Important Patient Information

Patients of this facility have certain rights and responsibilities, including the right to have access to protective services. Protective services include advocacy services, certification and licensure agencies, Medicare/Medicaid fraud, abuse reporting agencies, etc. A list of agencies with telephone numbers and addresses is provided below. If you have questions regarding the need to access these services, please contact Matagorda Regional Medical Center administration or ask for the administrator-on-call who can assist you during the weekends and evenings.

Please note the additional Senior Care rights listed in the drop-down below this information.

Reporting Suspected Abuse/Neglect

Texas Department of Aging and Disability Services, Consumer Rights and Services Hotline  1-800-458-9858
Advocacy Incorporated 1-800-252-9108

Grievances/Complaints

Matagorda Regional Medical Center Administration   979-241-5520

Advocacy Incorporated   1-800-252-9108 7800 Schoal Creek Blvd, Ste.171E, Austin, TX 78757

Health Facility Licensure & Certification Division   1-888-973-0022 Texas Department of State Health Services, Patient Quality Care Unit 1100 W. 49th St., Austin, TX 78711-2668

Patient Care or Safety concerns that have not been addressed by the hospital may be reported to: The Joint Commission’s Office of Quality Monitoring   1-800-994-6610

E-mail: complaint@jointcommission.org

Medicare/Medicaid Fraud

Medicare Fraud (ask to speak to a Medicare Representative)   1-800-633-4227

Medicaid Fraud (ask to speak to a Medicaid Specialist)   1-800-436-6184

Anti-Discrimination

Matagorda County Hospital District (MCHD) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MCHD does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. You can access our full Anti-Discrimination Notice here.

For more information with additional assistance in English, አማርኛ, العربية, বাংলা, tsalagi gawonihisdi, 繁體中文, Chahta, Oroomiffa, Nederlands, Français, Kreyòl Ayisyen, Deutsch, ગુજરાતી, हिंदी, Hmoob, Igbo asusu, Ilokano, Italiano, 日本語, 한국어, Ɓàsɔ́ɔ̀‑wùɖù‑po‑nyɔ̀, ພາສາລາວ, Kajin Ṃajōḷ, ខ្មែរ, Diné Bizaad, नेपाली, Deitsch, فارسی, Polski, Português, ਪੰਜਾਬੀ, Română, Русский, Gagana fa’a Sāmoa, Srpsko‑hrvatski, Español, ܣܘܼܪܸܬ݂, Tagalog, ภาษาไทย, Türkçe, Українська, اُردُو, Tiếng Việt, and èdè Yorùbá, click here.

Reporting Of Concerns Related To Patient Care, Discharge, Or Coverage

Texas Medical Foundation
1-800-725-9216
Bridgepoint 1, Ste 300
5918 West Courtyard Drive
Austin, TX 78730-5036

1. Matagorda County Hospital District respects and supports the patient’s right to impartial access to care, treatment, and services that are consistent with relevant laws and regulations and medically indicated.

2. A patient has the right to high quality, considerate and respectful care given by competent personnel and to expect that high professional standards are continually maintained and reviewed. A patient has a right to medical and nursing services without discrimination based upon race, color, creed, religion, national origin, age, sex, sexual preference, disability, diagnosis, or source of payment for care. A patient has the right to participate in making care decisions.

3. A patient has the right to high quality, considerate and respectful care given by competent personnel and to expect that high professional standards are continually maintained and reviewed. A patient has a right to medical and nursing services without discrimination based upon race, color, creed, religion, national origin, age, sex, sexual preference, disability, diagnosis, or source of payment for care. A patient has the right to participate in making care decisions.

4. A patient has the right to designate a surrogate decision maker when the patient is unable to make decisions regarding health care. Alternatively, the patient has the right to exclude family members from participating in his or her health care decisions.

5. A patient has the right to know what hospital rules and regulations apply to his or her conduct. A patient has the right to expect good management techniques to be implemented within the hospital to effectively utilize his or her time and to avoid personal discomfort. Please see the list of patient responsibilities at the end of the document.

6. A patient has the right to refuse any drug, treatment, or procedure offered by the hospital to the extent permitted by law. A physician shall inform the patient of the medical consequences of his or her refusal of any drug, treatment, or procedure.

7. Patients, including terminal patients, have the right to all necessary measures to assure comfort by the provision of treatment of symptoms, pain management and the acknowledgement of the psychological, psychosocial, emotional, cultural and spiritual concerns of the patient and family. These includes the right to have all personal values, beliefs, and preference respected.

8. Regarding pain management, patients have the right to information about pain and pain relief measures. As a patient, you can expect a concerned staff member committed to pain prevention and state of the art pain management.

9. A patient has the right to self determination, which includes the right to formulate an Advance Directive. (Living Will, Directive to Physician, Medical Power of Attorney, Organ Procurement Card, or Mental Health Advance Directive.) Provision of care is not conditioned upon whether or not the patient has an Advance Directive. The patient also has the right to receive information about the hospital’s policies and procedures relating to Advance Directives. The patient has the right to have their advance directive followed, as allowed by law and regulation.

10. Terminal patients shall have the right to die with dignity. The care, treatment, and services of the dying patient will be honored through effective pain management, consultation with the patient and their family, and the acknowledgement of psychosocial, cultural, spiritual, personal values and beliefs and preferences of the patient.

