travelers checks.

Insurance Claims The hospital will file with your insurance for inpatient and outpatient hospital charges approximately five to seven days after your discharge. For an updated list of our managed care plans, visit houstonmethodist.org/ sugarland.If you have questions or need further information while you are still in the hospital, please call patient access services at 281.274.7000. If you have questions after your discharge, call patient billing services at 832.667.5900.

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Preparing to Leave the Hospital Medicare

Financial Assistance Program

This hospital is an approved Medicare provider. All services billed to Medicare follow federal guidelines and procedures. Medicare has a COB clause. At the time of service you will be asked to answer questions to help determine the primary insurance carrier paying for your visit. This is referred to as an MSP Questionnaire and is required by federal law. Your assistance in providing accurate information will allow us to bill the correct insurance company.

To inquire about the financial assistance program, you can speak with a financial counselor located on the first floor of the Main Pavilion. Our financial counselors will ask you or your family member to complete a financial assistance application for uncompensated or discounted hospital care.

Medicare deductibles and coinsurance are sometimes covered by your secondary insurance. If you do not have a secondary insurance, you will be asked to pay these amounts or establish a payment plan. If you are unable to pay these amounts, we will help you determine if you qualify for financial assistance.

Patient Access Services and Patient Accounting Departments will be responsible for reviewing completed financial assistance application forms (FAAF) and determining eligibility. The eligibility criteria rely on income levels and means testing indexed to the federal poverty guidelines, updated at the beginning of each calendar year and available from the federal government. Eligible applicants are classified as either financially indigent (FI) or medically indigent (MI). The review may be conducted using either the traditional or fast track method.

Plain Language Summary Houston Methodist’s Financial Assistance Policy Houston Methodist is committed to providing charity care to persons who are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay for emergency and medically necessary care based on their individual financial situation. Patients whose family income is at or below 200 percent of the Federal Poverty Level (FPL) are eligible to receive free services; and patients whose family income is above 200 percent but not more than 400 percent of the FPL are eligible to receive services at a discounted amount. This discounted amount is not to exceed the average amount Houston Methodist would get paid by private insurance and Medicare, including any patient payments in the form of deductibles, co-payments, and co-insurance. You will not be required to make advanced payments or payment arrangements for emergency and medically necessary services prior to the rendering of services. However, if you are required to pay a discounted amount, and you cannot pay the discounted amount in full after the services are provided, Houston Methodist will attempt to collect this discounted amount. Houston Methodist will provide monthly billing statements requesting payment from you. If you cannot pay the discounted amount in a single payment, Houston Methodist offers interest free extended payment options. Any discounted amounts remaining unpaid will be turned over to a third party collection agency for further collection attempts. Third party collection activity will not include personal liens, legal actions or credit bureau notification. A free copy of Houston Methodist’s Financial Assistance Policy, the Financial Assistance Application and Collection Policies are available on Houston Methodist’s website at www.houstonmethodist.org/billing, are available in the

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Hospitals’ Admitting and Registration areas, can be obtained by contacting the Centralized Business Office at (local) 832.667.5900, (toll free) 1.877.493.3228, and can be requested by mail: Houston Methodist Centralized Business Office Attn: Financial Assistance Unit 701 S. Fry Road Katy, TX 77450 This Plain Language Summary, Financial Assistance Policy, Financial Assistance Application and Collection Policies are available in various languages at the contacts listed above. Houston Methodist’s Financial Assistance Unit is available to answer questions and provide information about the Financial Assistance Policy and to assist you with the application process. You can reach a member of the Financial Assistance Unit Monday through Friday between the hours of 7 a.m. through 7 p.m. and Saturday between the hours of 8 a.m. – noon at 832.667.5900 or 877.493.3228. Once you have completed the Financial Assistance Application, please attach all required supporting documents and mail to the Financial Assistance Unit, see address listed on previous page, or fax to the attention of the Financial Assistance Unit at 832.667.5995.

