HospitalInspections.org

Based on record review and staff interview, it was determined that the facility failed to ensure an appropriate discharge plan for 2 (#4,#5) of 11 sampled patient. This practice does not ensure appropriate placement.

Findings include




1. 42 CFR 483.100 requires that the facility transferring a patient to a Skilled Nursing Facility (SNF) ensures that a Pre-Admission Screening and Resident Review (PASRR) be completed prior to the patient's being transferred to the SNF to ensure appropriate placement.

2. Review of the medical record of patient #4 revealed the patient's discharge plan was to be discharged to a SNF. Review of the medical record revealed no evidence that the PASRR screen had been completed.

3. Review of the medical record or patient #5 revealed his discharge was discharge to a skilled facility for rehabilitation. There was no documentation that a PASRR screen had been completed.

4. Interview with the Social Services Coordinator on 11/19/11 at 11:30 revealed that the facility staff is not ensuring that the level I PASRR is being completed prior to the patient's transfer. She stated she was unaware that the hospital is responsible.

Based on record review and staff interview, it was determined that facility failed to provide complete information regarding availability of qualified home health providers for 1 (#11) of 11 sampled patients. This practice to does ensure patient's right to free choice of providers.



Findings include:


Review of the medical record of patient #11 revealed the patient had a discharge plan for home with home health. Review of the medical record revealed there was a referral to the home health agency which is part of the same organization as the hospital. There was no documentation that the patient was provided with a list of home health agencies from which to choose.
An RN from the home health agency was interviewed on 11/10/11 at approximately 2:00 p.m. The RN from the home health agency, whose office is located in the facility's medical arts building, stated that "non-Medicare patients who are to be discharged home with home health are referred to the home health agency. A nurse from the agency meets with the patient and explains the services available." She stated that the patient is told there are other agencies, but that some insurance will not cover home health care provided by some of the other agencies. She stated that a list of available home health agencies is not provided to non-Medicare patients.
The Administrator from the home health agency was interviewed on 11/10/11 at approximately 4:00 p.m. confirmed that non-Medicare patients are not provided a list of home health agencies to from which to choose.