HospitalInspections.org

Based on review of facility documents, medical records (MR), and staff interview (EMP), it was determined the facility failed to inform each patient, or when appropriate, the patient's representative of the patient's rights, in advance of furnishing or discontinuing patient care whenever possible for eight out of ten Medicare patients records reviewed (MR1, MR2, MR3, MR4, MR5, MR6, MR8, and MR10).

Findings include:

A review of facility policy "Important Message from Medicare Delivery and Appeal Process," dated July 2, 2007, revealed "I. Purpose...It is the purpose of this policy to ensure that patients with Medicare insurance coverage are notified of their discharge appeal rights when they are admitted to the hospital...IV. Procedure....B. Follow up Delivery of the Important Message from Medicare [IMM]:...1. The follow up IMM will be given within 2 calendar days of discharge or when unavoidable on the day of discharge...2. The patient's signature will be obtained. A copy of the IMM will be given to the patient and a copy will be placed in the patient's chart...3. In the event that a patient is not competent or is unable to sign the form for any reason, the responsible party for the patient will be presented with the IMM and will be asked to sign on the behalf of the patient. If the responsible party is not available in person,...contact the responsible party by telephone and will mail/fax or e-mail a copy of the form to the responsible party on the day of the notification. The name of the responsible party who was notified by telephone will be documented directly on the IMM form..."

A review of MR1, MR2, MR3, MR4, MR5, MR6, MR8, and MR10, revealed no documentation that the patients received the initial delivery of the Important Message from Medicare or the Follow up Delivery of the Important Message from Medicare.

An interview with EMP1 on December 26, 2012, confirmed that MR1, MR2, MR3, MR4, MR5, MR6, MR8, and MR10, revealed no documentation that the patients received the initial delivery of the Important Message from Medicare or the Follow up Delivery of the Important Message from Medicare according to facility policy.