11. A patient, next-of-kin, or legally responsible representative has the right to participate in the consideration of ethical issues. For more information about the hospital’s Ethics Committee, contact Administration at 979-245-6383 Monday through Friday, 8a.m. – 5p.m. or a Nursing House Supervisor by contracting the hospital operator.

12. Each patient has the right to have his or her spiritual and personal values, beliefs and preferences respected. Patients are asked on admission if they would like to list a religious preference and if so this information is given to their religious representatives. Patients may also personally call their minister, rabbi, priest or other religious leader. You may also request assistance from your caregiver.

13. A patient has the right, upon request, to be given the name of his or her attending physician, the names or identity of all other physicians directly participating in his or her care, and the names and identity of other health care personnel having direct contact with him or her. A patient has the right to refuse students to provide care.

14. The patient has the right to confidentiality, privacy, and security of protected health information or medical record information. A patient has the right to have all records pertaining to his or her medical care treated as confidential expect as otherwise provided by law or third-party contractual arrangements. The hospital shall provide the patient, upon request, access to all information contained in his or her medical records in accordance with applicable regulations (unless access is specifically restricted by the attending physician for medical reasons or is prohibited by law.)

15. A patient has the right to access, request amendment to, and receive an accounting of disclosures regarding his or her own health information. For more information on these topics, please see the hospital’s HIPAA Notice of Privacy Practice.

16. A patient has the right to full information in layman’s terms concerning diagnosis, treatment and prognosis, including information about risk, benefits, alternative treatments and possible complications. When it is not medically advisable to give such information to the patient, the information shall be given to the patient’s next-of-kin or other appropriate persons. Except in emergencies, a patient has the right to expect that his or her physician will obtain the necessary informed consent prior to the start of any procedure or treatment.

17. Patients have the right to information about outcomes of care and treatment. The patient has the right to be informed of unanticipated outcomes of care and treatment, according to law and policy.

18. A patient (or in the event the patient is unable to give informed consent, a legally responsible party) has the right to be advised when a physician is considering him or her as part of a medical care research program, investigational, or donor program. The patient, or legally responsible party, must give informed consent prior to participation in such a program. The patient or legally responsible party may at any time refuse to continue in any such program to which he or she has previously given informed consent. Such refusal will not compromise access to services and will not in any way affect the provision of healthcare to the patient. Informed consent will consist of expected benefits, potential discomforts and risks, a description of alternative services that might also prove advantageous and a full explanation of procedures to be followed.

19. A patient has a right to refuse the recording or filming of care and the right to request that the recording stop any time during the filming or recording process even if consent was given by the patient. Patients have the right to rescind the consent to use the videotape or filming up until a reasonable time before the videotape or film is used.

20. A patient has the right to every consideration of his or her privacy and security and personal dignity concerning his or her own medical care. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly, making every attempt to maintain the patient’s verbal and visual privacy.

21. A patient has the right to be free from all forms of abuse and harassment and neglect and to have his/her care provided in a safe environment. This includes the mental, physical, verbal abuse, neglect, exploitation, harassment from visitors, staff, students, volunteers, other patients, or family members.

22. A patient has the right to freedom from restraints in acute medical and surgical care and/or freedom from seclusion and restraints in behavior management, unless clinically necessary or in an emergency situation to protect the patient or others from harm.

23. A patient has the right to expect emergency procedures to be implemented without unnecessary delay.

24. A patient has the right to assistance in obtaining consultation or a second opinion with a physician other than the attending physician.

25. When medically permissible, a patient may be transferred to another facility, only after the patient or next of kin or other legally responsible representative has received complete information and an explanation concerning the needs for and alternatives to such a transfer. The institution to which the patient is to be transferred must accept the patient for transfer in advance.

26. A patient has the right to expect that the hospital will provide a mechanism whereby he or she is informed upon discharge of his or her continuing health care requirements, and the means for meeting them.

27. Patients have a right to effective communication. A patient who cannot communicate with hospital staff because he or she does not speak English or because of hearing or speech impairment shall have access, where possible, to an interpreter and/or technology that will facilitate communication. The interpreter is provided at no charge to the patient.

28. A patient has the right of access to an individual who, or an agency which, is authorized to act on behalf of the patient to assert or protect the rights set out in this policy.

29. A patient has the right to examine and receive a detailed explanation of hospital bills. He or she has a right to full information and counseling on the availability of financial resources for health care.

30. A patient has the right to communicate and have resolution complaints or grievances regarding his or her care. Complaints or grievances can be communicated to your physician, nurse team member, hospital management or administration. Complaints communicated to the hospital’s Administration Manager should be called to (979) 241-5522.

31. A patient has the right to be informed of these rights at the earliest possible time during the course of hospitalization.

32. The patient has a right to be protected from reasonably known risks.

33. The patient has a right to not be discriminated against based on age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation, and gender identity or expression.

34. The patient has a right for a family member, friend, or other individual to be present for emotional support during the course of stay. The presence of a support individual is allowed unless the individual’s presence infringes on others’ rights, safety or is medically or therapeutically contraindicated. The individual may or may not be the patient’s surrogate decision-maker or legally authorized representative.

1. A patient should provide, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalization, medications and other matters relating to his or her health. Unexpected changes in condition are also to be reported to the appropriate individual.

2. Patients are responsible for asking questions when they do not understand what they have been told about their care or what they are expected to do.