Special Information for Outpatients Registration If you will require hospital services after your stay, you are encouraged to register in person at least two days prior to your outpatient procedure. Registration is available from 6 a.m. to 9 p.m., Monday through Friday; Saturday from 7 a.m. to 7 p.m. Preparation for Your Outpatient Procedure Many procedures require special preparations, which may begin a day or more before your actual procedure. Please contact your physician’s office for complete instructions. The physician office staff will let you know if you will need assistance following the procedure. Payment Arrangements The hospital will file with your insurance for outpatient hospital charges. However, you will be asked to make payment arrangements for any patient portion not satisfied. In addition to your hospital bill, your doctor and any specialist called for consultation will mail you separate bills. For example, if you have surgery, your anesthesiologist and other specialists will also send bills, such as radiologists, emergency physicians and/or pathologists. If you have specific questions following your procedure, please call patient access services at 281.274.7000.

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For the Caregiver Caregiver... Know what condition your loved one is being treated for.

Ask questions If your loved one is too ill or reluctant to ask questions, make note of their concerns and don’t be afraid to speak up. (See Speak Up! on page 12)

Patient’s rights Know your loved one’s patient’s rights and responsibilities. (See page 13)

Advance directives? Know whether or not your loved one has a Directive to Physician and if so, what it specifies. (See page 25) If they have one, bring a copy from home.

Help track medications Your loved one may be prescribed medications while in the hospital and may be seen by several doctors. Keep track of it all with My Medications on page 56.

What’s next Will your loved one need home care or care at another facility? Ask to speak with a case manager to find out what your options are.

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Your role as a patient advocate While your loved one is in the hospital, who will speak up for him or her? You can, by being the patient’s advocate — the person who will help the patient work with doctors, nurses and hospital staff. To help your loved one make the best decisions about their care and treatment, follow the advice in the caregiver list to the right. While you are making sure that your loved one’s needs are being met, don’t neglect your own. Caregiving is a stressful and time-consuming job. You may neglect your diet, your normal exercise routine and your sleep needs. You may find that you have little or no time to spend with friends, to relax or to just be by yourself for a while. But down time is important. Don’t be reluctant to ask for help in caring for your loved one. Take advantage of friends’ offers to help, and look into local adult daycare programs. Find out more about how you can ease the stress of caregiving at caregiver.org.


Resources Physicians Your primary care physician or a hospitalist, will supervise your care while you are in the hospital. Nurses In each nursing unit, a registered nurse is responsible for supervising patient care and directing the nursing and support staff of the unit. Registered nurses are assisted by nursing assistants and nurse technicians. The nursing staff is available around the clock. Dietitians 281.274.7015 A registered dietitian will review your medical record and work with your health care team to develop a nutrition care plan for you. Registered dietitians are also available to educate you about your diet. Your nurse will be able to assist you with this request. Rehabilitation Therapists Inpatient 281.274.7064 Outpatient 281.274.0123 Physical therapists, occupational therapists and speech pathologists will work with you, your family and your medical team to help meet goals of recovery. Therapy may range from brief consultation to long-term intervention, based on the extent of your injuries or illness. Guest Relations 281.274.7806 If you have concerns about the care you or your family member received, we encourage you to speak with your physician or with the nursing supervisor. If you feel that your issue wasn’t resolved, please contact the Guest Relations Department. Case Managers and Social Workers 281.274.7108 Case managers will review your medical record and discuss your discharge planning. They are also available to assist you with arrangement for home care, admission to a long-term care facility or rehabilitation care. Social workers offer emotional support, counseling and guidance to help patients and their families deal with financial, social and emotional problems related to illness or hospitalization.

