Texas Center for Infectious Disease

Patient Information

Patient Information

Welcome to the Texas Center for Infectious Disease information page for patients, their families and the community.  TCID has remained a leader in the treatment of tuberculosis and other infectious, contagious respiratory diseases for the last four decades.

Some of the documents below are PDF format documents.  For you to be able to view these documents, you must have the Adobe Acrobat Reader installed on your computer.  Download it now! 

Notice of Health Information Practices (PDF File, 155 KB):  This notice tells you about your privacy rights, TCID's duty to protect health information that identifies you, and how TCID may use or disclose health information that identifies you.  This notice does not apply to health information that does not identify you or anyone else.

Before Hospitalization

Admission Process

Because most often a patient must be admitted by an attending physician without benefit of actually personally examining a patient, the TB Nurse Case Manager is the contact to compile information required from the referrer. Requests for hospitalization and outpatient services will be evaluated individually to determine the need for hospitalization at TCID and that the facilities and specialists are appropriate at TCID for the required treatment. Instructions and forms for the referrer to use for the pre-admitting process are located at the “Admission to TCID” site.

Because patients are pre-admitted, patients arriving at the campus will be directed to the front entrance of the Center and then to the patient’s room where the intake process will be completed. Patients should arrive for admission from 8:00 a.m. to 5:00 p.m. Monday – Friday. Call 210-534-8857, ext. 2250 (Patient Care Office) to make arrangements if a patient transferring for admission is delayed beyond these hours.

1. The name, address and phone number of the physician who referred the patient to TCID.
2. The name, address and phone number of other physicians that have treated you.
3. Medicare card, current Medicaid certificate, and insurance information.
4. HMO or primary care physician referral authorization forms and/or policy numbers.
5. Proof of income and residency in the State of Texas and/or resident alien card.
6. Drivers license or other form of photo ID and the patient's Social Security card.
7. Medical records, including x-rays, lab reports, and any written medical history.
8. All prescription and over-the-counter medications (including home remedies) in original containers and a list of any allergies to medicine or foods.
9. Several changes of clothes, hats and shoes for daytime wear.
10. Pajamas, slippers, robe, and toilet articles for personal use.
11. The mailing addresses and phone numbers of relatives and friends.
12. Stationary, stamps and pens.
13. Favorite pictures.
14. Battery operated radios.
15. Reading material.
16. Pre-paid telephone card for long distance calls.

Please remember that storage space for personal belongings is limited.  No room is available for storage of large items or excessive clothing.  Arrangements for storage of those items should be made before coming to TCID.

Only limited cash (under $25.00) is recommended to be kept in a patient’s room. The Hospital cashier (ext. 2235) is available each business day to collect cash or other valuables for safekeeping. A patient account can be maintained for each person from which funds can withdrawn each business day (Monday-Friday, 8-5). Because only limited cash is maintained at the Hospital, for withdrawal amounts greater than $25.00, call ahead the business day before you want to withdraw the cash so the cashier will have sufficient funds.

For an outpatient visit to TCID, the patient needs to bring the following:

• The name, address and phone number of the physician who referred the patient to TCID
• The name, address and phone number of other physicians that have treated the patient
• Medicare card, current Medicaid certificate, and insurance information
• HMO or primary care physician referral authorization forms and/or policy numbers
• Proof of income and residency in the State of Texas and/or resident alien card
• Drivers license or other form of photo ID and the patient's Social Security card
• Medical records, including x-rays, lab reports, and any written medical history
• All prescription and over-the-counter medications (including home remedies) in original containers and a list of any allergies to medicine or foods.

Hotel and Motel Accommodations

DISCLAIMER:  The listing below does not constitute an endorsement of these establishments.  These establishments are listed only as a courtesy and for the convenience of our patients' visiting friends and family.

Patient Information Release

Information regarding each patient’s health care is confidential. TCID is responsible for safeguarding a patient’s information and has developed policies and procedures to protect a patient’s privacy. Except as required by state or federal law, each patient has the right to specify what information can be released from the medical record and to designate to whom personal medical information may be released. A written authorization properly completed and signed by the patient or legally authorized representative is required before releasing any health information to authorized individuals/agencies. The document copies to be released will be strictly limited to information required to fulfill the stated purpose.

