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.

HCA HOUSTON HEALTHCARE CLEAR LAKE 500 MEDICAL CENTER BLVD WEBSTER, TX 77598 Sept. 6, 2019
VIOLATION: PATIENT RIGHTS: GRIEVANCES Tag No: A0118
Based on interview and record review the facility failed to notify patients timely regarding in 2 of 4 (ID # 8. 9) complaints and grievances reviewed.

Findings Included:

Record review of the facility policy" Patient Grievances and Complaint Management" dated 04/2016 stated:
If a grievance will not be resolved, or if the investigation is not or will not completed within seven (7) days, the complainant should be informed that the facility is still working to resolve the grievance and the facility will follow-up with a written response within twenty-one (21) days.

Record review revealed:
Patient (ID #8) complaint was received on 04/17/19 and received a final letter dated 05/23/2019 and did not received an acknowledgement letter.

Patient (ID #9) complaint was received on 04/26/2019 and received a final letter dated 05/23/2019 and did not received an acknowledgement letter.

Interview with the Director of Patient Safety (Staff # 74) on 09/04/2019 at 1254 who stated:
"Our goal is to have a three-day turn-around time. We send out a letter to managers to address the complaint the same day."
VIOLATION: RN SUPERVISION OF NURSING CARE Tag No: A0395
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**


Based on record review and interview the facility failed to ensure registered nurses were supervising and evaluating the nursing care to confirm orders were completed for 6 patients out of 12 (ID #1, 10, 11, 14, 15, 17) medical records reviewed.

Findings Included:

Record review of current facility policy "Assessment/Reassessment" dated 04/2019 stated: Nursing, Critical care: reassessment include intake and output, daily weights unless contraindicated. Inpatient Rehab: Intake and output will be documented every 12 hours. Inpatient RN assessment (page 24) includes systems review ... ... gastrointestinal...genitourinary ... integumentary

Record review of the medical record on 09/03/2019 and 09/04/2019 revealed the following: Patient (ID #1), was not turned every two hours from August 1, 2019 to September 5, 2019. The patient does not ambulate and can not turn without assistance.
Patient (ID # 1), had nutritional supplemental ordered 08/04/2019 of Glycerina and Nepro ordered, there is no documentation noted that the patient was given or received the supplement.
Patient (ID #1) was not weighted since the day of admission 07/31/2019 and the same weight was documented in the medical record 8 times.

Record review on 09/03/2019 of the medical record, of Patient (ID #10), revealed nutritional supplements ordered on [DATE] for Glucerna 3 times per day (TID) and Juven 2 times per day (BID). There was no documentation that the supplement was offered or consumed by the patient.

Record review on 09/03/2019 of the medical record, of Patient (ID # 11) revealed nutritional supplements ordered on [DATE] for Glucerna TID, and Javen BID. There was no documentation that the supplement was offered or consumed by the patient.

Record review on 09/03/2019 of the medical record, Patient (ID # 14) had an order dated 08/20/2019 to receive Ensure BID. There was no documentation that the supplement was offered or consumed by the patient.

Record review on 09/03/2019 of the medical record, Patient (ID # 15) had an order dated 08/30/2019 for Liquid Protein daily. There was no documentation that the supplement was offered or consumed by the patient.

Record review on 09/03/2019 of the medical record, Patient (ID # 17), had an order dated 08/30/2019 for strict intake and output (I & O). There was no documentation of I & O noted in the medical.

Interview on 09/03/2018 at 1:00 p.m. with the charge nurse, (Staff # 61) who stated there was no documentation of intake or that the patients were not turned every two hours.

Interview on 09/03/2019 at Interview 09/05/2019 at 2:30 p.m., Quality Director (Staff ID # 51), validated there were no current weights on the patient (ID # 1) documented in the medical record.