Pharmacists A pharmacist is on duty around the clock to dispense your medications. Pharmacists also routinely review your medication lists to ensure medication safety as it might relate to drug interactions, duplication of therapy, dosing, administration and lab monitoring. Please let your nurse know if you would like to speak directly to a pharmacist. Chaplain 281.274.7164 The hospital Chaplain and a group of volunteer ministers are available to all patients and their families for prayer and support. Our chapels, located on the first floor of the Brazos Pavilion near the patient elevators, and on the first floor of the Sweetwater Pavilion near the patient elevators, are open 24 hours. The Muslim Prayer Room is located on the first floor of the Sweetwater Pavilion. Volunteers 281.274.7127 Volunteers give thousands of hours each year to our hospital to enhance the care of our patients and their families. They provide support throughout the hospital, including assisting at the information desk, delivering mail and flowers, escorting patients and assisting with clerical duties in the patient care areas. Care Management The care management team includes nurse case managers and social workers who work with your doctors during your hospitalization to help meet your health care needs. If your doctor orders services for after you are discharged such as home health, medical equipment or a transfer to another health care facility, the care management team will assist with this as well. The care management team can also provide information and community resources that may offer you assistance, especially with any lifestyle adjustments due to a change in your health. Please ask to speak to a social worker if you would like assistance with any of these services. Pet Therapy Faithful Paws pets visit with patients at 1:30 p.m. on the second and fourth Wednesday of every month. Personal pet visitation is also available. To arrange a visit, please talk to your nurse or call Volunteer Services at 281. 274.7127.

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Resources Support Groups

Caregiver Resources

Bereavement Support — Meets on the second Tuesday of each month from 5:30 to 7:30 p.m. Counseling is also available. Meal provided to attendees.

aoa.gov Caregiver resources from the Administration on Aging.

Breast Cancer Support — Survivors Offering Support meets on the third Thursday of each month from 5:30 to 7:30 p.m. for women, men, caregivers and patients whose lives have been touched by breast cancer. Powerful Tools for Caregivers — A six week program offered in the Spring and Fall for anyone caring for older adults with a long-term health conditions. For more information, please contact the Department of Spiritual Care at 281.274.7164. Ostomy Support — Meets quarterly for patients with urostomies, colostomies or ileostomies. For more information, call 832.506.4869.

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caregiveraction.org 202.454.3970 Support for caregivers of chronically ill, aged or disabled loved ones. caregiving.com Online support groups and articles on caregiving. caregiving.org Support for family caregivers and the professionals who serve them. eldercare.gov 800.677.1116 Help with locating aging services throughout the U.S. medicare.gov 800-MEDICARE Official U.S. government site for people with Medicare.


Giving Back Houston Methodist Sugar Land Hospital’s Cancer Fund

Help through Fundraising

Houston Methodist Sugar Land Hospital is committed to providing quality health care. You can help us help cancer patients undergoing treatment by making a contribution to Houston Methodist Sugar Land Hospital’s Cancer Fund.

We may share health information about you with Houston Methodist Hospital Foundation — such as your name, address, telephone number and the dates you received treatment or services at Houston Methodist Sugar Land Hospital — in an effort to raise money for our organization and its operations.

The cancer fund creates an opportunity to make a meaningful difference in our community. 100 percent of funds donated will stay within our community to assist patients with transportation, durable medical equipment, prescription medication and other household costs. You may make a donation in honor or in memory of a friend, family member or loved one. If there has been a staff member who has helped make your experience a great one, you may also make a donation in recognition of him or her. To make a donation, please visit our website at houstonmethodist.org/sugarland and click on the blue Donate Now button.

Gifts of Gratitude Program When you receive care at Houston Methodist, you become part of our family. Houston Methodist’s commitment to your health and well-being extends beyond you to caring for your loved ones, now and for generations to come. We invite you to ensure a legacy of health by contributing, advocating and volunteering through the Gifts of Gratitude program. No matter how you choose to partner with Houston Methodist, your involvement will make a significant difference in the lives of our patients. There are many ways you can get involved:

Volunteer Houston Methodist Sugar Land Hospital is proud of its volunteers. If you would like to become a volunteer, please do the following to assist us in placing you: • Submit an application • Pre-screen phone interview • Attend personal interview, health screen and orientation • Assignment and training To learn more call 281.274.7127.