Telephone inquiries regarding whether or not a patient is receiving inpatient/outpatient medical treatment at TCID or the status of a patient’s condition will not be released to outside sources, including family members. Telephonic inquiries will be managed by obtaining the caller's phone number, informing the patient of the call, and giving the patient the option to return the call. Telephone requests from another health care provider will require proper identification and verification to assure that the caller is entitled to receive the requested information. Once it is verified that an authorization signed by the specific patient or legally authorized representative has been obtained, the information will be released.

Information about a patient’s illness is maintained in a medical record which is protected by confidentiality laws and rules. As a patient, the person has the right to review or obtain a copy of this information. TCID is responsible for providing the information within 15 days of the request or notify the patient that it does not exist or is not readily available. A fee is charged for copies of records at a rate that is set forth by State rules.

As a public health hospital specializing in the management of infectious diseases, TCID is obligated by state and federal laws to comply with various reporting requirements. Among those to whom the law allows the hospital to disclose confidential health care information without a patient’s authorization are health care providers who are treating and caring for a patient, governmental agencies as authorized or required by law, third-party payers to obtain payment, and a court through a court order.

Texas law recognizes the following individuals as legally authorized representatives allowed to release health care information from a patient’s medical record if you are unable to sign:

• a parent or legal guardian if the patient is a minor (single, under the age of 18) 
• a legal guardian of a patient who has been judged incompetent by a court to manage his personal affairs
• an agent of the patient under medical power of attorney
• an attorney or guardian ad litem appointed by a court for the patient
• a personal representative or statutory beneficiary of a deceased patient
• or an attorney retained by the patient or the patient's legally authorized representative.

The legally authorized representative must show written evidence of his legal status to the hospital prior to signing permission for any disclosure.

Advance Directives

One of the most significant rights for each inpatient is the right to participate in medical decisions regarding the type of treatment that patient would desire in the event that he or she becomes unable to make decisions about medical care, including whether or not to withdraw or withhold “life-sustaining” treatment and who should make those decisions in the event that patient is incapacitated and unable to communicate. This right is documented in a form called an “advance directive.

The Patient Self-Determination Act (PSDA) is a federal law which requires hospitals to provide each inpatient with information concerning end-of-life decisions and other medical care, and to document in the patient’s medical record whether or not an advance directive is prepared. On each admission, the patient’s social worker will ask the patient to decide about issuing an advance directive and will ask the patient to sign a form acknowledging the presence or absence of an advance directive. The patient will also be provided with a booklet which explains information on advance directives and instructions on how to complete one if the patient wants to complete the “advanced directive” form at any time during the patient’s admission.

Patient Rights and Responsibilities

Some of the documents below are PDF format documents.  For you to be able to view these documents, you must have the Adobe Acrobat Reader installed on your computer.  Download it now!

Basic Rights for Hospitalized Patients at TCID (PDF File 110 KB)

Patient Responsibilities During Hospitalization at TCID  (PDF File 98 KB)

Smoking Policy

Tobacco products (cigarettes, other smoking materials, and all other tobacco products) are not sold at TCID.  As a unit of the Department of State Health Services, TCID is a tobacco-free campus. Patients who smoke will be assessed for smoking cessation interventions and other counseling, and will not be permitted to keep tobacco materials on the campus.  Patients anticipating referral to TCID should be made aware that the entire campus is tobacco-free.

Billing Information

As a state hospital, TCID will provide medical services to patients without regard to health care coverage or means to pay. However, in all cases, state law requires that a financial evaluation of ability to pay will be prepared for each patient seeking services. Based on this evaluation, each patient’s case will be financially classified, and the patient will be subject to all collection procedures enabled by State law.  It is important for each patient to willingly and completely cooperate with this financial evaluation.

A pay code classification is assigned based on financial and other data obtained during the admission or registration. These are categorized as follows:

1. Charity (Uncompensated Care) accounts;
    

2. Private pay accounts; and
    

3. Covered by a third party payer: insurance, Medicaid, Medicare, or other type of coverage.

Criteria used in determining pay code classification include proof of residency, poverty income guidelines, annual income, number of dependents and referral letters or authorization forms from agencies that have contracts with TCID, Medicaid, Medicare, insurance cards and other forms showing coverage.

