Was I right to decline this? Admission with no consents.

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I was on call last weekend. I was called to "go do a discharge on a patient who was going back to her board and care" and was currently at an acute hospital.

The admissions on call manager told me " we haven't gotten consents yet, dpoa out of the area and we are going to get them tomorrow" I asked what is it that you want me to do then since consents are not signed??

It was a back and forth conversation that finally got me to say, I am not LEGALLY able to touch, assess or even move a pateint without consents for admission. What is it you are asking me to do?

Last minute call from Administrator.

"pleaes arrange for a ambulance ride home and order a comfort kit" "We will finish all assessments tomorrow." My admin was very very very upset with me. But I am concerned were they asking me to do something illegal? Was I correct on not doing this? :nurse:

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Specializes in Pedi psych 4yrs, Med-surg 6yrs.

Wow. I dont know. If consents werent signed, has she been admitted? That is a really gray limbo area. Had she been in the hospital at the time of her "admit" to hospice?

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yes,, they were in an acute hospital discharged to go back to board and care with hospice to follow. DPOA was not able to be contacted until the following day.

My understanding it could be viewed as assault if I even assess a pateint with out written consents. My license would be on the line of the DPOA decides not to have hospice and I am the one who admitted without proper legal documents.

I spoke to my prior employer. What my current agency asked me to do is against the law.

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Specializes in hospice, home care, LTC.

I NEVER deal with a patient without legally executed consents. It's my license.

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You were right to decline it. You CANNOT just willy-nilly admit someone to hospice without signed consents, and if the patient cannot sign, a POA has to. The hospital cannot discharge without having somewhere to put the patient, but that is NOT your problem. I would have said, "Uh, I don't think so..."

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Ditto...you must have a signed EOB in order to provide any care for the patient.

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Specializes in Hospice.

CYA. That is what counts for you! Never admit without consent. Bad things will happen everytime that you do. Like the pt will die before the paperwork is signed (this has happened at my agency).

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Specializes in Med Surg, Hospice, Home Health.

cannot TOUCH a patient without consents. if dpoa was out of town, they could have been faxed to dpoa and faxed back....

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cannot TOUCH a patient without consents. if dpoa was out of town, they could have been faxed to dpoa and faxed back....

As you may or may not know, I am not longer with this company. HOWEVER!!! I did so some sluething the last few days I was there. It wasn't good.

I looked online and the pateint showed she was admitted that day by me. It's also shows that we are billing Medicare for this online by looking at payor source.

I asked the admissions dept " Did you guys ever get your consent signed by Mrs. X's DPOA? Because the e chart shows I admitted here and that our billing info in on the chart... I didn't admit her, unless you gyys got the consents later that day or the following day. " Admissions said.. " Don't worry, we got it all sorted out. We aren't biling for her".

LAST TIME I CHECKED THE CONSENTS ALLOWED US TO PROVIDE THE MUCH DELICATE PATIENT INFO PROTECTED BY HIPPA.. AND ALLOWED US TO COORDINATE SERVICES WIHT OUTSIDE VENDORS USING SOCIALS, DOB, ETC. This wasn't signed... still a no no.

Letting my jets cool and plan on following up with JACHO, Medicare the Dept of Health Services... Sorry, but this is a no no.

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Specializes in L&D, Hospice.

there is always a fine line between legal and moral

legally you were right morally i do not know

we let legal matters keep us from caring for people because there are those out there who will sue if we did not follow the legally prescribed road; or worse...

unlike MDs we do not have a hippocratic oath - however looking at our system i believe nurses follow the do no harm more than a lot of physicians and then we have to deal with the employers we work for who look at numbers first and foremost....

you did the right thing!!! no consent no service!

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THis agency I worked for has done many things of questionable ethics and legality.

I have spoken to another supervisor or mine. You can NOT admit without written consents. Medicare Benefit must be elected by either the patient or DPOA. You can't legally bill for something without consents.... and this agency is.

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Specializes in ..

Coming a little late to this post, but.....

What do you do in a case where it states that YOU admitted a pt. when you actually refused to do so on grounds of legality? Do you write a narrative and submit to BON and JCAHO?

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