3. A patient should make it known to the appropriate people whether or not he or she clearly understands a contemplated course of action and what is expected.

4. A patient should follow the treatment plan and all instructions recommended by the staff and practitioners responsible for his or her care. This may include following the instructions of nurses and allied health personnel as they carry out the coordinated plan of care and implement the responsible practitioner’s orders, as they enforce the applicable rules and regulation. The patient is responsible for resulting outcomes and for their actions if he or she refuses treatment or does not follow the practitioner’s instructions.

5. A patient should assure either personally or through a legally responsible party that the financial obligations of his or her stay are fulfilled as promptly as possible.

6. The patient is responsible for following hospital rules and regulations affecting care and conduct.

7. A patient should be considerate of the rights of other patient and personnel and for assisting in the control of noise, smoking, and number of visitors. This includes being respectful of the property of other patients, staff and the hospital. The hospital is designated as a no smoking campus and the patient is responsible for honoring this regulation.

8. The patient will immediately report to the physician or nurse in charge, risk management department, or administration, of any allegations of abuse, neglect, harassment, or exploitation.

9. The patient’s family is responsible for accompanying and staying with or securing another responsible adult to stay with any patient under the age of thirteen.

When you apply for or receive mental health services in the State of Texas, you have many rights. Your most important rights are listed in the following sections of this posting. These rights apply to all persons unless otherwise restricted by law or court order. A judge or lawyer will refer to the actual laws. If you want a copy of the laws these rights come from, you can call the Health Facility Licensure and Certification Division of the Texas Department of State Health Services at 1-888-973-0022.

It is the responsibility of this hospital under law to make sure you have been informed of your rights. But just giving you this information does not mean your rights have been protected. This hospital is required to respect and provide for your rights in order to maintain licensure and do business in this state.


Your Right to Know Your Rights

You have the right, under the rules by which this hospital is licensed, to be given a copy of these rights before you are admitted to the hospital as a patient. If you so desire, a copy should also be given to the person of your choice. If a guardian has been appointed for you or you are under 18 years of age, a copy will also be given to your guardian, parent, or conservator.

You also have the right to have these rights explained to you aloud in simple terms in a way you can understand within 24 hours of being admitted to the hospital to receive services (e.g., in your language if you are not English-speaking, in sign language if you are hearing impaired, in Braille if you are visually impaired, or other appropriate methods).


Your Right To Make a Complaint

You have the right to make a complaint and to be told how to contact people who can help you. These people and their addresses and phone numbers are listed below.

You have the right to be told about Advocacy, Inc., when you first enter the hospital and when you leave. Information about how to contact Advocacy, Inc. is also listed below.

If you believe any of your rights have been violated or you have other concerns about your care in this hospital, you may contact one or more of the following:

Health Facility Licensing and Compliance Division
1-888-973-0022
Texas Department of Health
1100 W. 49th St., Austin, TX 78756

Advocacy, Incorporated
1-800-315-3876
7800 Shoal Creek Boulevard, Suite 171 E
Austin, TX 78757

If you have been involuntarily committed and you believe that your attorney did not prepare your case properly or that your attorney failed to represent your point of view to the judge, you may wish to report the attorney’s behavior to the Ethics Committee of the State Bar of Texas by writing:

Disciplinary Council
State Bar of Texas
1414 Colorado
P.O Box 12487
Austin, TX 78711-2487

If you are a voluntary patient OR if you have been taken to the hospital against your will, refer to the section in this posting titled Voluntary Patients-Special Rights for a listing of your special rights under law in Texas. All patients should read the section in this posting titled Basic Rights for All Patients which explain the rights that apply to everyone receiving services at this hospital.


Basic Rights for All Patients

1. You have all the rights of a citizen of the State of Texas and the United States of America, including the right of habeas corpus (to ask a judge if it is legal for you to be kept in the hospital), property rights, guardianship rights, family rights, religious freedom, the right to register to vote, the right to sue and be sued, the right to sign contracts, and all the rights relating to licenses, permits, privileges, and benefits under the law.

2. You have the right to be presumed mentally competent unless a court has ruled otherwise.

3. You have the right to a clean and humane environment in which you are protected from harm, have privacy with regard to personal needs, and are treated with respect and dignity.

4. You have the right to appropriate treatment in the least restrictive appropriate setting available. This is a setting that provides you with the highest likelihood for improvement and that is not more restrictive of your physical or social liberties than is necessary for the most effective treatment and for protections against any dangers which you might pose to yourself or others.

5. You have the right to be free from mistreatment, abuse, neglect, and exploitation.

6. You have the right to be told in advance of all estimated charges being made, the cost of services provided by the hospital, sources of the program’s reimbursement, and any limitations on length of services known to the hospital. As part of this right, you should have access to a detailed bill of services, the name of an individual at the facility to contact for any billing questions, and information about billing arrangements and available options if insurance benefits are exhausted or denied.

7. You have the right to fair compensation for labor preformed for the hospital in accordance with the Fair Labor Standards Act.

8. You have the right to be informed of those hospital rules and regulations concerning your conduct and course of treatment.


Personal Rights

Unless otherwise specified, these personal rights can only be limited by your doctor on an individual basis to the extent that the limitation is necessary to your welfare or to protect another person. The reasons for and duration of the limitation must be written in your medical record, signed, and dated by your doctor, and fully explained to you. The limit on your rights must be reviewed at least every seven days and if renewed, renewed in writing.

