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.

MEDSTAR GOOD SAMARITAN HOSPITAL 5601 LOCH RAVEN BOULEVARD BALTIMORE, MD 21239 May 6, 2015
VIOLATION: PATIENT RIGHTS: NOTICE OF RIGHTS Tag No: A0117
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on a review of thirteen medical records, it was determined that the hospital failed to provide the Important Message for Medicare for three Medicare recipients as required by the regulation. Specifically, two patients received one of the two required "Important Messages," and one patient did not receive the either of the required "Important Messages."

The "Important Message" given two days prior to discharge was not found in the medical records of the following patients.

Patient #12, 66, was admitted on [DATE] and discharged on [DATE]. Review of the patient's medical record revealed that the initial Important Message was given to the patient on 04/08/2015. The second Important Message required to be given to the patient two days prior to discharge was not found in the patient's medical record.

Patient #10, 80, was admitted on [DATE] and discharged on [DATE]. Review of the patient's medical record revealed that the initial Important Message was given to the patient on 04/13/2015. The second Important Message required to be given to the patient two days prior to discharge was not found in the patient's medical record.

No Important message was found in the medical records for the following patient.

Patient #9, 71, was admitted on [DATE] and discharged on [DATE]. Review of the patient's medical record revealed that the required Important Messages were not given to the patient.