Pre-Certification Information

Where it is required, pre-certification and authorization for paid days of care will be obtained from the insurance company or the Primary Care Provider. Follow up for additional days of authorized care and treatment or additional pre-certification of consultations or procedures will be the Hospital’s responsibility.

In-patient Information

Upon Your Arrival

Upon arrival for admission to the Texas Center for Infectious Disease, Security personnel will direct the transporter to the appropriate unit, where unit staff will escort the patient to his or her room.  For the patient’s protection and the protection of others, security and nursing staff will inspect the patient’s belongings and secure any prohibited items until the patient is discharged.

1. Because TB is highly contagious and spread through the air, all personnel and patients are required to wear masks when in patient rooms at the beginning of patient's stay at TCID.  When the results of laboratory testing indicate that there is no longer any danger of being contagious, the restrictions can be relaxed.
2. The patient will be shown to his or her room and instructed on procedures that must be used to prevent the spread of TB.
3. The TB Nurse Case Manager will collect required information, have the patient sign consent forms, review instructions and collect financial information (such as number of dependents, income, medical expenses and insurance coverage).
4. A Nurse will assess the patient's medical needs and condition, explain unit procedures and make sure the patient knows what is expected during the patient's stay. 
5. Within the first days of the patient's admission, the patient will be visited by other professional staff members who will determine his or her needs, write assessments and assist in helping that person to get well.

All TCID entrances, including the main entrance at 2303 SE Military Drive, are accessible to persons who are disabled and connect to all other TCID buildings covered by passageway. Every entrance has an intercom or bell for assistance with after-hours entry.

Multidisciplinary Health Care Team

A Multidisciplinary Health Care Team, composed of the patient’s doctor, nurse, social worker, TB Nurse Case Manager, dietitian, and chaplain, and as appropriate, the substance abuse counselor, will meet with the patient regularly during that person’s hospitalization at TCID to discuss the course of treatment, progress, and prognosis.  They will work with a patient both as a team and individually.  These are the best times for a patient to ask questions about care or to discuss any needs or desires a patient may have, but staff are available at any time for a patient to seek information about his or her care and treatment.  

Some patients have problems with substance abuse as well as tuberculosis.  A licensed substance abuse counselor works with individuals in ongoing counseling regarding this need.  Patients who choose to participate in the program receive individual and group therapy. 

Attending physicians rotate admitting duties for patients. The physician who admits a patient is responsible for directing the care and treatment throughout the course of that patient’s hospitalization. Attending physicians are on call at all times.  As coordinator for a patient’s treatment program and the primary source for clinical orders directing a patient’s specific treatment, the attending physician should be consulted for questions or concerns about a patient’s illness, treatment or prognosis.

Patient Representatives

Social workers are assigned to each patient and trained to help the patient, guardians, and family members deal with social and emotional problems that relate to hospitalization.  They are the primary point of contact for complaints and are available to address questions from family and friends.

Wheelchairs and Stretchers

Wheelchairs and stretchers and available on all nursing units, but getting in and out of them without assistance may be hazardous.  Please ask for help from a member of the unit staff.

Patient Valuables

• The patient should limit valuables in his or her room.  Small valuables can be deposited in the Cashier's Office, Bldg. 501.
• Funds can be deposited in a Patient Trust Fund account especially designated for each person.  Withdrawals may be requested as desired during regular business hours (Monday-Friday, 8-5).
• Bring limited clothing as no storage facility or secure parking area can be guaranteed.  Arrangements can be made beforehand to keep a car on hospital property.  The State of Texas cannot be held responsible for damage or loss of clothing, personal belongings, or a vehicle.

Prohibited Items

Prohibited items, such as illegal substances, street drugs, alcoholic beverages, firearms, knives and tobacco products are considered dangerous to patient health and well being, and are forbidden to be in the possession of the patient at any time on the TCID campus.

Electronic Appliances

For each patient’s protection, strict safety codes in the hospital prohibit the use of any electrical appliances brought from home, such as TV sets, VCRs, fax machines, computers, or electric blankets.  Radios powered by batteries are best if one is desired.  Electrically-powered hair dryers and radios must be certified for electrical safety before they can be used.  TCID has hair dryers and electric shavers available for each patient’s use, and volunteers can assist with the provision of other items by request.

