HospitalInspections.org

Based on a review of documentation and interview, it was determined the facility failed to ensure discharge planning included a list of Hospice Facilities that are available to the patient, that are participating in the Medicare program, and (that serve the geographic area) in which the patient resides. The facility also failed to document in the patient's medical record that the list was presented to the patient or to the individual acting on the patient's behalf. The facility referred patients for hospice care without providing, provider/agency options available to provide hospice services, only one provider option was given.

Findings included:

Facility based policy entitled "Case Management", stated in part, The Providence Healthcare Network has endeavored to build a continuum of care, seamlessly integrating inpatient and outpatient services, and has ownership or preferred relationships with selected post-acute providers to facilitate transitions in care, avoid unnecessary readmissions, etc. Providence Health Center shall ensure patients are informed of their options and have a choice in selecting their post-discharge provider/service, and have been informed of financial interest the hospital has with any of the post-discharge providers (s).


I. Policy: (stated in part)


Discharge planning is performed by the transferring service and not the receiving service. Patients will be informed of their post-discharge options and have the ultimate choice in selecting the Provider/Service. These services may include, but are not limited to, the following:


* Skilled nursing care
* Hospice
* Rehabilitation
* Ambulance transportation


V. Procedure: (stated in part)


6. Each patient to be discharged to a home health agency, skilled nursing facility, Long Term Acute Care Hospital, or hospice will be given the current standard Providence A Health Center approved list of facilities that are Medicare-certified, licensed in Texas, and serve the area in which the patient resides (or, in the case of a skilled nursing facility, in the geographic area requested by the patient). The list clearly indicates, to the patient, which facilities are providence healthcare Network -affiliated with /or clinically integrated. These list can be down loaded from the Intranet site, Focus, under General Forms, Case Management Frequently Used Forms.


Medical Record of Patients discharged with referrals for Hospice care between 06/01/15 and 7/01/15 revealed that 7 patient out of 10 patients were referred to Providence Hospice facility and patients, # 2, # 3, #4, #5, #7, #8, and # 9 were not presented with options/choice in selecting their post-discharge provider/service and were not informed of financial interest the hospital has with any of the post-discharge providers (s).


The above findings were confirmed in an interview by the following staff members #1, #2, and #3.