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.

Based on review of the In-Patient Reservation form, staff and patient interviews it was determined in 1 of 1 (Pt #1) patients reviewed who presented for admission, the Hospital failed to ensure all patients were fully informed of their rights to request or refuse treatment.
Findings include:

1. The "In-Patient Reservation" form for Pt #1 was reviewed. The form indicated a reservation date of 3/14/13 for observation of Pt #1 with the diagnoses: "Hyperemesis Gravidarum, dehydration."

2. On 4/9/13 at 9:45 AM A-1 (An Admissions Coordinator) and A-2 (An Admissions Coordinator) were interviewed. A-2 verified that the only medical insurance Pt #1 had was with Harmony. A-2 contacted Pt #1's OB/GYN's office and Z-1 (Nurse Practitioner) was informed that Pt #1's insurance was no longer accepted at the Hospital effective 3/1/13. A-1 indicated in a written statement that during her telephone conversation with Z-1, Z-1 stated that Pt #1 needed to leave the Hospital and "go to (nearby Hospital) Emergency Department". A-1 then asked if Pt #1 was to be sent to (nearby Hospital) Emergency Department, then couldn't Pt #1 be seen in Memorial's emergency room . Z-1 said "No, she needs more care than that. I will call (nearby Hospital) Emergency Department and would you please let the patient know that?" A-1 told the nurse practitioner (Z-1) that she was uncomfortable doing that and it was not her place to tell a patient to leave the Hospital.

3. On 4/9/13 at 10:26 AM, N-1 (Direct Care Staff Nurse) was interviewed with N-2 (the 2C Nurse Manager) present. The personal statement of N-1 was also reviewed. It was indicated that Pt #1 presented by wheelchair from her OB/GYN's office. Pt #1 was placed in C241, vitals were taken and she was given an emesis basin. A call was received from the nurse practitioner (Z-1) and she asked to talk to Pt #1. N-1 wrote, "Patient voiced understanding of the insurance coverage and stated that she was directed to go to (nearby Hospital) for care ...." N-1 could not recall if she informed Pt #1 of Pt #1's right to be treated at Memorial Hospital.

4. Attempts were made to contact Pt. #1 by phone. On 4/11/13 at 3:45 PM a phone interview was conducted with Pt #1. During the interview, Pt #1 stated that while Pt #1 was in the 2C assessment room, the nurse told Pt #1 there were problems with Pt #1's medical insurance and that the doctor's office wanted to talk to Pt #1. At that time Pt #1 was informed by the nurse practitioner (Z-1) that Memorial no longer accepted Pt #1's insurance and Pt #1 was told to go to a nearby Hospital. Pt #1 was taken by wheel chair to the front door where Pt #1's sister picked Pt #1 up and took Pt #1 to the nearby Hospital where Pt #1 was admitted .