HospitalInspections.org

Based on review of the medical record, policy review and staff interview it was determined the facility failed to provide a list of available Skilled Nursing Facilities, emphasize the patient's right to choose a facility and document the patient's choice of facility for one (#3) of ten records reviewed.

Findings included:

Review of facility policy titled "Discharge Planning" dated 03/2017 indicated the initial and ongoing discharge plan will reflect the patient's involvement in and response to discharge planning activities, including agreement and refusal. The discharge planner will document all discussions with the patient, including all written and verbal options given. According to the policy, the patient will be provided a list of local skilled nursing facilities the patient can chose from and it will be documented in the medical record.

An interview was conducted on 07/25/17 at 11:20 a.m. with a registered nurse case manager regarding the process for supplying the patient with options for skilled nursing facilities.
According to the case manager, it was the case manager's responsibility to provide the patient with a list of available facilities based on the patient's insurance. According to the case manager, the patient was instructed to make a first, second and third choice on the facility of preference. The case manager would try to arrange for placement based of the patient's choice.

Review of the medical record for patient #3 revealed the patient was admitted on 04/27/17. A review of the medical record for patient #3 revealed no case management documentation of a discussion with the patient about being transfer to a skilled nursing facility. There was no documentation the patient was provided a list of skilled nursing facilities to pick from. There was no documentation patient #3 made a choice of the facility that was arranged for discharge.

According to a narrative note, a Registered Nurse notified the discharge physician on the morning of 05/02/17 the patient had appealed discharge. A nursing narrative note revealed on 05/02/17 at approximately 4:30 p.m. the patient was transferred via stretcher to a skilled nursing facility.

The facility failed to include patient #3 in the discharge process. The facility failed to provide a list of Medicare-participating skilled nursing facilities from which the patient could choose.

The Coordinator of Social Services confirmed the above findings on 07/26/17 at 11:00 a.m.