Trends in Long-Term Care - U.S. Senate Special Committee on Aging

Trends in Long-Term Care - U.S. Senate Special Committee on Aging Trends in Long-Term Care - U.S. Senate Special Committee on Aging

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3014 UNITED STATES OF AMERICA £coanm Of * tAmub tat" To Ar.~ Portall^,.. Inistrato:--.ths-othe~-otf~eegr--.f--tfstee,--I-i- -kLteratiioal Jaital.s .lflfO N.E .kh Inmz,.Bortb..Miami-, Eor - --- ------ - -- VUVtau to lawful authority, rOU ARE HEREBr COXMAXDED to appear before the .. ia.l___ ong>Committeeong> on Agong>inong>g - of the ong>Senateong> of the United States, on -- ebrury.4 4 1975., at -- 0: - o'clock &.m, at _ . . Association, 14 Vese! Street, Ne--York. New---of-- , then and there to testify what you may know relative to the subject matters under con- sideration by said committee. The ong>Committeeong> requests your aperneaogwihteflssn sosQda .ml4 documents with respect to Mr. Rocco Scarfone, a patient at the hospital named above:y_ - ---------------------------------------------- 1) Copy of the Admission Form and other necessary documents showong>inong>g: a. Date of admission b. Date arrangements for admission was made. .c. Name-persons or Persons,.makong>inong>g sich oxrangements {SEE RVERSE IDE) tecret fail not, as you will answer your default under the paong>inong>s and pen- alties ong>inong> such cases made and provided. To to serve and return. : - -M-r------------------ ------------------- *iben under my hand, by order of the committee, this -lat- day of _YEebruary -_- , ong>inong> the year of our Lord one tAJn~ nd nong>inong>e hundred and --aeventy=five-- Subcommittee on ong>Longong>-ong>Termong> ong>Careong>, U. S. ong>Senateong> ong>Specialong> ong>Committeeong> on Agong>inong>g

3015 d. Reason for patient's admission (diagnosis) e. Number assigned to patient for hospital stay: f. Number of room (or rooms) to which patient was assigned. 2) Copy of the patient's medical chart ong>inong>dicatong>inong>g any operations or other medical procedures performed, medications given, and projected prognosis. 3) A complete list of all doctors, nurses, and other medical personnel participatong>inong>g ong>inong> such operations or procedures. . . 4) A complete list of all nurses, aides and orderlies assigned to the floor (or floors for each shift) where Mr. Scarfone had his room (or rooms). 5) A copy of the form or other document ong>inong>dicatong>inong>g the official time and date of the release of Mr. Scarfone from the hospital. 6) A'copy of the statement or bill ong>inong>dicatong>inong>g all charges ong>inong>curred at the hospital (ong>inong>cludong>inong>g any documents submitted, or to be submitted to Medicare) relatong>inong>g to the medical care, room and board charged to the patient, to his family, or to any third party.

3015<br />

d. Reas<strong>on</strong> for patient's admissi<strong>on</strong> (diagnosis)<br />

e. Number assigned to patient for hospital stay:<br />

f. Number of room (or rooms) to which patient was assigned.<br />

2) Copy of the patient's medical chart <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g any operati<strong>on</strong>s or other<br />

medical procedures performed, medicati<strong>on</strong>s given, and projected prognosis.<br />

3) A complete list of all doctors, nurses, and other medical pers<strong>on</strong>nel<br />

participat<str<strong>on</strong>g>in</str<strong>on</strong>g>g <str<strong>on</strong>g>in</str<strong>on</strong>g> such operati<strong>on</strong>s or procedures. . .<br />

4) A complete list of all nurses, aides and orderlies assigned to the floor<br />

(or floors for each shift) where Mr. Scarf<strong>on</strong>e had his room (or rooms).<br />

5) A copy of the form or other document <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g the official time and<br />

date of the release of Mr. Scarf<strong>on</strong>e from the hospital.<br />

6) A'copy of the statement or bill <str<strong>on</strong>g>in</str<strong>on</strong>g>dicat<str<strong>on</strong>g>in</str<strong>on</strong>g>g all charges <str<strong>on</strong>g>in</str<strong>on</strong>g>curred at the<br />

hospital (<str<strong>on</strong>g>in</str<strong>on</strong>g>clud<str<strong>on</strong>g>in</str<strong>on</strong>g>g any documents submitted, or to be submitted to Medicare)<br />

relat<str<strong>on</strong>g>in</str<strong>on</strong>g>g to the medical care, room and board charged to the patient, to<br />

his family, or to any third party.

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