HospitalInspections.org

Based on review of policies/procedures, medical record reviews, facility complaints/grievances, and interviews with staff, facility failed to ensure a process for prompt analysis of patient grievances related to patient care and medical services for 1 of 4 sampled patients (#1).

Findings:

Review of 1 of 4 grievances by patient #1 noted the Hospital's Patient Advocate received a grievance on 08/04/2022 via phone call from patient #1's family member. The family member expressed concerns related to the patient's discharge in that they felt the patient was discharged prematurely on 08/02/2022, wasn't well enough at that time to be discharged due to a rectal mass/abscess that was biopsied, and also expressed concerns that there was no notification to family regarding the discharge date and time.

Interview on 09/14/2022 at 9:07 a.m. with the Patient Advocate and Risk Manager noted the family member's expressed concerns were taken as a "complaint, not as a grievance". Review of the grievance and interviews with staff found there was an analysis/investigation into the family's concerns to include documentation noting the discharge being put on hold until results of the biopsy report, received on 08/01/2022, that found it was non-malignant. The Chief Medical Officer's review of the chart determined there were no clinical indications to hold discharge, noting the patient was clinically stable and transfer to the Skilled Nursing Facility (SNF) was appropriate for rehabilitation which was the patient's choice. A progress notes from the Case Manager revealed that the wife was informed on 08/02/2022 at 3:59 PM that discharge would proceed as planned to their chosen SNF on 08/02/2022, that same day, and was given a tentative time frame that had been set up, between 5 PM and 6 PM, for the patient's transportation to the SNF.

Review of facility's policies and procedures for "Patient Complaints and Grievances, Chapter: Rights and Responsibilities Policy Number RI 58, last revised on 07/05/2022, noted that the facility's definition of Patient Grievance was "A written or verbal complaint (when the verbal complaint about patient care is not resolved at the time of the complaint by staff present) by a patient, or a patient's representative, regarding patient's quality of care . . ." The policy and procedure noted the investigation should be completed on average, within 7-10 days of receipt of grievance and the patient advocate to send a letter acknowledging the grievance and results of the investigation. If the grievance will not be resolved or investigation not completed within the 7 days, Patient Advocate will send a letter to inform the grievant that the hospital is still working to resolve the matter and will follow-up with a final resolution letter within 30 days of acknowledgment letter."

Interview with the Patient Advocate and Risk Manager on 09/14/2022 at 9:07 AM, as well as review of grievance information given by the staff, confirmed there was no letter sent to the grievant acknowledging receipt of the grievance or follow-up with analysis and final resolution of expressed concerns.