HospitalInspections.org

Intakes: TN00032241

Based on policy review, medical record review and interview, it was determined the facility failed to ensure the patient's family was notified of the discharge date for 1 of 3 (Patient #2) sampled patients.

The findings included:

1. Review of the faciltiy's "Discharge Planning" policy revealed, "Discharge planning is an interdisciplinary team decision making process involving physician, hospital staff, patient, family... Once the projected discharge date is identified in team conference, the Case Manager completes the following... Advises the patient/patient representative..."

Review of the facility's "Discharge Procedures" policy revealed, "A Discharge Plan will be developed for each patient at the time of admission with all disciplines setting goals in conjunction with the patient and family, and/or significant caregivers ensures the continuum of care through the discharge process... The Case Manager has the primary responsibility for discharge planning and the coordination of discharge procedures with the other team members in conjunction with the patient and primary caregivers. The Case Manager will assure all team members, patients, and primary caregivers are aware of the discharge plans..."

2. Medical record review for Patient #2 revealed an admission date of 7/2/13 with Encephalopathy. The patient was admitted for intravenous antibiotic therapy for aspiration pneumonia, C-diff, and sepsis.

3. Review of Case Management progress notes documented the following:
7/10/13 notified the patient's daughter by telephone of the discharge date of 7/19/13 and she was agreeable to the date.
7/16/13 notified the daughter by telephone of the discharge date of 7/19/13 and she was agreeable to the date.
7/18/13 the Case Manager met with the patient's daughter in the therapy and discussed post-discharge needs. The discharge date was set for 7/19/13.
There was no further documentation by Case Management.

4. Review of a 7/19/13 physician's order/progress record revealed, "...Blood Cx [culture] 2- 5 min[minutes apart], CXR [chest xray] 2 views Dx [diagnosis] Fever... Cancel D/C [discharge] until 7/22... 2 Fever spikes"
There was no documentation the patient's daughter was notified discharge had been changed to 7/22/13.

5. During an interview on 6/18/14 at 11:45 AM, the Chief Executive Officer verified she was unable to find documentation the family was notified of the 7/22/13 discharge date.