The Centers for Medicare & Medicaid Services recently released a report of its surveyor inspection of Ascension Seton Medical Center Austin, which is located at 1201 W 38th St., in Austin, Texas. This Ascension hospital is part of the large Ascension Health system.
Hospitals, such as Ascension Seton Medical Center Austin, that participate in Medicare and Medicaid must allow on-site surveys by state agencies and accrediting organizations, such as The Joint Commission, to ensure that they’re complying with federal regulations. If the surveyor finds that the hospital isn’t in compliance, there will be a citation for violations and a survey report that details the findings.
The April 15, 2021 surveyor visit to Ascension Seton Medical Center Austin was prompted by a complaint investigation. The surveyor uncovered six substantial deficient practices and issued citations and a report. The substantial deficient practices broadly included:
• Medical staff accountability
• Patient rights, including care in a safe setting
• Data collection and analysis
• Organization of nursing services
• Discharge planning, including a physician request for plan
These survey citations shed light on the reality of how modern healthcare should be provided. Although Texas law prohibits the corporate practice of medicine—meaning that doctors, not hospitals, practice medicine—hospitals still have an important role in ensuring safe, quality medical care.
Botched diet orders
The surveyor found that Ascension Seton Medical Center Austin failed to ensure that physicians on its medical staff ordered carbohydrate control diets for diabetic patients. This resulted in a patient experiencing elevated blood sugars and required giving the patient insulin to correct the problem. The surveyor noted that the hospital’s own policy requires physician orders to be “complete, clear, accurate, and legible such that there is no ambiguity regarding the order.”
The hospital policies and procedures also provide that, “Authorized prescribing Practitioner and Clinical Staff will manage patient orders to effectively provide safe care.” This part of the hospital policy accurately reflects that nurses have a role in providing safe patient care. In the event that an order is unclear in any way, though, the standard of care requires the hospital’s nursing staff to consult with the physician, physician assistant, or nurse practitioner who made the order to seek clarification.
Lacking discharge instructions
As a former hospital administrator, I’m well aware that Medicare closely examines re-admission rates because they, of course, impact the amount of money Medicare has to spend on patient care.
The idea behind this focus is that with quality care and discharge planning, once the patient goes home, the process of healing should continue rather than face setbacks that require a costly return to the hospital.
The surveyor found that Ascension Seton Medical Center Austin failed to provide wound care discharge instructions for an elderly patient that needed help to understand how to care for a surgical wound. Although the patient had a follow-up appointment with the surgeon scheduled, the hospital risk manager admitted that there was no documentation of wound care teaching or dressing changes. Under the standard of care, it’s a shared responsibility of the discharging physician and nursing staff to make sure that the patient has proper discharge instructions that will allow the safe transfer of the patient from the hospital to home or other facility.
If you’ve been seriously injured because of poor hospital health care in Texas, contacted top-rated experienced Texas medical malpractice lawyer for a free consultation about your potential case.