HospitalInspections.org

Based on record review and interview the facility failed to follow their process for patient grievances citing one out of one record reviewed.

Findings:

1. A review of the facility's grievance log on 04/27/10 found no documented evidence of a complaint made by patient #1 or by patient #1's family.
2. An interview with the Chief Nursing Officer (CNO) on 04/27/10 revealed that she did not log the complaint as a grievance and only had written an anecdotal note. A review of the anecdotal note found that patient #1's family member had complained on 4/6/10 about the care their mother was receiving.
3. A review of the facility policy titled "Patient Grievances" policy number 910-02-039, effective date August 7, 1999 found that a patient grievance should be documented on a Quality Control Report. An investigation into the complaint/grievance should be investigated and a written response should be sent to the patient or family member by the end of 30 days. The policy further stated "The Risk Management Department will respond with notice of its decision that contains the name of the contact person, the steps taken on behalf of the patient to investigate the grievance, the results of the grievance process, and the date of completion." The facility failed to follow their policy on patient grievances and this was confirmed in an interview with the CNO.