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.

GOOD SAMARITAN MEDICAL CENTER 1309 N FLAGLER DR WEST PALM BEACH, FL 33401 July 31, 2018
VIOLATION: PATIENT RIGHTS: NOTICE OF RIGHTS Tag No: A0117
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**


Based on facility document review and staff interviews, the facility failed to inform the patient's health care surrogate of the patient's discharge in 1 of 3 sampled patients (Patient #1).

The findings included:

The policy and procedure revealed the case management staff will be responsible for the discharge planning. This may include referrals to home health, durable medical equipment, and placement in an alternate care setting.

06/19/18, this [AGE] year-old female with a history of Chronic Obstructive Pulmonary Disease, presented to the hospital with worsening shortness of breath and dyspnea on exertion. She has a Health Care Surrogate and a Power of Attorney. The patient was residing in an assisted living facility and the Health Care Surrogate was making the health care decisions for the patient.

On 06/21/18, the Health Care Surrogate selected 3 skilled nursing facilities and presented the signed form to the case manager. The plan was to have the patient receive more physical and occupational therapy at a skilled nursing facility upon discharge from the hospital.

06/23/18, the physician ordered discharge with home health; arrange home oxygen, once scheduled, to assisted living.

Review of the record revealed the hospital failed to notify the Health Care Surrogate of the patient's discharge.

During an Interview with the Director of Case Management, she stated they did not do their due diligence regarding notification to the patient's Health Care Surrogate. She stated Case Management is the primary group who should notify the patient's representative.
VIOLATION: IMPLEMENTATION OF A DISCHARGE PLAN Tag No: A0820
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on facility document review and staff interviews, the facility failed to arrange for the implementation of the patient's discharge plan including notification to the assisted living facility in 1 of 3 sampled patients (Patient #1).

The findings included:

The policy and procedure revealed the case management staff will be responsible for the discharge planning. This may include referrals to home health, durable medical equipment, and placement in an alternate care setting.

06/19/18, this [AGE] year-old female with a history of Chronic Obstructive Pulmonary Disease, presented to the hospital with worsening shortness of breath and dyspnea on exertion. She has a Health Care Surrogate and a Power of Attorney. The patient was residing in an assisted living facility and the Health Care Surrogate was making the health care decisions for the patient.

On 06/21/18, the Health Care Surrogate selected 3 skilled nursing facilities and presented the signed form to the case manager. The plan was to have the patient receive more physical and occupational therapy at a skilled nursing facility upon discharge from the hospital.

06/23/18, the physician ordered discharge with home health; arrange home oxygen, once scheduled, to assisted living.

Review of the record revealed, that prior to discharging the patient, the hospital failed to notify the Assisted Living Facility of the patient's discharge.

During an Interview with the Director of Case Management, she stated they did not do their due diligence regarding notification to the assisted living facility. She stated Case Management is the primary group who should notify the assisted living facility.