Hospital Administers Medication Without Obtaining Informed Consent

The Centers for Medicare and Medicaid Services (CMS) cited Holly Hill Hospital for failing to uphold patient rights to informed consent regarding their medical treatment and care. CMS found that hospital staff failed to obtain informed consent for the administration of psychotropic medications to three patients involuntarily committed at the facility. The facility’s policy on psychotropic medication states that “‘[a]ll patients receiving psychotropic medication will be provided information by a physician and will give informed consent before such medications are administered.'”  However, according to CMS interviews with facility staff and administrators, there were different interpretations as to when informed consent should be obtained from patients. For example, when a physician (physician #2) was interviewed about obtaining informed consent from a 37-year old patient (patient #2) s/he replied, “‘We may give the first dose of the psychotropic medication, one dose, to stabilize the patient or prevent withdrawal from a current medication, but by the second day the physician should obtain informed consent.'”  In contrast, the Nursing Director stated that consent should be obtained upon admission, while the Assistant Director of Nursing stated consent should be obtained “‘as soon as possible after the physician deems the patient competent to sign the consent.'” Holly Hill Hospital was required to submit a plan of correction to address its cited deficiencies and deficient practices for obtaining informed patient consent.