ID Band

For the patient's protection, each patient will be given a personal identification bracelet.  The ID band is to be worn at all times.

Medications

All medications to be taken while a patient is admitted to TCID are to be prescribed by the patient’s attending physician, dispensed by the hospital's pharmacy and administered by a nurse. Patients are not permitted to administer their own drugs or keep personal medications at their bedside.  Each patient may not, therefore, bring to TCID any prescription or non-prescription medications unless the attending physician specifically asks for the patient to provide personal medications. After drugs and pharmaceuticals presented at admission to TCID have been collected and stored, any other drugs and pharmaceuticals in a patient’s possession may be considered as a prohibited items and subject to seizure.

Prescriptions

At the time of a patient’s discharge, all discharge prescriptions can be filled at the outpatient pharmacy located in Bldg 533.  The pharmacy number is (210) 531-4581, and it is open from 8 a.m. to 5 p.m., Monday-Friday. The charges for prescriptions will be billed using the patient’s pay code classification to determine discounts from posted charges. Most prescription plans are accepted.  Credit cards and checks are also accepted for payment.

Meals

TCID offers patients a restaurant-style menu, with daily menu selection for three meals and snacks either eaten in the patient’s room or dining room in accordance with dietary and unit requirements.  Meals are provided at specific times, although schedules are adapted for tests or procedures. Special dietary requirements (such as Kosher, ethnic, or vegetarian products) are available upon request and in accordance with prescribed dietary requirements.  Initial and regularly updated assessments will be made by a registered, licensed dietitian.

When no longer in isolation, patients are invited to eat in the TCID dining room (Bldg. 503) at the times it is open.  If a patient is eating in the patient’s room, meals arrive at approximately the same time each day and are delivered to the patient’s room. Sometimes certain tests or procedures will require changes or delays in meal schedules. The patient’s nurse will communicate changes in meal schedules to make sure a meal is not missed due to tests, procedures, or other reasons for absence during regular meal times.

Safety and Security

Fire and disaster drills are conducted regularly. If a drill occurs, patients are instructed to remain in their rooms and do not become alarmed. TCID is in fire-resistant buildings. The staff is trained in fire protection.  Fire and disaster drills are necessary to exercise the staff and facilities to respond properly in the event of an emergency, and to make sure patients are aware of the steps that will be taken in the event of an emergency.

TCID's security officers patrol the hospital 24 hours a day for the patient’s protection and the protection of others.

1. Gates into the campus are closed most of the time. Campus access is through the guarded main gate.  All building entrances are locked after business hours; patient units remain open.
2. Packages brought to the campus and articles of clothing are subject to search for prohibited items.  A patient may be asked to empty pockets and/or bags before entering the campus.
3. Periodic room inspections and thorough room searches (occasionally using drug sniffing dogs) are authorized.  A patient may be present during room searches.

   Some of the documents below are PDF format documents.  For you to be able to view these documents, you must have the Adobe Acrobat Reader installed on your computer.  Download it now! 

   Information for Patients - Prohibited Items (TCID Form 9174), PDF File 17 KB
   
   Statement Acknowledging Review of TCID Prohibited Items Policy, PDF File 7.9 KB
    

4. San Antonio Police officers may come on the campus in response to a call from TCID.  They will be called in the event of violence, weapons on campus, or unauthorized exit from the campus by a court-ordered patient.  Patients are subject to arrest just as any other person.

Visiting

Visitors can be good medicine for patients, and family members and friends are welcome to visit. However, patient care is the primary concern at the Texas Center for Infectious Disease. To enhance the quality of care, specific visiting hours have been established:

1. All patient units - 10:00 a.m. to 8:00 p.m. every day. Two visitors per patient are permitted at any given time.
2. Visiting will occur in designated visiting areas, not in patient rooms.

Exceptions may be authorized by the attending physicians only and should be kept to a minimum. In case of exceptions for after 8:00 p.m. visitation, only two visitors are allowed in the unit waiting area.

