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 6 of 7 MR reviewed of patients receiving Medicare benefits (#1, 4, 13, 14, 15 & 16) out of a total of 16 MR reviewed, and 1 of 1 staff interviews (A & B), the hospital failed to ensure that each Medicare beneficiary is informed of his/her right to appeal discharge from the facility which became effective July 13, 2007 per S&C memorandum 07-28.

Findings include:

On 9-5-2012 at 10:50 AM an interview of physician H was completed. Physician H expressed being familiar with pt. #1. Physician H denied refusing to give pt. #1 the Important Message from Medicare form, however physician H would not be the one to do that. Physician H denied telling the patient, " I think you are faking it. " Physician H did explain they could not find anything wrong with pt. #1 and it was a case of malingering.

On 9-5-12 from 7:30 AM to 9:30 AM records for pt.s #1 through #16 were completed.
Pt. #1 ' s record revealed pt. #1 was admitted to the unit, via the ED on 7-5-2012 after an episode of syncope. The discharge summary dated 7-29-2012 shows pt. #1 was admitted to the hospital because of previous episodes of passing out, dizziness and inability to walk. The discharge summary shows extensive lab work, MRI of brain, CT scans, chest x-ray, neurological testing, psychological testing and treatments with physical therapy. A Neurology progress note dated7-29-2012 from physician H states in part, " Informed pt that he will be discharged to home with a diagnosis of malingering of gait complaints. Informed risk management of the decision. Pt. did not challenge the decision and said that " basically I told him he is lying. " Nursing discharge summary dated 7-29-2012 states in part, pt. #1 needs assist of a walker at times for mobility, no restrictions, no home care referrals and pt. #1 should follow up with primary care physician.
The first notice of An Important Message from Medicare, was signed by pt. #1 on 7-4-2012. QMC D explained the second notice may not be scanned in yet, and would find it.

The record for pt. #4 did not have either the first or second notice in the record. Review of pt ' s #13, 14, 15, and 16 revealed they did not have a signed second copy of the notice in their records.
On 9-5-12 at 11:20 AM QMC A and Director of Quality B stated the missing Medicare Discharge notices could not be located and understood this was a problem that the hospital was in the midst of fixing.