HospitalInspections.org

Based on record review and interview the facility failed to follow the timelines outlined in the grievance policy to acknowledge and investigate 1 grievance (Patient #13) in a total of 2 grievances reviewed.

Findings Include:

A review of the facility's policy titled, "Patient Complaints and Grievances Policy" last revised 02/2025 revealed, "... Grievances will be forwarded to the leader of the department/clinical manager involved... for ALL hospitals, if unable to investigate and resolve the grievance within approximately 7 business days from receipt, a written or verbal notice of acknowledgement will be communicated to the patient..."

A review of the grievance "PC78550" filed by Patient #13 to the facility on 03/17/2025 revealed that Patient #13 stated that his linens had not been changed throughout his hospitalization and that the CNAs (certified nursing assistants) had not rounded on him throughout his hospitalization. Further review of the grievance revealed that there was no acknowledgement letter sent to Patient #13 and there was no investigation started as of 04/08/2025 (date of survey).

During an interview on 04/08/2025 at 10:30 AM with Director of Quality E, when asked about the grievance, Director of Quality E stated, "It has not been addressed yet."