Visitors must be 16 or older to visit patients within the ward areas. Visitors under 16 may visit with patients who are permitted to leave the ward to visit on the grounds. 

Patient Condition Information

Relatives and friends may call the operator at the main number (210) 534-8857 for information about a patient’s condition and location.  Each patient must authorize release of information at admission.  That authorization may be updated at any time during hospitalization.

Discharge Planning

Planning for return home begins when a patient is admitted even though the patient’s stay may be quite lengthy.  Toward the end of a patient’s hospitalization, specific plans will be made to make the patient’s transition back to that individual’s community as smooth as possible.

Toward the end of a patient’s stay, the social worker will provide a bus ticket for the designated community of residence if it is necessary. If the patient needs treatment for tuberculosis after leaving TCID, the attending physician, social worker, and TB Case Manager will coordinate continued care through the Department of State Health Services Tuberculosis Control Facility nearest to the patient’s home.  Protracted care for other medical problems or follow up for those problems will also be arranged prior to discharge.

Outpatient Information

Appointments

Outpatient Services at (210) 531-4625 will be called for an appointment for Multiple Drug Resistant (MDR) TB or Hansen's Disease treatment, the two types of clinics operated at TCID.

While referrals from private practitioners, health departments, and public clinics are accepted, ”walk-ins" will not be accepted. Eligibility for physician evaluation and consultation at TCID must be considered by request for an appointment from a physician or other professional practitioner. Services are limited to outpatient treatment of a pulmonary infectious disease, including non-contagious TB infections, infections due to non-tuberculous mycobacteria and fungal infections, and Hansen's disease.

If a patient is unable to keep an appointment and rescheduling is needed,  the office can be called during office hours (8:00am-5:00pm M-F) for another appointment.

Emergencies

TCID does not have an organized emergency room, although emergency treatment is provided in the event of illness or injury occurring on the campus.  Go to the nearest hospital with an emergency department in the case of illness or injury you think requires urgent medical attention.

Medical Specialties

Laboratory Tests

Outpatient laboratory testing is performed through Women's Health Laboratory  Certain specialized tests that are beyond its capability will be sent to a certified reference laboratory.

Indicated Immunizations

Indicated immunizations are available for qualified patients.  Adults should have a tetanus booster every 10 years.  Patients over 65 years of age or who have chronic illness should have a pneumonia immunization and should receive influenza annually.  Attending Physician will be consulting with each patient regarding immunization history and immunizations that are needed.

Patient Conveniences

Television

Large screen televisions and VCR units are available in the patient lobbies.  Each patient room is equipped with a television which receives all of the local stations.  Channel 6 is the TCID in-house channel.  TV channels are provided free to all patients.

Telephone

TCID offers in-house and AT&T Language Line translation services to our patients.  A roster of interpreters are available at each nursing unit.  Patient treatment flash cards in international sign language are also available.

Pay telephones are located at throughout the hospital.  Except in extreme emergencies, patients will not be allowed to use hospital telephones.

No telephones are connected in patient rooms; however, a portable pay phone is available for use in patient rooms upon request.

Mail, Newspapers and Magazines

Mail is delivered to the patient care unit.  All mail received is subject to being opened.  Newspapers and magazines are provided to each patient unit and are available for patients.

Barber/Hairdresser

When medically appropriate, arrangements will be made for an appointment with a barber or hairdresser.  Payment for the service is required. 

Pass Policy

A pass is permission for patients to leave the hospital grounds without being discharged from the hospital.  The purpose of the pass is to allow the patient to leave the hospital grounds for important personal business.  The first consideration in issuing a pass will be the inpatient's medical condition.  The request must be made to the physician by the patient or family.

Repeated incidences of leaving the campus without a pass, or disruptive or threatening behavior at TCID before leaving or on return, arecan be grounds for DSHS to administratively dischare a patient for community follow up; to call the San Antonio Police Department for assistance; or to request court proceedings for quarantine under HSC Chap. 81.

Activities

TCID provides patients with a variety of activities during their stay. Patients are encouraged to utilize the physical fitness area, which boasts a wide range of exercise equipment.

Patient activities depend on the patient's individual treatment restrictions.  The following activities are available as either group or individual activities:

Last Updated May 17, 2005