The Centers for Medicare & Medicaid Services recently released a report of its surveyor inspection of PAM Health Specialty Hospital of San Antonio, which is located at 5418 North Loop 1604 W, San Antonio, TX 78249.
PAM is a long-term acute care hospital with 62 licensed beds and 250 physicians on its medical staff.
When a hospital, such as PAM Health Specialty Hospital of San Antonio, participates in Medicare and Medicaid, it has to permit state agencies and accrediting organizations to send surveyors to conduct on-site inspections and records review to ensure compliance 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.
A Medicare surveyor visited PAM Health Specialty Hospital of San Antonio on April 20, 2021, in response to a complaint. The surveyor uncovered three substantial deficient practices and issued citations and reports. The substantial deficient practices broadly included:
• Nursing services
• Organization of nursing services
• Infection control program
The surveyor found that PAM’s nursing staff failed to implement physician orders for the wound care nurse to evaluate and propose a treatment plan for patients. According to the surveyor, the hospital doesn’t have wound care staff working on weekends. This setup delayed wound care evaluations, recommendations, and treatment orders, and placed any patient with wounds at risk for worsening wounds or infections from delayed treatment, incorrect treatments, or no treatment.
Here at Painter Law Firm, we’ve handled many medical malpractice cases involving wound care and prevention. One of the consistent comments from wound care experts is that the best way to treat wounds is to prevent them from forming in the first place. This requires careful attention by the nursing staff and physicians, as well as necessary involvement by wound care specialists.
The Medicare surveyor found that PAM Health Specialty Hospital of San Antonio had an internal policy called “Wound Care Assessment and Reassessment,” with the stated purpose of ensuring the optimization of all wounds and monitoring high-risk patients for skin breakdown.
According to the policy, the admitting registered nurse should perform an initial head to toe assessment. If there are no wounds, preventative measures should be implemented. If the nurse finds wounds, though, documentation should include wound photographs and documentation including the size, length, width, depth, and tumbling, as well as appearance of the wound and characteristics. Based on the initial findings, the registered nurse should advocate for wound care orders, and reassess the patient any time there’s been a change in condition.
Interestingly, PAM’s own policy reflects that “Wound Care is a Monday thru Friday program at PAM Specialty San Antonio. The wound care team will perform their initial assessment on the next day or within the first 72 hours if admit arrives on the weekends.” The surveyor found that there were no wound care instructions for weekend staff to follow.
These policies are concerning because pressure injuries don’t take off weekends, as the PAM wound care team apparently does. In fact, pressure injuries can occur or worsen within a matter of hours of inappropriate conditions.
Facilities like PAM Health Specialty Hospital of San Antonio exist to provide skilled nursing services to medically complex patients who require extended hospitalization to recover from new illnesses and injuries. Patients are often discharged from a regular hospital to specialty hospitals for additional care because they aren’t quite ready for the independence of home life.
When proper wound care prevention and treatment policies aren’t in place, it can cause patient setbacks rather than improvements.
If you’ve been seriously injured because of poor wound prevention and care in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for a free consultation about your potential case.
