911 West 38th Street
Suite 400
Austin, Texas 78705
Tel: 512-553-1700
Fax: 512-503-3959
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PSCA Patients Have the Right to:
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Personal privacy and care in a safe setting free from all forms of abuse, harassment, discrimination, or reprisal.
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Accurate and easily understand information about your health plan, treatment, health care, professionals, and health care facilities. If you speak another language, have a physical or mental disability, or just need to understand something, help should be given so you can make informed health care decisions prior to your treatment or procedure. Please ask for help.
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Choose health care providers who can give you high-quality health care. If you do not feel you are receiving appropriate care from a provider, you have the right to change providers if other qualified providers are available.
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Be screened and stabilized using emergency services if you have severe pain, an injury, or sudden illness that makes you believe that your health is in serious danger. You should be able to use these services whenever and wherever you need them, without needing to wait for authorization and without any financial penalty.
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Treatment options and the right to take part in decisions about your care. Parents, guardians, family members, or surrogates that you select can represent you if you cannot make your own decisions according to state law. If you are judged incompetent under applicable state health and safety laws by a court of proper jurisdiction, your rights as a patient are to be exercised by the person appointed under state law to act on your behalf.
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Refuse or opt out of care that is part of research or a teaching event.
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Considerate, respectful care from your doctors, health plan representatives, and other health care providers that does not discriminate against you.
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Talk privately with health care providers and to have your health care information protected. You also have the right to read and copy your own medical record. You have the right to ask that your doctor change your record if it is not correct, relevant, or complete. Unless authorized by law, you have the right to approve or refuse record release.
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An objective review of any complaint you have against your health plan, doctors, hospitals or other health care personnel without fear of reprisal. This includes complaints about waiting times, operating hours, the actions of health care personnel, and the adequacy (or lack of) of treatment or care.
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ADVANCE DIRECTIVES: You have the right to present an Advance Directive; however, it is our policy not to honor all terms of an Advanced Directive at our surgery center, as lifesaving measures will be made in the event of an emergency. We will do everything to stabilize you, the patient, and arrange for immediate transfer to a nearby hospital. The Advanced Directive will be kept with your medical records in case you are transferred to another facility where it will be honored in the event of such an emergency.
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PSCA Patient Responsibilities:
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Provide complete and accurate health information to the best of your ability about your health, any medications, including over- the-counter products and dietary supplements, and any allergies or sensitivities.
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Ask for an explanation if you do not understand papers you are asked to sign or anything about your own or your child’s care.
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Accept personal financial responsibility associated with your own or your child’s care if not covered by insurance.
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Gather as much information as you need to make informed decisions. You are responsible to participate in your plan of care.
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Be available so staff can teach you how to care for yourself or your child. You are responsible for following the treatment plan recommended; discharge instructions outlining your care will be reviewed with you prior to surgery and given to you to take home. If clarification is needed, please ask.
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Follow the agreed- upon treatment plan prescribed by your provider and participate in your care.
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Behave respectfully toward all health care professional and staff, as well as other patients and visitors. Respect the rights and privacy of others, and for the personal property of other persons at PSCA.
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Take an active role in ensuring safe patient care for yourself, please state any concerns while in our care.
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You are responsible for making known whether or not you clearly understand the medical treatment plan. If you don’t understand, please ask again.
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Inform your provider about any living will, medical power of attorney, or other directive that could affect your care.
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You must provide a responsible adult to provide your transportation home and to remain with you as directed by your provider or as indicated on your discharge instructions.
PHYSICIAN OWNERSHIP: You understand and acknowledge that the ASC is owned in part by physicians. At the time of last revision of this document, physicians who have financial interest or ownership in the ASC facility include:
Otis Barron, MD Karen Stierman, MD
Sean Gallagher, MD Russel Briggs, MD
Robert Graham, MD Benjamin Amis, MD
Michael Trotter, MD Brian Mazzarella, MD
Trinity Mereau, DPM David Cuellar, MD
Subir Chhikara, MD
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Feedback, Complaints, or Grievances:
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Persons who have concerns or grievances regarding Pinnacle Surgery Center of Austin, including but not limited to decisions regarding admission, treatment, discharge, denial of services, quality of services, courtesy of personnel or any other issue are encouraged to contact the Administrator or send a written statement to:
Pinnacle Surgery Center of Austin
911 W 38th Street, Suite 400
Austin, TX 78705
Pinnacle Surgery Center of Austin is Medicare certified. For More information about your Medicare patient rights, please call:
The Medicare Beneficiary Ombudsman 1-800-MEDICARE
Any complaints regarding services provided at Pinnacle Surgery Center can be directed in writing or by telephone to:
Health and Human Services Commission Complaint and Incident Intake
Mail Code E-249
P.O. Box 149030 Austin, TX 78714-9030
Hotline: 888-973-0022
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Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, acupuncturists, and surgical assistants may be reported for investigation at the following address:
Investigations Dept MC- 263
P.O. Box 2018 Austin, Texas 78768-2018
Hotline: 1-800-201-9353
www.tmb.state.tx.us
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Pinnacle Surgery Center is accredited with the Accreditation Association for Ambulatory Health Care. If you would like to provide feedback, please complete the online form at
https://www.aaahc.org/contact-us/ feedback-about-organization
and email it to complaints@aaahc.org.
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