HospitalInspections.org

Based on interview and document review, the Critical Access Hospital (CAH) failed to assure the "An Important Message from Medicare" (a document which informs patients of their rights to receive Medicare covered services and is required to be provided to all qualified Medicare patients) had been provided for 3 of 5 Medicare patient (P3, P4, P5) beneficiaries reviewed in the sample.

Findings include:

P3's Admission Summary Sheet indicated P3 was admitted to the CAH on 6/21/14. P3's clinical record lacked evidence of having been given the "An Important Message from Medicare" information for this admission.

P4's Admission Summary Sheet indicated P4 had been admitted to the CAH on 6/22/14. P4's clinical record lacked evidence of having been given the "An Important Message from Medicare" information for this admission.

P5's Admission Summary Sheet indicated P5 had been admitted to the CAH on 6/27/14. P5's clinical record contained a signed "An Important Message from Medicare", however it was not dated.

On 7/15/14, at 3:10 p.m. the medical records staff member (MR) confirmed the "An Important Message from Medicare" letter was lacking from P3's and P4's medical record and P5's "An Important Message from Medicare" letter in the medical record was incomplete.

On 7/15/14, at 4:05 p.m. licensed social worker (LSW) reviewed her audits for compliance with distributing and signing of "An Important Message from Medicare" letters. LSW's audit revealed:

* P3 had not been provided the "An Important Message from Medicare" letter.

* In the LSW's audit, the LSW indicated P4 had received the "An Important Message from Medicare" letter, however after further review the LSW confirmed P4's medical record lacked documentation of the letter being distributed and signed by P4.

* In the LSW's audit, she had indicated P5 had received the "An Important Message from Medicare" letter, however after further review the LSW confirmed P5's "An Important Message from Medicare" letter was signed but not dated rendering it incomplete.

The LSW verified the audit information for patients receiving and signing the "An Important Message from Medicare" letter was inaccurate and the CAH continued to struggle on getting these letters distributed and signed appropriately.

The CAH's policy and procedure for Important Message From Medicare for Hospital Patients [undated] directed staff to distribute the letter at the time of admission and if not discharged within two days, a copy of the letter needed to be resigned by the patient two days prior to discharge and placed in the patient's medical record.


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