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1955 WEST TRUCKER'S DRIVE

FAYETTEVILLE, AR 72704

PATIENT RIGHTS: NOTICE OF RIGHTS

Tag No.: A0117

Based on clinical record review and interview, it was determined the facility failed to present a copy of the "Important Message from Medicare" not more than two days of discharge for one of one patient discharged on 06/30/11 from the Senior Adult Unit. Failure to provide a copy of the Important Message from Medicare did not promote the Patient's right notification prior to stopping care. The failed practice affected the one patient who was discharged on 06/30/11 and had the potential to affect the two other patients on the Senior Adult Unit at the time of the survey. Findings follow:

Clinical record review on 06/30/11 of one (Patient # 3). Patient was admitted 06/23/11 and plan for discharge 06/30/11. Chart documentation did not include evidence a second notice of medicare rights was provided to the patient or his representative not more than two calendar days of discharge. In an interview with the Quality Assurance Performance Improvement Director 06/30/11 at 1340, she confirmed the Facility did not have a Policy or Procedure to provide the "Important Message form Medicare" not more than two calendar days of discharge and was unaware of the requirement.