HospitalInspections.org

Based on review of facility policies/procedures, medical record review, and staff interviews the facility failed to document in 4 (Sample patients #2, #3, #17, and #18) of 20 sample records that a list of available Skilled Nursing Facilities (SNF) was presented to the patient or to the individual acting on the patient's behalf when such placement was arranged by discharge planners.

The findings were:

A review of the facility policy titles "Selection of Services" revealed the following, in pertinent part:
"...Policy: Patients will be asked to select agencies/companied for services that will be needed at the time of discharge.
Procedures: Patients/significant other will be given a list of agencies to make their selection from. This will be provided for durable medical equipment, home health care, boarding homes, and nursing homes...
...After selection, the patient/significant other will sign the form. The form will be maintained in the patient's chart."

Review of twenty patient medical records was conducted from 7/26/10 through 7/27/2010. The review revealed that in 4 (Sample patients #2, #3, #17, and #18) of 20 records, there was no documentation that a list of available SNFs was presented to the patient or the individual acting on behalf of the patient.

Sample patient #2 was an adult patient who was admitted to the hospital on 5/8/2010 for a hip fracture and was transferred to a SNF on 5/13/2010. There was no documentation in the record that a list of available SNFs was presented to the patient or the individual acting on behalf of the patient.

Sample patient #3 was an adult patient who was admitted to the hospital on 5/3/2010 after undergoing a knee surgery and was transferred to a SNF on 5/6/2010. There was no documentation in the record that a list of available SNFs was presented to the patient or the individual acting on behalf of the patient.

Sample patient #17 was an adult patient who was admitted to the hospital on 5/5/2010 for pneumonia and was transferred to a SNF on 5/11/2010. There was no documentation in the record that a list of available SNFs was presented to the patient or the individual acting on behalf of the patient.

Sample patient #18 was an adult patient who was admitted to the hospital on 5/5/2010 after sustaining an ankle fracture and foot fracture and was transferred to a SNF on 5/11/2010. There was no documentation in the record that a list of available SNFs was presented to the patient or the individual acting on behalf of the patient.

An interview was conducted with the Director of Continuing Care on 7/27/2010 at approximately 10:00 a.m. The interview revealed it was the department's policy to provide a list of available providers and that the list was to be signed by the patient or the patient's representative. The signed list was then scanned into the computer charting system to be available for review. S/he stated that the list may not have been scanned into the system. S/he stated the Discharge Planning nurse could start to document the provision of the list in the computer documentation already completed, in the event the list was not scanned into the computer system.

Based on review of facility documents and staff interviews, the facility failed to disclose financial interest in the Home Health Agency the facility owned.

The findings were:

A review of a facility document titled "Local Home Care Agencies" that was provided patients needing home healthcare was provided by the Director of Continuing Care on 7/27/10 at approximately 10:30 a.m. The document listed home care agencies in the region where the hospital served. The list contains an entry for "Parkview Homecare" which was owned by the hospital. The list did not disclose the hospital's disclosable financial interest in the home care agency.

An interview with the Director of Continuing Care was conducted on 7/27/2010 at approximately 10:30 a.m. S/he stated s/he thought the disclosure of financial interest was on the list, but confirmed that it was not. S/he stated the form could be modified to disclose the hospital's financial interest.