Make a Philanthropic Contribution We invite you to make a gift in honor of a Houston Methodist physician, nurse or other staff member who has made a difference in your care. Through an honorary gift, you can help us recognize the positive difference a special individual has made in your life. Philanthropic contributions advance Houston Methodist’s leading medicine mission by supporting the latest innovations in research, education and patient care. Make your gift online at houstonmethodist.org/giving or by mail to Houston Methodist Hospital Foundation, P.O. Box 4384, Houston, Texas 77210-4384. Share Your Story Has Houston Methodist touched your life? We encourage you to share your experience with us. With your permission, your story could be included in a Houston Methodist communication or special event. Join Our Mailing List Learn more about Houston Methodist news and events by subscribing to our publications. Keep informed about the latest leading medicine advances and achievements throughout our hospital system. To participate in the Gifts of Gratitude program or to learn about additional giving opportunities, visit houstonmethodist.org/giving or contact Houston Methodist Hospital Foundation at 832.667.5816. houstonmethodist.org/sugarland | 55


My Medications Keep track of all medications you are prescribed while in the hospital. When you get home, add all other medications — including over-the-counter, vitamins and herbs — to this list. Update your list as needed. Medication: ______________________________________________________________________________________________________ (include brand and generic names)

Dose: Take ________________ times per day at (circle all that apply): midnight–1 a.m. / 2–3 a.m. / 4–5 a.m. / 6–7 a.m. / 8–9 a.m. / 10–11 a.m. / noon–1 p.m. / 2–3 p.m. / 4–5 p.m. / 6–7 p.m. / 8–9 p.m. / 10–11 p.m. Reason for taking: _______________________________________________________________________________________________ Prescribed by: ____________________________________________________ Date started:____________________________________ Pharmacy name and number: ______________________________________________ /_______________________________________ Medication: ______________________________________________________________________________________________________ (include brand and generic names)

Dose: Take ________________ times per day at (circle all that apply): midnight–1 a.m. / 2–3 a.m. / 4–5 a.m. / 6–7 a.m. / 8–9 a.m. / 10–11 a.m. / noon–1 p.m. / 2–3 p.m. / 4–5 p.m. / 6–7 p.m. / 8–9 p.m. / 10–11 p.m. Reason for taking: _______________________________________________________________________________________________ Prescribed by: ____________________________________________________ Date started:____________________________________ Pharmacy name and number: ______________________________________________ /_______________________________________ Medication: ______________________________________________________________________________________________________ (include brand and generic names)

Dose: Take ________________ times per day at (circle all that apply): midnight–1 a.m. / 2–3 a.m. / 4–5 a.m. / 6–7 a.m. / 8–9 a.m. / 10–11 a.m. / noon–1 p.m. / 2–3 p.m. / 4–5 p.m. / 6–7 p.m. / 8–9 p.m. / 10–11 p.m. Reason for taking: _______________________________________________________________________________________________ Prescribed by: ____________________________________________________ Date started:____________________________________ Pharmacy name and number: ______________________________________________ /_______________________________________

Medication: ______________________________________________________________________________________________________ (include brand and generic names)

Dose: Take ________________ times per day at (circle all that apply): midnight–1 a.m. / 2–3 a.m. / 4–5 a.m. / 6–7 a.m. / 8–9 a.m. / 10–11 a.m. / noon–1 p.m. / 2–3 p.m. / 4–5 p.m. / 6–7 p.m. / 8–9 p.m. / 10–11 p.m. Reason for taking: _______________________________________________________________________________________________ Prescribed by: ____________________________________________________ Date started:____________________________________ Pharmacy name and number: ______________________________________________ /_______________________________________

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Nominate a Nurse for the DAISY Award DAISY Award honorees personify Houston Methodist Sugar Land Hospital’s remarkable patient experience. These nurses consistently demonstrate excellence through their clinical expertise and extraordinary compassionate care, and they are recognized as outstanding role models in our nursing community.

