HospitalInspections.org

Based on document review and interview, the chief executive officer failed to ensure that policy & procedures addressed the timely disposition of patient bodies for those patients without family members whose bodies were to be donated to an education program after death for 1 of 5 death medical records (MR) reviewed (Patient #1).

Findings include:

1. Review of patient #1's MR indicated the patient died on 08-12-12 at 1925 hours. Patient #1's MR indicated the patient had made a Certificate of Bequeathal on 07-14-1986 for the patient's body to be donated for medical education and research and a copy was in the patient's MR. The Notice of Death form indicated the patient's body was to be donated to facility #2. Patient #1's MR lacked documentation of having any family members.

2. On 10-22-12 at 1145 hours, staff #44 confirmed that he/she received a phone call on 8-18-12 from patient #1's power of attorney (POA) asking why patient #1's body was not sent to facility #2. Staff #43 confirmed that he/she spoke with a representative of facility #2 on 08-20-12 who confirmed that they could not accept patient #1's body due to it being deceased for more than 48 hours.

3. On 10-22-12 at 1355 hours, staff #43 confirmed that patient #1's body left the facility on 09-10-12 and was sent to facility #3 to be cremated.

4. Review of policy/procedure RHC 1.02 AP, Care at the Time of Death, indicated the following on page 2:
"D. Family or Health Care Representative Responsibilities
3. The family must notify hospital personnel if the patient's body is to be donated to a medical school or other facility for education or research.
4. The family is responsible for notification of the Anatomical Education Program to arrange transport to the facility."
This policy/procedure was last reviewed/revised on 04-2012.

5. The patient's MR indicated the facility was notified prior to the patient's death of the patient's wishes for his/her body to be donated to facility #2. Policy/procedure RHC 1.02 AP, Care at the Time of Death, failed to address if patient had no family who was to contact the facility to arrange for the patient's body to be transported for the purposes of education or research.

Based on document review and interview, the facility failed to ensure that the patient was involved in making decisions about his/her care for 1 of 5 medical records (MR) reviewed (Patient #1).

Findings include:

1. Review of patient #1's MR indicates the following order was written on 07-30-12 at 1514 hours:
"Continuous tube feeding, 10 ml, nasojejunal tube." Review of patient #1's MR indicated the patient had a living will dated 10-28-93 that indicated the following; "If you become terminally ill, and cannot speak for your self, do you want the following options:
3. If you are terminally ill and cannot swallow food or liquid, would you want a feeding tube through your nose to your stomach? The answer was checked No."
The patient's MR lacked documentation that the patient and or the patient's power of attorney agreed to the placement of the nasojejunal tube and the feeding via the nasojejunal tube.

2. On 10-22-12 at 1445 hours, staff #46 confirmed that patient #1's MR lacked documentation of who approved the feeding via the nasojejunal tube.