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1201 HADLEY RD

MOORESVILLE, IN 46158

PATIENT RIGHTS: NOTICE OF RIGHTS

Tag No.: A0117

Based on document review and interview, the facility failed to document that the notice of patient rights was provided to a patient or the patient's representative prior to receiving care for 1 of 6 (patient 22) medical records (MR) reviewed.

Findings:

1. The policy/procedure Patient Rights and Responsibilities (reviewed 3-14) indicated the following: "The hospital will provide information on patients ' rights and responsibilities to all patients receiving services ...Inpatients are notified upon admission through the Patient Information Guide."

2. The MR for patient 22 failed to indicate documentation that the patient or the patient's representative was provided with a copy of the notice of Patient Rights around the time of admission on 6-22-14 at 1230 hours.

3. During an interview on 11-24-14 at 1405 hours, the medical-surgical unit manager A3 confirmed that the MR for patient 22 lacked documentation indicating that notice of Patient Rights was provided to the patient or the patient's representative at the time of admission to the facility.