What is the DAISY Award? The DAISY Award is an international program that rewards and celebrates the extraordinary clinical skill and compassionate care given by nurses everyday. Houston Methodist Sugar Land Hospital is proud to be a DAISY Award Partner, recognizing one of our nurses with this special honor quarterly.

About the DAISY Foundation The DAISY Foundation was established in 1999 by the family of J. Patrick Barnes, who died of complication of the autoimmune disease Idiopathic Thrombocytopenia Purpura (ITP) at the age of 33. (DAISY is an acronym for diseases attacking the immune system.) During Pat’s eight week hospitalization, his family was awestruck by the care and compassion his nurses provided not only to Pat but to everyone in his family. So one of the goals they set in creating a foundation in Pat’s memory was to recognize extraordinary nurses everywhere who make an enormous difference in the lives of so many people by the super-human work they do every day. Each DAISY Award honoree will be recognized at a public ceremony in her/his unit and will receive: a beautiful certificate, a DAISY Award pin and a hand-carved stone sculpture entitled “A Healer’s Touch”. Additionally, everyone in the unit will celebrate with Cinnabon® cinnamon rolls — a favorite of Patrick’s during his illness. The Barnes family asks that whenever and wherever nurses smell that wonderful cinnamon aroma, they stop for a moment and think about how special they are. To find out more about the program, including the growing list of partners, please go to DAISYfoundation.org.

How to Nominate an Extraordinary Nurse Patients, visitors, nurses, physicians and employees may nominate a deserving nurse by filling out this form and submitting it to the nurse manager. An electronic version of the form is available on our website at houstonmethodist.org/sugarland. Click the For Patients tab, then click Nominate a Nurse.

Nomination Form I nominate ____________________________________________________ as a deserving recipient of the DAISY Award. This nurse has demonstrated clinical skill, compassionate care, exemplary service and a commitment to excellence. I would like to share a story about why this nurse is so special. (Additional space provided on back.)

Thank you for taking the time to nominate an extraordinary nurse for this award. Please tell us about yourself so we may include you in the celebration of this award should the nurse you nominated be chosen. Your Name ________________________________ Phone____________________ Email____________________________ I am l RN l Patient l Family/Visitor l MD l Staff l Volunteer Date of Nomination__________________________ Manager Acknowledgment: I acknowledge that this nurse is in good standing. Signed _______________________________________________ Title _____________________________________________________ Nominations received after March 1, June 1, September 1 or December 1 will be considered for the following quarter’s DAISY Award. houstonmethodist.org/sugarland | 57


Nominate a Nurse for the DAISY Award

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Notes

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Notes

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A TRADITION OF INNOVATION & COMPASSION THE DIFFERENCE BETWEEN PRACTICING MEDICINE AND LEADING IT. Houston Methodist MethodistSugar SugarLand LandHospital Hospitalbrings brings expertise, up-to-the-minute technology Houston thethe expertise, skillskill andand up-to-the-minute technology of of the world-renowned world-renowned Houston HoustonMethodist MethodisttoHospital to Fort and surrounding counties, the alleviating the Fort Bend and Bend surrounding counties, alleviating need the need to travel the Medical Texas Medical for high-quality and compassionate care. to travel to the to Texas CenterCenter for high-quality and compassionate care. We‘re changing changingwhat whatititmeans meanstotobe beaacommunity communityhospital, hospital,performing performing most advanced surgical We’re thethe most advanced surgical andand diagnostictechniques techniquesavailable available in Fort Bend County, including surgery, opensurgery heart surgery diagnostic in Fort Bend County, including brain brain surgery, open heart and jointand joint replacementsurgery, surgery,totoname name a few —backed all backed a healing on compassion, hands-on care and replacement a few—all by a by healing focusfocus on compassion, hands-on care and outstandingservice. service. outstanding The physicians physiciansand andstaff staffofofHouston Houston Methodist Sugar Land Hospital deliver the world-class medical The Methodist Sugar Land Hospital deliver the world-class medical care care you and and your yourfamily familydeserve—with deserve — with convenience desire. you thethe convenience you you desire. Physician Scheduling: Visit houstonmethodist.org/appointments to schedule an appointment Physician Scheduling: Visit houstonmethodist.org/spg to schedule an appointment online,or orcall call281.274.7500 281.274.7500for foraareferral. referral. online Outpatient Imaging Visit houstonmethodist.org/online-scheduling 281.274.7170. Outpatient ImagingScheduling: Scheduling: Visit houstonmethodist.org/appointmentsororcall call 281.274.7170.