1. You have the right to talk and write to people outside the hospital. You have the right to have visitors in private, make private phone calls, and send and receive sealed and uncensored mail. In no case may your right to contact or be contacted by an attorney, the department, the courts, or the state attorney general be limited.This right includes a prohibition on barriers to communication imposed by a hospital, such as:

  • rigid and restrictive visiting hours;
  • policies that restrict hospitalized mothers and fathers from visiting with their minor children;
  • policies that restrict parents from visiting their hospitalized children
  • limited access to telephones; and
  • failure to provide assistance to patients who wish to mail a letter.

2. You have the right to keep and use your personal possessions including the right to wear your own clothing and religious or other symbolic items. You have the right to wear suitable clothing which is neat, clean and well-fitting.

3. You have the right to have an opportunity for physical exercise and for going outdoors with or without supervision (as clinically indicated) at least daily. A physician’s order limiting this right must be reviewed and renewed at least every three days. The findings of the review must be written in your medical record.

4. You have the right to have access to appropriate areas of the hospital away from your living unit, with or without supervision (as clinically appropriate), at regular and frequent times.

5. You have the right to religious freedom. However, no one can force you to attend or engage in any religious activity.

6. You have the right to opportunities to socialize with persons of the opposite sex, with or without supervision, as your treatment team considers appropriate for you.

7. You have the right to ask to be moved to another room if another person in your room is disturbing you. The hospital staff must pay attention to your request, and must give you an answer and a reason for the answer as soon as possible.

8. You have the right to receive treatment of any physical problems which affect your treatment. You also have the right to receive treatment of any physical problem that develops while you are in the hospital. If your physician believes treatment of the physical problem is not required for your health, safety, or mental condition, you have the right to seek treatment outside the hospital at your own expense.

9. You have the right not to be unnecessarily searched unless your physician believes there is a potential danger and orders a search. If you are required to remove any item of clothing, a staff member of the same sex must be present and the search must take place in a private place.


Confidentiality

1. You have a right under HIPAA (Health Insurance Portability and Accountability Act) to have your confidentiality rights explained to you at admission. You will be provided a written copy of your confidentiality rights, including how to make a complaint,

2. You have the right to review the information contained in your medical record. If your doctor says you shouldn’t see a part of your record, you have the right to file a complaint with the hospital HIPAA privacy officer. You may also, at your expense, have another doctor of your choice review that decision. The doctor must also reconsider the decision to restrict your right on a regular basis. The right extends to your parent or conservator if you are a minor (unless you have admitted yourself to services) and to your legal guardian if you have been declared by a court to be legally incompetent.

3. You have the right to have your records kept private and to be told about the conditions under which information about you can be disclosed without your permission, as well as how you can prevent any such disclosures.

4. You have the right to be informed of the current and future use of products of special observation and audiovisual techniques, such as one-way vision mirrors, tape recorders, television, movies, or photographs.


Consent

1. You have the right to refuse to take part in research without affecting your regular care. You have the right to refuse any of the following:

  • surgical procedures;
  • electroconvulsive therapy (prohibited for minors under the age of 16); unusual medications;
  • behavior therapy
  • hazardous assessment procedures;
  • audiovisual equipment; and
  • other procedures for which your permission is required by law.

This right extends to your parent or conservator if you are a minor, or your legal guardian when applicable.

2. You have the right to withdraw your permission at any time in matters to which you have previously consented.


Care and Treatment

1. You have the right to be transported to, from, and between private psychiatric hospitals in way that protects your dignity and safety. You have the right not to be transported in a marked police or sheriff’s car or accompanied by a uniformed officer unless other means are not available.

2. You have the right to a treatment plan for your stay in the hospital that is just for you. You have the right to take part in developing that plan, as well as the treatment plan for your care after you leave the hospital. This right extends to your parent or conservator if you are a minor, or your legal guardian when applicable. You have the right to request that your parent/conservator or legal guardian take part in the development of the treatment plan. You have the right to request that any other person of your choosing, e.g., spouse, friend, relative, etc., take part in the development of the treatment plan. You have a right to expect that your request be reasonably considered and that you will be informed of the reasons for any denial of such a request. Staff must document in your medical record that the parent/guardian, conservator, or other person of your choice was contacted to participate.

3. You have the right to be told about the care, procedures, and treatment you will be given; the risks, side effects, and benefits of all medications and treatment you will receive, including those that are unusual or experimental, the other treatments that are available, and what may happen if you refuse the treatment.

4. You have the right to receive information about the major types of prescription medications which your doctor orders for you (effective May 1, 1994).

5. You have the right not to be given medication you don’t need or too much medication, including the right to refuse medication (this right extends to your parent or conservator if you are a minor, or your legal guardian when applicable). However, you may be given appropriate medication without your consent if:

  • your condition or behavior places your or others in immediate danger; or
  • you have been admitted by the court and your doctor determines that medication is required for your treatment and a judicial order authorizing administration of the medication has been obtained.

6. You have the right to receive a list of medications prescribed for you by your physician, including the name, dosage, and administration schedule, within four hours of the facility administrator or designee receiving such a request in writing.

7. You have the right not to be physically restrained (restriction of movement of parts of the body by person or device or placement in a locked room alone) unless your doctor orders it and writes it in your medical record. In an emergency, you may be restrained for up to one hour before the doctor’s order is obtained. If you are restrained, you must be told the reason, how long you will be restrained, and what you have to do to be removed from restraint. The restraint has to be stopped as soon as possible.

