Department of Health & Human Services

Centers for Medicare & Medicaid Services
Form Approved

OMB No. 0938-0391
Statement of Deficiencies (X1) Provider/Supplier/CLIA Identification Number 713026 (X3) Date Survey Completed 04/09/2026
Name of Provider or Supplier Bogalusa Rehabilitation Hospital Street Address, City, State 621 Columbia Street, Bogalusa, LA
For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency.
(X4) ID Prefix Tag Summary Statement of Deficiencies

(Each deficiency should be preceded by full regulatory or LSC identifying information)
A0132 PATIENT RIGHTS: INFORMED DECISION
CFR(s): 482.13(b)(3)

The patient has the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives, in accordance with §489.100 of this part (Definition), §489.102 of this part (Requirements for providers), and §489.104 of this part (Effective dates).


This STANDARD is not met as evidenced by:
Based on record review and interview, the hospital failed to ensure the medical record was prominently documented as to whether or not the patient had an advanced directive in 2 (#22, #23) of 30 medical records reviewed. Findings: A review of hospital policy titled, "Advanced and Other Healthcare Directives, DNR Orders, LAPOST," policy number unavailable, origination 03/2020 and last revised/approved 01/2024, revealed in part: "POLICY At the time of admission, patients shall be informed of their right under Louisiana and Federal Law to make decisions regarding medical care, including the right to accept or refuse medical treatment and the right to formulate an advanced directive. No patent shall be discriminated against with respect to provisions of care or otherwise, based on whether he or she executed an advanced directive. PROCEDURE FOR DETERMING, DOCUMENTING PRESENCE OF AND COMPLETING AN ADVANCED DIRECTIVE B. The Hospital will inquire of each patient at the time of admission whether or not he/she has executed an Advanced Directive and will document the answer in the patient's medical record. PROCEDURE 1. At the time of admission, all adult patients, 18 years or older, or their representative, will be asked by the admitting nurse or case manager if he/she has existing living will or durable power of attorney for health care. The admitting nurse or case manager will indicate on the Advanced Directive Acknowledgement sheet either "yes" or "no", or "revoked" based on the response from the patient or representative. The admitting nurse or case manager will ask the patient or representative to provide the original, to be copied and returned, or a copy of the advanced directive. The admitting nurse or case manager will acknowledge receipt of the Advance Directive." A review of medical records revealed the following: --Patient #22's medical record revealed a document titled, "Pre-Admission Assessment," completed on 11/10/2025 at 1:00 p.m. This assessment included a category as "Advanced directives" with the corresponding answer as, "Full code." A review of the medical record failed to reveal the documentation of patient inquiry at the time of admission related to whether or not the patient had executed an Advanced Directive; and --Patient #23's medical record revealed a document titled, "Pre-Admission Assessment," completed on 11/07/2025 at 1:45 p.m. This assessment included a category labeled as "Advanced directives" with the corresponding answer as, "Full code." A review of the medical record failed to reveal the documentation of patient inquiry at the time of admission related to whether or not the patient had executed an Advanced Directive. In an interview on 04/09/2026 at 11:00 a.m. S25Consult confirmed the above-mentioned findings. S25Consult confirmed the documentation in the pre-admission screening related to the Advance Directive category did not acknowledge whether or not the patient had an Advance Directive and only indicated the patient's code status.