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5602 CAITO DRIVE

INDIANAPOLIS, IN 46226

RN SUPERVISION OF NURSING CARE

Tag No.: A0395

Based on document review and interview, facility nursing staff failed to inventory and document patient belongings for 1 of 10 medical records reviewed. (P1)

Findings include:

1. Facility policy titled,"Valuables and Belongings, Patient", no policy number, approved 4/2020, indicated under POLICY: Staff shall complete an inventory of patient belongings and provide safe storage of patient possessions while they are hospitalized. PROCEDURE: 2. Patient Belongings. a. Patient belongings shall be inventoried and itemized on the Patient Belongings Form. e. Once all belongings are inventoried and listed the form is signed by the employee completing the inventory and patient/legal representative. f. Discharge process will include reviewing the Patient Belongings list with the patient/responsible party, validating the return of items to the patient at discharge, and a signature by the patient/responsible party.

2. MR (Medical Record) for P1 indicated the patient was transferred from H2 (Acute Care Hospital) to H1 (Psychiatric Hospital) on 11/23/24 at 7:46 pm. H2 documentation for P1 indicated belongings included a pair of sweatpants, a pair of socks, a pair of shoes, two sweaters, one bra, four bracelets, and one watch. P1 was transferred to H1(Psychiatric Hospital) on an EDO after being medically cleared for discharge on 11/23/24 at approximately 10:22 pm. MR for P1 at H1 lacked documentation of itemized inventory of personal belongings on the Patient Belongings Form both at the time of admission and the time of discharge.

3. In an interview on 1/2/25 at approximately 1:00 pm with A4 (Risk) confirmed P1 did not have a patient belongings sheet documenting his/her belongings on admission and discharge from H1 but should have.