HospitalInspections.org

This Condition Level defeciency is the result of a Life Safety Code survey completed on April 2, 2014.

Based on review of facility documents, medical records (MR) and staff interview (EMP), it was determined the facility failed to ensure swing bed patients were provided with the Patient's Bill of Rights and Patient's Responsibilities for three of four closed swing bed patient medical records reviewed (MR17, MR19 and MR20).

Findings include:

Review on April 2, 2014, of the facility policy "Swing Bed Program," reviewed February 4, 2014, revealed "Purpose: Swing Bed services will be provided to Medicare and Medicare Advantage Plan patients to continue to receive active treatment as an extension of inpatient acute hospital care for the condition or conditions relating to the care received as a hospital inpatient. Patients approved for Swing Bed will be admitted to any or all rooms upon availability of the room, upon approval of the Care Management Department, upon written order of the attending provider, and upon physician certification. ... F. Patient's Rights: Patient's Bill of Rights and Patient's Responsibilities (see attachment) will be given to the patient or representative by the Care Manager. A signed copy of the acknowledgement page will be maintained in the Swing Bed record. ... "

Review on April 2, 2014, of the attachment to the facility policy "Swing Bed Program," titled "Charles Cole Memorial Hospital Swing Bed Patient's Responsibilities," revealed "... 9. A patient is informed in writing the acknowledgement of their rights, rules and regulations governing patient conduct and responsibilities. ... Receipt Acknowledged: Dated: "

Review on April 2, 2014, of MR17 revealed the patient was admitted to Swing Bed status on January 25, 2014. Further review of MR17 revealed no signed Patient Responsibilities acknowledgment page.

Review on April 2, 2014, of MR19 revealed the patient was admitted to Swing Bed status on November 30, 2013. Further review of MR19 revealed no signed Patient Responsibilities acknowledgment page.

Review on April 2, 2014, of MR20 revealed the patient was admitted to Swing Bed status on November 19, 2013. Further review revealed no signed Patient Responsibilities acknowledgment page.

Interview with EMP3 on April 2, 2014, at approximately 10:00 AM confirmed MR17, MR19 and MR20 were admitted to swing bed status. EMP3 confirmed the medical records did not have the signed Patient Responsibilities acknowledgment page. EMP3 also confirmed the facility policy "Swing Bed Program" stated a signed copy of the acknowledgement page will be maintained in the Swing Bed record.

Based on review of facility documents, medical records (MR), and staff interview (EMP), it was determined the facility failed to inform patients on swing bed status of their Patient Rights regarding the right to choose a personal attending physician for six of six swing bed patient medical records reviewed (MR15, MR16, MR17, MR18, MR19 and MR20).

Findings include:

Review on April 2, 2014, of the facility policy "Swing Bed Program," reviewed February 4, 2014, revealed "Purpose: Swing Bed services will be provided to Medicare and Medicare Advantage Plan patients to continue to receive active treatment as an extension of inpatient acute hospital care for the condition or conditions relating to the care received as a hospital inpatient. Patients approved for Swing Bed will be admitted to any or all rooms upon availability of the room, upon approval of the Care Management Department, upon written order of the attending provider, and upon physician certification. ... F. Patient's Rights: ... 1. Attending physician: The resident and/or legal representative will be given the opportunity to choose and [sic] attending or primary physician. An attending physician is required and must have admitting privileges at Charles Cole Memorial Hospital. The patient is seen by the physician as determined by the level of care required by the patient. Normally the provider who cared for the patient in acute care will be retained for the Swing Bed admission. ..."

Review on April 2, 2014, of the attachment to the facility policy "Charles Cole Memorial Hospital Swing Bed Program," titled "Swing Bed Patient Bill of Rights," revealed no notification of patients on swing bed status of their right to choose a personal attending physician.

Review on April 2, 2014, of MR15, MR16, MR17, MR18, MR19 and MR20 revealed no documentation the facility informed these patients on swing bed status of their right to choose a personal attending physician.

Interview with EMP1 and EMP2 on April 2, 2014, at approximately 2:00 PM confirmed the facility Swing Bed Patient Bill of Rights did not include the swing bed patient's right to choose a personal attending physician. EMP1 and EMP2 also confirmed the swing bed patient is assigned the hospitalist on duty as their physician and is not given the choice of a physician.

Based on review of facility documents, medical records (MR) and staff interview (EMP), it was determined the facility failed to notify the Swing Bed patient in writing of their discharge from the Swing Bed program prior to their discharge for four of four medical records reviewed (MR17, MR18, MR19 and MR20).

Findings include:

Review on April 2, 2014, of the facility policy "Swing Bed Program," reviewed February 4, 2014, revealed "Purpose: Swing Bed services will be provided to Medicare and Medicare Advantage Plan patients to continue to receive active treatment as an extension of inpatient acute hospital care for the condition or conditions relating to the care received as a hospital inpatient. Patients approved for Swing Bed will be admitted to any or all rooms upon availability of the room, upon approval of the Care Management Department, upon written order of the attending provider, and upon physician certification. ... G. Discharge from Swing Bed: All patients will be discharged appropriately, receiving their personal belongings, any medications from home, prescriptions and discharge instructions in a safe and courteous manner. ..."

Further review of this policy revealed no statement that a written notice of discharge would be given to the Swing Bed patient prior to discharge.

Review on April 2, 2014, of MR17, revealed the patient was admitted to Swing Bed status on January 25, 2014, and discharged on February 4, 2014. Further review revealed no written notification of the facility's intent to discharge MR17 from the Swing Bed program.

Review on April 2, 2014, of MR18, revealed the patient was admitted to Swing Bed status on January 6, 2014, and discharged on January 14, 2014. Further review revealed no written notification of the facility's intent to discharge MR18 from the Swing Bed program.

Review on April 2, 2014, of MR19, revealed the patient was admitted to Swing Bed status on November 30, 2013, and discharged on December 6, 2013. Further review revealed no written notification of the facility's intent to discharge MR19 from the Swing Bed program.

Review on April 2, 2014, of MR20, revealed the patient was admitted to Swing Bed status on November 19, 2013, and discharged on November 26, 2013. Further review revealed no written notification of the facility's intent to discharge MR20 from the Swing Bed program.

Interview with EMP2 on April 2, 2014, at approximately 10:00 AM confirmed there was no documentation a written notification of the facility's intent to discharge the patients from the Swing Bed program in MR17, MR18, MR19 and MR20.