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Based on record review and family interview, the facility failed to inform the patient and family of procedures that were scheduled and then cancelled throughout the course of the patient's stay (Patient #1). This deficient practice resulted in the patient and family not knowing what was going on while the patient was in the hospital. The findings are:

A. On 07/10/14 at 10:30 am, during interview, Patient #1's wife explained that her husband was scheduled for an ultrasound (US) of the liver and a liver biopsy on 05/01/14. Patient #1 had the US of the liver on 04/30/14, but the liver biopsy never took place. On 05/01/14, the day of the liver biopsy, her husband was told the night before that he should not eat anything until after the liver biopsy which they were told would be at 9:00 in the morning. So, when Patient #1 received a breakfast tray in the morning, the patient and family were confused. Patient #1 did not eat anything from the breakfast tray. The patient and his family waited all day for the scheduled liver biopsy. The nurse or the doctor did not come into the room to explain to the patient or his family what the delay was or why he was not having the liver biopsy that day. Later in the day, Patient #1 and his family were told that he was going to be discharged that afternoon. The family then asked the nurse about getting a dinner tray, since Patient #1 did not eat all day. The nurse explained to them that it would take a long time for the patient to receive a food tray and suggested that the family could take the patient to the cafeteria to eat and then they could go home from there.

B. Review of Patient #1's medical record revealed the following:
1. The Discharge Summary dictated on 05/01/14 at 5:16 pm, indicated that Patient #1 was admitted to the hospital on 04/24/14. Patient #1 had a colonoscopy procedure which was abnormal. Patient #1 had two masses, one mass on the wall of the colon and another mass in the cecum. The biopsy came back showing adenocarcinoma. Patient #1 had a CT of the chest, abdomen and the pelvis. There was a single lesion in the liver which was concerning for metastasis (spreading of the cancer.) The plan was made with the Radiology Interventionalist to try to reach this lesion, biopsy it and also ablate (cutting of the lesion) if possible. As a first step the ultrasound of the liver was performed on 04/30/14. At that time the lesion was not seen at all.
At that point, the Radiology Interventionalist felt that the liver biopsy should not be done. The Hematologist/Oncologist and the Radiology Interventionalist both felt that they should not intervene and essentially just follow the patient along with periodic imaging studies.
2. Review of the electronic physician orders, the liver biopsy was ordered on 04/30/14 at 10:45 am and was never discontinued by a physician. As of 05/01/14, the liver biopsy was still on the schedule for Patient #1.
3. There was no evidence to indicate that either the Hematologist/Oncologist and the Radiology Interventionalist discussed these issues with the Patient and family. The only document in evidence to indicate that this plan was discussed with the Patient and son was the Discharge Summary dictated by the Hospitalist before the patient was discharged.