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1600 WEST 40TH AVENUE

PINE BLUFF, AR 71603

PATIENT RIGHTS: INFORMED CONSENT

Tag No.: A0131

Based on clinical record review and policy and procedure review it was determined the facility failed to ensure one ( #3) of 10 (#1-10) Patients received their notification of patient rights or consent for treatment. Failure to provide notice of the patient's rights created the potential of not allowing the patient to understand their rights as a patient, the grievance process, and where to lodge complaints. The failed practice affected Patient # 3. Findings follow:

A. Review of Patient # 3's clinical record revealed no Patient Rights notification for admission on 10/05/17.

B. Review of policy and procedure titled Patient Rights and Responsibilities showed, The Patient Rights and Responsibilities will be given to each patient and/or patient representative during the registration process.

C. During interview with the Assistant Vice President of Patient Care Services on 12/19/17 at 11:55 AM the findings in A and B were verified.