8. You have the right to meet with the staff responsible for your care and to be told of their professional discipline, job title, and responsibilities. In addition, you have the right to know about any proposed change in the appointment of professional staff responsible for your care.

9. You have the right to request the opinion of another doctor at your own expense. You have the right to be granted a review of the treatment plan or specific procedure by hospital medical staff. This right extends to your parent of conservator if you are a minor, or your legal guardian, if applicable.

10. You have the right to be told why you are being transferred to any program within or outside the hospital.

11. You have the right to a periodic review to determine the need for continued inpatient treatment.If you have questions concerning these rights or a complaint about your care, call the Health Facility Licensure and Certification Division for the Texas Department of Health at 1-888-973-0022.


Voluntary Patients – Special Rights

1. You have the right to request discharge from the hospital. If you want to leave, you need to say so in writing or tell a staff person. If you tell a staff person you want to leave, the staff person must write it down for you.

2. You have the right to be discharged from the hospital within four hours of requesting discharge. There are only three reasons why you would not be allowed to go:

  • First, if you change your mind and want to stay at the hospital, you can sign a paper that says you do not wish to leave, or you can tell a staff member that you don’t want to leave, and the staff member has to write it down for you.
  • Second, if you are under 16 years old, and the person who admitted you (your parents, guardian, or conservator) doesn’t want you to leave, you may not be able to leave. If you request release, staff must explain to you whether or not you can sign yourself out and why. The hospital must notify the person who does have the authority to sign you out and tell that person that you want to leave. That person must talk to your doctor, and your doctor must document the date, time, and outcome of the conversation in your medical record.
  • Third, you may be detained longer than four hours if your doctor has reason to believe that you might meet the criteria for court-ordered services or emergency detention because: – you are likely to cause serious harm to yourself; – you are likely to cause serious harm to others; or – your condition will continue to deteriorate and you are unable to make an informed decision as to whether or not to stay for treatment.

If your doctor thinks you may meet the criteria for court-ordered services or emergency detention, he or she must examine you in person within 24 hours of your filing the discharge request. You must be allowed to leave the hospital upon completion of the in-person examination unless your doctor confirms that you meet the criteria for court-ordered services and files an application for court-ordered services. The application asks a judge to issue a court order requiring you stay at the facility for services. The order will only be issued if the judge decides that either:

  • you are likely to cause serious harm to yourself;
  • you are likely to cause serious harm to others; or
  • your condition will continue to deteriorate and you are unable to make an informed decision as to whether or not to stay for treatment.

Even if an application for court-ordered services is filed, you can not be detained at the hospital beyond 4:00 p.m. of the first business day following the in-person examination unless the court-order for services is obtained.

3. You have the right not to have an application for court ordered services filed while you are receiving voluntary services at the hospital unless your physician determines that you meet the criteria for court-ordered services as outlined in §573.022 of the Texas Health and Safety Code and:

  • you request discharge (see number 2 above);
  • you are absent without authorization;
  • your doctor believes you are unable to consent to appropriate and necessary treatment; or
  • you refuse to consent to necessary and appropriate treatment recommended by your doctor and your doctor states in the certificate of medical examination that: – there is no reasonable alternative treatment; and – you will not benefit from continued inpatient care without the recommended treatment.

4. Your doctor must note in your medical record and tell you about any plans to file an application for court-ordered treatment or for detaining you for other clinical reasons. If the doctor finds that you are ready to be discharged, you should be discharged without further delay. Note: The law is written to ensure that people who do not need treatment are not committed. The Texas Health and Safety Code says that any person who intentionally causes or helps another person cause the unjust commitment of a person to a mental hospital is guilty of a crime punishable by a fine of up to $5,000 and/or imprisonment in county jail for up to one year.


Emergency Detention – Special Rights for People Brought Against to the Hospital Against Their Will

1. You have the right to be told:

  • where you are;
  • why you are being held; and
  • that you might be held for a longer time if a judge decides that you need treatment.

2. You have the right to call a lawyer. The people talking to you must help you call a lawyer if you ask.

3. You have a right to be seen by a doctor. You will not be allowed to leave if the doctor believes that:

  • you may seriously harm yourself or others;
  • the risk of this happening is likely unless you are restrained; and
  • emergency detention is the least restrictive means of restraint.

If the doctor decides you don’t meet all of these criteria, you must be allowed to leave. A decision concerning whether you must stay must be made within 48 hours, except that on weekends and legal holidays, the decision may be delayed until 4:00 in the afternoon on the first regular workday. The decision may also be delayed in the event of an extreme weather emergency or disaster. If the court is asked to order you to stay longer, you must be told that you have a right to a hearing within 72 hours (excepting weekends, holidays, or extreme weather emergencies or disasters).

4. If the doctor decides that you don’t need to stay here, the hospital will arrange for you to be taken back to where you were picked up if want to return, or to your home in Texas, or to another suitable place within reasonable distance.

5 You have the right to be told that anything you say or do may be used in proceedings for further detention.


Order of Protective Custody – Special Rights

1. You have the right to call a lawyer or to have a lawyer appointed to represent you in a hearing to determine whether you must remain in custody until a hearing on court-ordered mental health services is held.

