Clinicians,
Recently, one of our crews encountered a patient at a local skilled nursing facility, whose staff erroneously presented the attached form as a mental incapacity form for the patient to be transported.
You’ll notice this form will have the patient’s name as well as two physician signatures. However, this is an in-patient form for Meritus use only, and ONLY valid for the duration of the patient’s hospital admission. It has no impact to the EMS transport decision making process.
If you see this form (which you shouldn’t), do not consider this a valid mental incapacitation certification and proceed with your normal mental capacity screening assessment.
Let me know if you have any further questions!
<www.washco-md.net/emergency-services/>
Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 240-527-5940 (office) 240-313-2911 (fax) 240-313-4375 www.washco-md.net<www.washco-md.net/>
Recently, one of our crews encountered a patient at a local skilled nursing facility, whose staff erroneously presented the attached form as a mental incapacity form for the patient to be transported.
You’ll notice this form will have the patient’s name as well as two physician signatures. However, this is an in-patient form for Meritus use only, and ONLY valid for the duration of the patient’s hospital admission. It has no impact to the EMS transport decision making process.
If you see this form (which you shouldn’t), do not consider this a valid mental incapacitation certification and proceed with your normal mental capacity screening assessment.
Let me know if you have any further questions!
<www.washco-md.net/emergency-services/>Melanie Higgins, BS, NRP Captain – EMS Quality Assurance Division of Emergency Services 16232 Elliott Parkway Williamsport, MD 21795 (cell) 240-527-5940 (office) 240-313-2911 (fax) 240-313-4375 www.washco-md.net<www.washco-md.net/>
meritus-incapacity-form.pdf