OUR OUR SERVICES SERVICES INCLUDE: • • • • • •• • • ••

Aquatic Therapy Aquatic Therapy Childbirth Center Birthing Center – Level II A&B NICU -Breast Level Care II A&B NICU Center Breast Care Center Cancer Center Cath LabCenter Cancer Diagnostic CardiologyImaging Emergency Cath Lab Department

• Diagnostic Imaging

houstonmethodist.org/sugarland 16655 16655 Southwest SouthwestFrwy. Freeway Sugar 77479 Sugar Land, Land, TX Texas 77479 281.274.7000 281.274.7000

• • • • • • • •

• Neuroscience & Spine Center Occupational Therapy • Occupational Therapy Physical Therapy • Physical Therapy Respiratory Therapy • Respiratory Therapy Speech Therapy • Speech Therapy • Surgical Spine Center Services – Robotics Surgical ServicesTechnology • Wound Care Program - Robotics Technology

• Endoscopy Emergency Department • Headaches and Migraines Endoscopy • Heart & Vascular Center Headache Migraines • Infusion & Center Infusion Center • Inpatient Services • Intensive Care Inpatient Services • Joint Center Intensive Care • Lab Joint Center

• • • • • •

Lab

• Wound Care Program

comprehensive therapy services The area’s finest and most experienced therapists staff our facilities, providing the latest and most effective treatments custom-tailored to deliver maximum effectiveness and quick return to full and pain-free function. Many of our therapists have completed clinical residency programs and fellowship programs within their subspecialty area of practice. In addition, many of our therapists hold national certifications, including:

• • • • •

Board Certification in Orthopedics Board Certification in Sports Physical Therapy Certified Hand Therapist Certified Strength and Conditioning Specialist LSVT BIG® and LSVT LOUD® Certification

Whether the goal is to get you back in the game, back to work, or back to your hobbies and passions, our therapists will be with you every step of the way.

Schedule Now: 281.274.0123 Three Convenient Locations: Houston Methodist Sugar Land Hospital Neuroscience & Spine Center 16605 Southwest Frwy. Medical Office Building 3, Suite 115 Sugar Land, TX 77479 Monday – Friday: 8 a.m. – 5 p.m. • Physical Therapy • Occupational Therapy • Speech Therapy • BIG and LOUD Therapy Houston Methodist Orthopedics & Sports Medicine at Sugar Land 16811 Southwest Frwy., Suite 100 Sugar Land, TX 77479 Monday – Thursday: 7 a.m. – 7 p.m. Friday: 7 a.m. – 6 p.m. • Physical Therapy • Occupational Therapy • Hand Therapy • Aquatic Therapy Houston Methodist Sienna Plantation Physical Therapy 8330 Hwy. 6, Suite 200 Missouri City, TX 77459 Monday – Friday: 8 a.m. – 5 p.m.

houstonmethodist.org/sugarland-therapy

• Physical Therapy


Patient Guide

Welcome to Houston Methodist Sugar Land Hospital

To learn more or to make a donation, visit houstonmethodist.org/sugarland and click on the red Donate Now button!

16655 Southwest Frwy. Sugar Land, TX 77479 houstonmethodist.org/sugarland

01.17


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