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Based on observation, record review and interview the facility failed to ensure that a choice list of Home Health Agencies was presented to 3 (#2, #4, and #8) patients out of 20 records sampled. Failure to give the patient's a choice of Home Health Agencies violates their Patient's Rights to chose.

The findings include:

Record review for patient #2, revealed plans for discharge to named Home Health Agency and the Case Manager documented that the patient requested that agency on the Case Management Assessment. Further review of the medical record did not reveal a choice sheet which is signed by the patient choosing this Agency.

Record review for patient #4, revealed plans for discharge to a Home Health Agency. Further review of the record did not reveal a choice sheet signed by the patient, nor is there documentation by the Case Manager indicating where the patient was referred to.

Record review for patient #8, revealed that the attending physician wrote an order to refer to a specifically named Home Health Agency. Further review of the record revealed that there is no choice sheet signed by the patient. Review of the Case Management Assessment documented that the patient requested the specified Agency as their choice.

Review of the facility policy revealed a three page document that is presented to the patients when discharge planning is begun and the patients have been assessed for Home Health after discharge. Page one is the choice page which requires the patient to sign in agreement or in disagreement and state their preference. Pages two and three list all of the area Home Health Agencies.

Interview with nine Case Managers from the Hospital units on 4/15/10 from 11:20 AM through 12:03 PM, revealed that all of them make this choice form available to the patient and request a signature from the patient. They also stated that it is a part of the permanent record and they also document the Home Health Agency chosen on the Case Management Assessment form.