2. Before a probable cause hearing is held, you have the right to be told in writing:

  • that you have been placed under an order of protective custody;
  • why the order was issued; and
  • the time and place of a hearing to determine whether you must remain in custody until a hearing on court-ordered mental health services can be held.
  • This notice must also be given to your attorney.

3. You have the right to a hearing within 72 hours of your detention, except that on weekends or legal holidays, the hearing may be delayed until 4:00 in the afternoon on the first regular workday. The hearing may also be delayed in the event of an extreme weather emergency or disaster.

4. You have the right to be released from custody if:

  • 72 hours has passed and a hearing has not taken place (excepting weather emergencies and extensions for weekends and legal holidays);
  • an order for court-ordered mental health services has not been issued within 14 days of the filing of an application (30 days if a delay was granted); or
  • your doctor finds that you no longer need court-ordered mental health services.

Involuntary Patients – Special Rights

Under most circumstances, you or a person who has your permission may, at any time during your commitment, ask the court to ask a physician to reexamine you to determine whether you still meet the criteria for commitment. If the physician determines you no longer meet the criteria for commitment, you must be discharged. If the physician determines you continue to meet the criteria for commitment, the physician must file a Certificate of Medical Examination with the court within 10 days of the filing of your request. If a certificate is filed, or if a certificate has not been filed within 10 days and you have not been discharged, the judge may set a time and place for a hearing on your request.

Our rights under the Health Insurance Portability & Accountability Act of 1996 (HIPAA)

This notice is designed to explain how your medical information may be used and disclosed, and how you can get access to this information. If you have any questions about this notice, please contact the Facility Privacy Officer.

PLEASE REVIEW CAREFULLY

Who Will Follow This Notice of Privacy Practices (“Notice”):

This Notice describes Matagorda County Hospital District’s (the “Facility”) practices and that of:

  • Any health care professional authorized to enter information into your medical record maintained by the Facility
  • All departments and units of the Facility Any member of a volunteer group allowed to help you while you are receiving services from the Facility
  • All employees, staff, agents and other Facility personnel
  • All entities, sites and locations within this Facility’s system will follow the terms of this Notice. They also may share medical
  • information with each other for treatment, payment and health care operations purposes.

Our Pledge Regarding Medical Information:

We understand that medical information about you and your healthcare is personal. We are committed to protecting medical information about you. A medical record is created to document the care and services you receive at this Facility. This record is needed to provide patient care and to comply with legal requirements. This Notice applies to all of the medical records of your care generated by the Facility. Your personal physician may have different policies or privacy notices regarding the physician’s use and disclosure of your medical information in the physician’s office or clinic.

This Notice will tell about the ways in which the Facility may use and disclose medical information about you. Also described are your rights and certain obligations we have regarding the use and disclosure of medical information.

The law requires the Facility to:

  • Make sure that medical information that identifies you is kept private;
  • Inform you of our legal duties and privacy practices with respect to medical information about you; and
  • Follow the terms of the Notice that is currently in effect.

HOW THE FACILITY MAY USE & DISCLOSE YOUR MEDICAL INFORMATION:

The following categories describe different ways the Facility uses and discloses medical information. Each category will be explained. Not every possible use or disclosure will be listed. However, all the different ways the Facility is permitted to use and disclose information will fall within one of these categories.

  • Treatment.Your medical information may be used to provide you with medical treatment or services. This medical information may be disclosed to physicians, nurses, technicians, or other workforce members of the Facility who are involved in your care at the Facility. Your medical information may also be disclosed to healthcare and medical students. For example: A doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. The doctor may need to tell the dietitian about the diabetes so appropriate meals can be arranged. Different departments of the Facility may also share medical information about you in order to coordinate your different needs, such as prescriptions, lab work and x-rays. The Facility also may disclose medical information about you to people outside the facility who may be involved in your medical care after you leave the facility, such as family members, home health agencies, or others used to provide services that are part of your care.
  • Your medical information may be used and disclosed so that the treatment and services received at the Facility may be billed and payment may be collected from you, the insurance company and/or a third party. For example: The health plan or insurance company may need information about the care you received from the Facility so they can provide payment for the costs of services. Information may also be given to someone who helps pay for your care. Your health plan or insurance company may also need information about a treatment you are going to receive to obtain prior approval or to determine whether they will cover the treatment.
  • Health Care Operations.Your medical information may be used and disclosed for purposes of furthering day-to-day Facility operations. These uses and disclosures are necessary to run the Facility and to monitor the quality of care our patients receive.
    For example: Your medical information may be:

