HospitalInspections.org

18816



05409

Based on record reviews, and staff interviews, the facility failed to ensure that 3 of 3 medicare recipients/pt. representatives sampled (Pts. #2, #4, and #7) from a total sample of 10, were provided the IM (Important Message form Medicare) Medicare Discharge Appeal Notice (MDA) forms regarding discharge appeal rights within 2 days of admission. Failure to ensure that all medicare recipients or their representatives are informed of discharge appeal rights has the potential to affect all Medicare recipients who receive services at this facility.


Findings include:

This is an uncorrected deficiency from the recertification survey completed on 4/3/13. Reference survey event ID ILDH11 at 42 CFR 482 for policy entitled "Hospital Admission Information" dated 6/12.


(1.) Per medical record review of Pt. #2 beginning at 1:55 p.m. on 5/20/13, no MDA notice was found in the record.

(2.) Per medical record review of Pt. #4 beginning at 12:00 p.m. on 5/20/13, no MDA notice was found in the record.

(3.) Per medical record review of Pt. #7 beginning at 2:15 p.m. on 5/20/13, no MDA notice was found.


At approximately 3:00 p.m. on 5/20/13, The missing MDA notices for pts. #2, #4, and #7 were discussed with Senior Executive A.

Per 3:17 p.m. interview on 5/20/13 with Senior Executive A, A said was unable to find the Medicare appeal rights for Pts. #2, #4, and #7, but is having Emergency Services Coordinator B look for them.

Per exit interview beginning at 3:45 p.m. on 5/20/13, Emergency Services Coordinator B said that the Medicare appeal notices could not be found and there was no documented proof that the notices were provided to Pts. #2, #4, and #7, nor to their representatives.