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.

FOREST HILLS HOSPITAL 102 - 01 66TH ROAD FOREST HILLS, NY Dec. 4, 2015
VIOLATION: MEDICAL STAFF RESPONSIBILITIES Tag No: A0359
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on document review and interview, it was determined that the physician and or other Licensed Independent Practitioner (LIP) failed to appropriately assess the patient's condition after admission, to plan an adequate course of treatment.

Findings include:

Review of patient MR #2, identified: a [AGE] year old admitted on [DATE] with a chief complaint of not eating and taking medications. The past medical history is significant for CVA, CAD, Afib, HTN, right leg venous ulcer. Past surgical history: S/P CABG, MVR, TVR (tricuspid valve replacement). On admission the patient is noted with multiple deep tissue injury (DTI) to bilateral hips, left buttock, right heel and great toe. The patient was placed on a Hilrom pressure reducing mattress, turned and positioned every 2 hours and positioned off wounds. There was no physician's order for wound care of the right lower leg venous ulcer until 11/27/15, 2 days after admission.
This was brought to the attention of Staff #3 (Senior Administrative Director, Patient Care Services).
VIOLATION: PATIENT RIGHTS: NOTICE OF GRIEVANCE DECISION Tag No: A0123
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on document review and staff interview, it was determined that the facility did not ensure that complainants were given a written response to grievances. (MR #1 & File #1)


Findings include:

Review of MR #1, identified: This [AGE] year old arrived to the Emergency Department on 11/18/14 accompanied by relative, with a complaint of shortness of breath, cough with sputum and constipation for 5 days. Documentation on 11/19/14 indicated that the patient sustained a laceration to the right hand while being place in wrist restraints. The patient was seen and examined by the physician; the surgeon was called and the site was cleansed and sutured by the surgeon. There was an occurrence report documenting the incident but there was no evidence that the family received written correspondence regarding the outcome of the investigation.
This was brought to the attention of Staff #1 (Patient Service Manager), and Staff #2 (Associate Executive Director, Quality Management) on 12/2/15, approximately 2:40 PM.



File #1 was reviewed on 12/2/15. It was noted, this complainant filed the complaint on 7/16/15 with the facility through the nurse manager, regarding not receiving a timely telephone call that his wife, a patient, had been transferred from the ICU to room 613; and additional issues regarding her care. It was noted there was a family meeting but no documentation as to date, time, who were in attendance and the outcome of the meeting. In addition there, was no written correspondence to the complainant located in this file, regarding the investigation and outcome.
This was brought to the attention of Staff #1 (Patient Service Manager), and Staff #2 (Associate Executive Director, Quality Management) on 12/2/15, approximately 2:40 PM.