HospitalInspections.org

Based on record review and interview, the hospital failed to ensure patients received notification of patient's rights for two (Patient #4 and #5) of 10 patients.
This failed practice has the likelihood to impede patient knowledge of rights and thereby prevent patients from the ability to fully exercise their rights and be actively involved in care decisions.
Findings:
Hospital policy dated January 2018 and titled "Patient Rights and Responsibilities" in part stated, "Inspire Specialty Hospital shall inform each patient .... of the patient's rights, in advance of furnishing or discontinuing patient care whenever possible." A review of a document contained within the admission packet titled "Conditions of Admission/Consent for Treatment" has a section titled "Patient Rights" which in part stated, "your rights include ...the right to be treated with dignity ...to have an advance directive ...to privacy, security and communication ...to be free from restraint and seclusion". The document read in part, "My signature acknowledges that I have been given the opportunity to satisfy myself by asking questions about the Conditions of Admission/Consent for Treatment". Review of an admission packet document titled "Acknowledgement of Patient Bill of Rights & Patient Responsibilities" stated in part "informed participation in decisions involving your health care is your right". Patient acknowledgement read in part, "I have received a copy of the Patient Bill of Rights ...I also understand and agree to fulfill my responsibilities as a patient here."
A review of the clinical records of two (patient #4 and #5) of 10 showed no signed notice of patient rights. Documentation showed no evidence the patients were informed of their patient rights upon admission and showed no rationale for not obtaining signed acknowledgement.
On 12/8/23 Staff A reviewed the clinical record for patients #4, and #5 and stated there were no signed notices of patient rights. Staff A stated that every patient should have signed acknowledgment of patient rights in their clinical records, but some patients refuse to sign. Staff A stated there was no documentation to support refusal by any patient.

Based on record review and interviews, the hospital failed to ensure that two (patient #4 and #5) of 10 patients were provided with information regarding the patient's rights to formulate Advance Directives.
This failed practice has the likelihood of the patient's medical care decisions to go unaddressed, thereby impeding their rights as patients.
Findings:
During the survey, the hospital staff were asked to provide the admission packet given to patients. The admission packet provided contained information related to advance directives.
A hospital policy dated January 2018 and titled "Advance Directives" in part stated "as part of the admission process .... patient/significant other shall be provided with an information packet. The information packet provided shall include .... information concerning the Patient Self-Determination Act .... will be provided to the patient upon each admission to Inspire Specialty Hospital. Admitting Department staff shall document in the medical record whether the patient has completed the advance directive and that information concerning advance directives has been given to the patient/significant other during the admission process".
A review of a document from the admission packet titled "Advance Directives" stated in part, "It is Inspire Specialty Hospital's policy to uphold patient's rights ...including the right to accept or refuse treatment and the right to formulate Advanced Directives". A document titled "Oklahoma Notice to Patients Required by the Patient Self-Determination Act" stated in part "this notice is given to you to tell you about your rights, under Oklahoma law, to make medical care decisions".
A review of the clinical records of two (patient #4 and #5) of 10 patients showed no completed advance directive acknowledgment. There was no evidence the patients were informed of their patient rights to formulate an advance directive and showed no rationale for not obtaining signed acknowledgement.
On 12/8/23 Staff A reviewed the clinical records of patients #4 and #5 and stated there were no signed acknowledgements regarding Advance Directives. Staff A stated that each patient should be provided with information regarding the formulation of an advance directive and that acknowledgment should be placed in the patient's medical record.