HospitalInspections.org

Based on review of the Rules and Regulations for Critical Access Hospitals in Arkansas, review of CPR (Cardiopulmonary Resuscitation) cards and interview, it was determined three (#2, #5 and #6) of six (#1-#6) Registered Nurses (RNs) were not currently certified in CPR. Failure to ensure all nurses maintained current CPR registration did not ensure the availability of a nurse competent in life saving measures in the event of a cardiac emergency. The failed practice affected any patient provided care by RNs #2, #5 and #6. Findings follow:

A. Review of the Rules and Regulations for Critical Access Hospitals in Arkansas, revealed the following; " Section 11., B., 4. All licensed nursing personnel shall be competent in life support measures."

B. Review of the CPR cards for RN #5 and #6 revealed the expiration dates were 06/16 and 09/14 respectively.

C. During an interview with the Director of Nursing at 1300 on 01/05/17 she stated she could not find the CPR card for RN #2, there was no policy and procedure for CPR certification but it was understood by all nursing staff it was expected to be current.

Based on clinical record review, interview and Admission Procedure document it was determined the Facility failed to ensure three (#6, #8 and #9) of seven (#4, #6 - #11) Medicare patients signed the Medicare Important Notice. Failure to issue the Medicare Important Notice did not allow the patients the opportunity to be informed of and aware of their rights as a hospital patient, as well as their discharge and appeal rights. The failed practice affected Patients #6, #8 and #9. Findings follow:

A. Review of the clinical records of Patients #6, #8 and #9 revealed there were no signed Medicare Important Notices. The above findings were verified by the Medical Record Coder at 0930 on 01/05/17.

B. During an interview with the Utilization Nurse/Social Services Manager at 1251 on 01/05/17 she stated all Medicare patients should have a Medicare Important Notice signed at admission.

C. Review of the Admission Procedure document received from the Revenue Cycle Manager at 1310 on 01/05/17 revealed the following under "Admission Procedure for Inpatients, Observation and Outpatient Procedures: ...If Patient has Medicare sign Important Message from Medicare (Patient will get original make two copies one for the business office one for chart at nurses station)...".