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)
A0358 MEDICAL STAFF RESPONSIBILITIES - H&P
CFR(s): 482.22(c)(5)(i)

[ The bylaws must:] Include a requirement that-- (i) A medical history and physical examination be completed and documented for each patient no more than 30 days before or 24 hours after admission or registration, but prior to surgery or a procedure requiring anesthesia services, and except as provided under paragraph (c)(5)(iii) of this section. The medical history and physical examination must be completed and documented by a physician (as defined in section 1861(r) of the Act), an oral and maxillofacial surgeon, or other qualified individual in accordance with State law and hospital policy.


This STANDARD is not met as evidenced by:
Based on record review and interview, the hospital failed to ensure that a medical history and physical examination was completed and documented for each patient no more than 30 days before or 24 hours after admission or registration for 3 (#18, #2, #24) of 14 (#6, #15-#19., #21, #24-#30) records reviewed. Findings: Review of the hospital's policy # 00-06-01 titled "Medical Staff By-Laws", revealed in part: ARTICLEII- Purpose: The purpose of the Medical Staff is develop and adopt bylaws and rules for self-governance of professional activity with accountability directly to the Governing Board. Section 3: Responsibilities of the Membership: 2. Each member of the Medical Staff shall: Completion of the Addendum to H&P justifying IRF admission following the pre-admission screening and after the order to admit but within the 24-hour post-admission window. This may be completed as part of the H&P or on the approved separate form. Complete and transcribed H&P on all patients no less than seven (7) days prior to admission or withing twenty-four (24) hours of admission. A. The H&P must be transcribed and, on the patient's, medical record within 24 hours of admission. The physician should document in the progress notes indicating H&P has been dictated. Review of Patient #18's medical record revealed Patient #18 was admitted on 01/15/2026 at 3:45 PM for CVA with right body involvement and discharged on 01/23/2026. Further review of Patient #18's medical record revealed the History & Physical was completed on 01/27/2026 at 11:31 AM. In an interview on 04/08/2026 at 3:49 PM S1NSM verified the above mentioned information. Review of Patient #21's medical record revealed Patient #21 was admitted on 03/17/2026 for Neuromuscular Disorder and discharged on 03/28/2026. Further review of Patient #21's medical record revealed the History & Physical was completed on 03/19/2026 at 4:26 PM. In an interview on 04/09/2026 at 5:00 PM S25Consultant verified the above mentioned information. Review of Patient #24's medical record revealed Patient #24 was admitted on 11/03/2025 at 2:15 PM for Non-Traumatic Spinal Cord Dysfunction and discharged on 11/17/2025. Further review of Patient #24's medical record revealed the History & Physical was completed on 11/18/2025 at 6:40 PM. In an interview on 04/09/2026 at 4:36 PM S25Consultant verified the above mentioned information.