    1. Reviewed to evaluate the treatment and services performed by our staff in caring for you.
    2. Combined with that of other Facility patients to decide what additional services the Facility should offer, what services are not needed, and whether certain new treatments are effective.
    3. Disclosed to doctors, nurses, technicians, and other agents of the Facility for review and learning purposes.
    4. Disclosed to healthcare and medical students.
    5. Combined with information from other facilities to compare how we are doing and see where we can improve the care and services offered. Information that identifies you in this set of medical information may be removed so others may use it to study health care and health care delivery without knowing who the specific patients are.
    6. Used to assess your satisfaction with our services.
    7. Used for population based activities relating to improving health or reducing health care costs.
  • Private Accreditation Organizations.Your medical information may be used to fulfill this Facility’s requirements to meet the guidelines of private facility accreditation organizations such as Joint Commission, National Committee for Quality Assurance, etc.
  • Business Associates.There are some services provided in this Facility through contracts with business associates. Examples include information technology support services or a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we’ve asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, business associates, and subcontractors of business associates, are required by federal law to appropriately safeguard your information.
  • We may include certain limited information about you in the Facility Directory while you are a patient at the Facility. The information may include your name, location in the Facility, your general condition (e.g., good, fair) and your religious affiliation. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name. If you would like to opt out of being in the Facility Directory please inform the admission staff or the Facility Privacy Officer.
  • Future Communications.We may communicate to you via newsletters, mail outs or other means regarding treatment options, health related information, disease-management programs, wellness programs, or other community-based initiatives or activities our Facility is participating in.
  • Organized Health Care Arrangement (“OCHA”).This Facility and its medical staff members have organized and are presenting you this document as a joint Notice. Information will be shared as necessary to carry out treatment, payment and health care operations. Physicians and caregivers may have access to protected health information in their offices to assist in reviewing past treatment as it may affect your treatment at the time. This Notice covers the following list of Facilities and organizations. The OHCA does not cover the information practices of practitioners in their private offices or at other practice locations. The following is a list of entities or organizations that will follow this Notice:
  1. Matagorda Regional Medical Center
  2. All MCHD Community Health Program Locations
  3. WIC-Women, Infant, and Children’s Clinic
  4. Matagorda Regional Medical Center Rehabilitation Services
  5. Matagorda Regional Medical Center Diagnostic Center
  6. Matagorda Regional Wellness Center and Associated Programs
  7. All Medical Staff, including physicians with privileges to provide health care services to patients of Matagorda Regional Medical Center and associated clinics.

SPECIAL SITUATIONS:

  • Organ and Tissue Donation.If you are an organ or tissue donor, your medical information may be released to organizations that handle organ procurement or organ, eye and tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
  • Medical Devices.Your social security number and other required information will be released in accordance with federal laws and regulations to the manufacturer of any medical device(s) you have implanted or explanted during a hospitalization and to the Food and Drug Administration, if applicable. This information may be used to locate you should there be a need with regard to such medical device(s).
  • HIV, Substance Abuse, Mental Health and Genetic Information.Special privacy protections apply to HIV-related information, alcohol and substance abuse, mental health, and genetic information. Some parts of this Notice may not apply to these kinds of protected health information. Please check with our Facility Privacy Officer for information about the special protections that do apply. For example, if we give you a test to determine if you have been exposed to HIV, we will not disclose the fact that you have taken the test to anyone without your written consent unless otherwise required by law.
  • Military and Veterans.If you are a member of the armed forces, your medical information may be released as required by military command authorities. If you are a member of the foreign military personnel, your medical information may be released to the appropriate foreign military authority.
  • Workers’ Compensation.If you seek treatment for a work-related illness or injury, we must provide full information in accordant with state-specific laws regarding workers’ compensation claims. Once state-specific requirements are met and an appropriate written request is received, only the records pertaining to the work-related illness or injury may be disclosed.
  • Public Health Risk.Your medical information may be used and disclosed for public health activities. These activities generally include the following:
    1. To prevent or control disease, injury or disability;
    2. To report births and deaths;
    3. To report child abuse or neglect
    4. To report reactions to medications or problems with products;
    5. To notify people of recalls of products they may be using;
    6. To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
    7. To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
  • Coroners, Medical Examiners, and Funeral Directors.Your medical information may be released to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the facility to funeral directors as necessary to carry out their duties.
  • If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary for the following reasons:
    1. For the institution to provide you with health care;
    2. To protect the health and safety of you and others; and
    3. For the safety and security of the correctional institution.

ADDITIONAL SITUATIONS:

  • Other Uses of Medical Information.Most uses and disclosures of psychotherapy notes, uses and disclosures of your protected health information for marketing purposes and disclosures that constitute a sale of your protected health information require your authorization prior to such use and disclosure. Other uses and disclosures of medical information not covered by this Notice or the laws that apply to this Facility will be made only with your written authorization. If you provide the Facility authorization to use or disclose your medical information, you may revoke that authorization at any time by submitting a written revocation to our Facility Privacy Officer. If you revoke your authorization, we will no longer use or disclose your medical information for the reasons covered in your written authorization. You understand that we are unable to take back any disclosures already made with your permission, and that we are required to retain our records of the care that the Facility provided to you, therefore disclosures that we made in reliance on your authorization before you revoked it will not be affected by the revocation.

ADDITIONAL INFORMATION CONCERNING THIS NOTICE:

  • Changes To This Notice.We reserve the right to change this Notice and make the revised or changed Notice effective for medical information we already have about you as well as any information we receive in the future. The Facility will post a current copy of the Notice with the effective date within the Facility as well as on its website. In addition, each time you are admitted to the Facility for care/services, as an inpatient or outpatient, we will offer you a copy of the current Notice in effect.
  • You will not be penalized for filing a complaint. If you believe your privacy rights have been violated, you may file a complaint with the Facility or with the Secretary of the Department of Health and Human Services. To file a complaint with the Facility, contact the Facility Privacy Officer and/or follow the process outlined in this Facility’s Patient Rights documentation. All complaints must be submitted in writing.

YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION

You have the following rights regarding medical information the Facility maintains about you:

** NOTE: All Requests to Inspect and Copy Medical Information or to Receive an Electronic Copy of the Medical Information that May be Used to Make Decisions About You Must Be Submitted in Writing to the Facility Health Information Management Department.**

  • Right to Inspect and Copy.You have the right to inspect and copy medical information that is maintained by this Facility and that is used to make decisions about your care. Psychotherapy notes may not be inspected or copied. You also have the right to request an explanation or summary of your medical information. If your request is approved, we have thirty (30) days in which to respond to your request. If we are unable to respond within thirty (30) days (for example, the records you have requested are stored off site), we may request an additional thirty (30) days in which to respond to your request. You will receive written notice of this extension if needed and such notice will explain the reasons for the delay and the expected date of delivery. We will respond to the request within a reasonable amount of time but no later than sixty (60) days from the date your written request is submitted to the Health Information Management Department.

If you request a paper copy of the information, we may charge a fee for the cost of copying, mailing or other supplies associated with your request. If you request an explanation or summary of your medical information, we may charge a fee equal to the labor cost of compiling such explanation or summary.

If the Facility uses or maintains an electronic health record in one or more designated record sets with respect to your medical information, we must provide you with access to the electronic information in electronic form and the format requested, if it is readily producible, or, if not, in a readable form and format mutually agreed upon. You may direct the Facility to transmit the copy to another entity or person that you designate provided the choice is clear, conspicuous, and specific. Your request must be submitted to the Health Information Management Department in writing; it must be signed by you; and it must clearly identify the designated person or persons and where to send the copy.

We may deny your request to inspect and copy in some limited circumstances (see below). If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional, other than the person who denied your request, will be chosen by the Facility to review your request and the denial. The Facility will comply with the outcome of the review.

  1. A licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to endanger the life or physical safety of the individual or another person.
  2. The protected health information makes reference to another person (unless such other person is a health care provider) and a licensed health care professional has determined, in the exercise of professional judgment, that the access requested is reasonably likely to cause substantial harm to such other person.
  3. The request for access is made by the individual’s personal representative, and a licensed health care professional has determined, in the exercise of professional judgment, that the provision of access to such personal representative is reasonably likely to cause substantial harm to the individual or another person.
  4. The information requested is not maintained by our Facility. In such situation, if we know the location of the information requested, we must provide that information to you.
  • Right to Amend.If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment to information kept by or for the Facility. To request an amendment, your must submit a written request to the Facility Health Information Management Department. You must also provide a reason that supports your request. Your request for an amendment may be denied if:
    1. Your request is not in writing or does not include a reason to support the request;
    2. The medical information was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
    3. The medical information is not part of the medical information kept by or for the facility;
    4. The medical information is not part of the information you would be permitted to inspect and copy; or
    5. The medical information is accurate and complete.
  • Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures”. This is a list of the disclosures we made of your medical information for purposes other than treatment, payment and health care operations.

To request this list or accounting of disclosures:

  1. You must submit your request in writing.
  2. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003.
  3. Your request should indicate in what form you want the list (for example. on paper, electronically).

The first list you request within a12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

  • Right to Request Restrictions. You have a right to request a restriction or limitation on the medical 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 medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member. This restriction does not apply to uses or disclosures of your health information related to your medical treatment.

To request restrictions, you must make your request in writing to the Facility Health Information Management Department. In your request, you must tell us:

  1. What information you want to limit;
  2. Whether you want to limit our use, disclosure or both;
  3. To whom you want the limits to apply (for example, disclosures to your spouse).

You also have a right to request that a health care item or service not be disclosed to your health plan for payment purposes or health care operations. We are required to honor your request IF the health care item or service is paid out of pocket and in full. Your restriction will only apply to records that relate solely to the service for which you have paid in full. We are not required to agree to any other request and will notify you if we are unable to agree. If we agree to your request, we must follow your restrictions (unless the information is necessary for emergency treatment). You may cancel the restrictions at any time. In addition, we may cancel a restriction at any time, unless it relates to a health care item or service that is paid out of pocket and in full, as long as we notify you of the cancellation and continue to apply the restriction to information collected before the cancellation.

  • Right to Request Confidential Communication.You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
    For example: You can ask that we only contact you at work or by mail.
    To request confidential communications, you must make your request in writing to the Facility Health Information Management Department or Facility Privacy Officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
  • Right to a Paper Copy of This Notice.You have the right to a copy of this Notice. You may ask us to give you a copy at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.
  • Right to Receive Notice of a Breach.We are required to notify you by first class mail or by e-mail (if you have indicated a preference to receive information by e-mail), of any breach of your unsecured protected health information.
  • Facility Privacy Officer.If you have any questions about this Notice, please contact the Facility Privacy Officer at: 979-241-5551.

Effective Date of Notice: April 14, 2003

Revised on: August 19, 2013

Instructions: Print, complete and send or present form to the Health Information Department.

Download Authorization in English
Descarga la Autorizacion en Español

Patient safety is a concern of importance to all.
We encourage you to utilize these resources:
View the Emmi Safety Video
Download our Personal Medication Record

Advance directives are  documents that state your choices for health careor name someone to make those decisions, if you are unable to make your wishes known in the future because of illness or injury.

By putting your wishes in writing, you take the burden off your family and doctors for making those most difficult decisions.

Here are two links from the Texas Hospital Association on Advance Care Planning and Advance Directives.

Texas Price Point is sponsored by the Texas Hospital Association, provides information on Texas hospitals including basic demographic, quality, and pricing information. Read More