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890 OAK STREET, SE

SALEM, OR 97301

PATIENT RIGHTS: NOTICE OF RIGHTS

Tag No.: A0117

Based on a review of 6 patient records, a review of hospital documents, and based on interviews with hospital staff members, it was determined that the hospital failed to assure that each patient was informed of his/her patient rights.
Findings include:
Six patient records were chosen and reviewed. Included in that number were three records for patients who were admitted to the hospital's critical care unit in December of 2010, and three records for patients who were seen in the hospital's emergency department in February of 2011.
In an interview with I2 at 0930 hours on 04/29/11 in the hospital's administrative office, I2 presented a tri-fold brochure titled: "The Patient at Salem Hospital," which s/he stated had been given to each patient at the time of admission to the hospital for services. This brochure contained a listing of patient rights.
A form titled: "Conditions of Admission" was present in all 6 patient records reviewed. This form contained information regarding the financial agreement between each patient and the hospital. Each of the 6 forms reviewed had been signed by the patient, acknowledging a financial agreement. Beneath that signature was the following statement:
"PATIENT RIGHTS AND RESPONSIBILITIES: I acknowledge receipt of my Rights and Responsibilities as a patient. Patient Initials _____________. "
During a review of 6 patient records, it was noted that in 5 records, numbered 1, 2, 3, 4, and 6, the line indicated for a patient to acknowledge receipt of patient rights information had been left blank. This observation was confirmed with I1, who stated that this appeared to demonstrate a "systems problem."
It was determined that the hospital's system to assure the receipt of patient rights by each of the patients admitted for care to the hospital was deficient.