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.
|SEASIDE BEHAVIORAL CENTER||4201 WOODLAND DRIVE NEW ORLEANS, LA 70131||May 4, 2017|
|VIOLATION: DISCHARGE PLANNING NEEDS ASSESSMENT||Tag No: A0806|
|**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on record review and interview, the hospital failed to ensure its discharge planning evaluation included an evaluation of the availability of post-hospital services as evidenced by failure to determine whether a patient had an established primary care physician (PCP) when orders at discharge were given to contact the patient's PCP within 2 weeks after discharge if necessary for 1 (#2) of 5 (#1 - #5) patient records reviewed for evaluation of the availability of post-hospital services frrom a total sample of 5 patient records.
Review of the hospital policy titled "Discharge Planning", presented as a current policy by S1ADM, revealed that the hospital would provide all patients with a discharge plan that identifies and addresses aftercare needs and ensures coordination of needed services.
Review of Patient #2's medical record revealed he was admitted on [DATE] and discharged to a group home on 05/02/17. Review of his nursing admission assessment revealed the section related to discharge planning had the column labeled "no" with a check mark for the criteria listed as "name address & (and) phone of primary care physician." There was no documented evidence in Patient #2's medical record whether he had a PCP or not.
Review of Patient #2's "Patient Instruction Sheet And Discharge Instructions", signed by Patient #2 on 05/02/17 and S5PLPC on 05/02/17, revealed the instructions included to follow-up with his PCP within 2 weeks if needed to address any physical health concerns and to follow-up with the intensive outpatient program for mental health services and his PCP if needed.
In an interview on 05/04/17 at 11:20 a.m., S5PLPC indicated unless the psychiatrist writes an order to consult for a PCP or a specialist for a patient who doesn't have Medicaid, the discharge planners don't have to set up an appointment with a PCP. She further indicated they just tell the patient to follow-up with their PCP if they need to. She indicated Patient #2 was on Medicare, and he was able to go to the intensive outpatient program for his medical needs. S5PLPC confirmed the intensive outpatient program has a psychiatrist on staff but not a medical doctor. She confirmed if a patient doesn't have a PCP, one of the responsibilities of the discharge planning staff is to assist the patient in establishing a PCP.
|VIOLATION: IMPLEMENTATION OF A DISCHARGE PLAN||Tag No: A0820|
|Based on record reviews and interview, the hospital failed to ensure the patient and family members or interested persons were counseled to prepare them for post-hospital care as evidenced by failure to ensure the patient's list of medications to be taken after discharge clearly indicated the changes from the patient's pre-admission medications for 3 (#2, #3, #5) of 5 (#1 - #5) patient records reviewed for counseling related to discharge medications from a total sample of 5 patients.
Review of the hospital policy titled "Discharge Planning", presented as a current policy by S1ADM, revealed the discharge plan should include special instructions, medication access/referral assistance, and patient acknowledgement of understanding and agreement. There was no documented evidence that the policy addressed that the patient and family members or interested persons were to be counseled regarding changes from the pre-admission medications and those being ordered upon discharge.
Review of the medical records of Patients #2, #3, and #5 revealed each discharge medication list revealed no documented evidence of the changes in the medications ordered at discharge from the medications taken prior to admission.
In an interview on 05/03/17 at 11:48 a.m. with S1ADM and S2DON present, S2DON confirmed the discharge process for nursing does not include a comparison of the patient's discharge medications from those taken prior to admission to the hospital.