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Based on observation, interview, record review and policy review, it was determined the facility failed to ensure three (3) of ten (10) sampled patients, (Patient #3, #4 and #10) were provided privacy during medical/nursing treatments.

The findings include:

Review of the Patient Rights and Responsibilities Policy, released May 2015, revealed the rights and responsibilities should be protected and exercised for each patient and his/her family/guardian. The hospital would respect the rights of the patients, recognize that each patient was an individual with unique health care needs, and because of the importance of respecting each patients personal dignity, the hospital would provide considerate, respectful care focused upon the patients individual needs. The patient has the right to personal privacy.

1. Review of Patient #3's record, revealed Patient #3 was admitted on 07/21/15 with a diagnosis of Acute Respiratory Failure.

Observation of Patient #3's room during initial tour, on 07/22/15 at 10:00 AM, revealed Patient #3's gown was open to the front, exposing his/her body, while a staff member was providing some form of therapy. Patient #3's door and curtain was left open.

2. Review of Patient #4's record, revealed the facility admitted the patient on 06/25/15 with diagnoses of Acute Respiratory Failure, Advanced Chronic Obstructive Pulmonary Disease, Malnutrition and Percutaneous Endoscopic Gastrostomy (PEG).

Observation of Patient #4's room during initial tour, on 07/22/15 at 9:42 AM, revealed a nurse providing medication to Patient #4 through his/her PEG with stomach exposed. The curtain and door to Patient #4's room was open.

3. Review of Patient #10's record, revealed the facility admitted the patient on 07/08/15 with diagnoses of Infection and Pressure.

Observation of Registered Nurse (RN) #7 administering medication to Patient #10, on 07/22/15 at 2:30 PM, revealed RN #7 administered medications through Patient #10's Central Venous Line in his/her right femoral. RN #7 exposed Patient #10's right leg and groin and did not close Patient #10's doors or curtain before providing the care.

Interview with RN #1, on 07/23/15 at 11:05 AM, revealed there had been no complaints from patients about privacy. RN #1 stated if a nurse was providing medications through a PEG or a Central Venous Line the nurse should provide privacy by closing the curtain or door. RN #1 stated they wanted to ensure privacy was provided for the dignity of the patient.

Interview with the Nurse Manager of the 2nd Floor, on 07/23/15 at 12:00 PM, revealed if she witnessed staff not providing privacy she would remind the staff to do so, but had not seen this that often. The Nurse Manager stated she wanted to provide privacy to protect the patient and because it was the right thing to do for the patient. The Nurse Manager stated it was human nature for visitors to look in patient rooms. People do not need to know what was going on in a patient's room. Nursing Care needs to be private.

Interview with the Chief Clinical Officer, on 07/23/15 at 3:10 PM, revealed she had not identified privacy being a concern or problem in the facility. The Chief Clinical Officer stated they provide privacy for dignity and respect as a person.