The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.
|COMMUNITY HOSPITAL OF SAN BERNARDINO||1805 MEDICAL CENTER DRIVE SAN BERNARDINO, CA 92411||April 10, 2012|
|VIOLATION: PATIENT RIGHTS: CONFIDENTIALITY OF RECORDS||Tag No: A0147|
|Based on interview and record review, the facility failed to ensure that Patient B's personal health information (PHI) was kept private from Patient A, when patient B's face sheet was mixed in with Patient A's consent forms.
On 4/10/12 at 1:10 PM, an investigation was initiated into an entity reported event of a possible breach of Patient B's demographics to Patient A on 3/29/12, while they were both patients in the emergency room (ER).
During an interview with the Facility Privacy Officer by phone on 4/10/12 at 1:20 PM, she stated , "Patient A was handed a packet with a consent for him to sign while he was in the ER. He noted as he went through the packet that there was a face sheet that had another patient (Patient B's) name on it. Patient A pulled out the face sheet and gave it to the nurse. We notified Patient B of the mix up".
A review of the information indicated that the face sheet for Patient B contained the following personal information: Patient B's name, home address and phone number, date of birth, race, religion, address and phone number of his next of kin, his medical record number, reason for visit and insurance information.
This was a breach of PHI for Patient B.