HospitalInspections.org

Based on staff interview, observation, review of facility policies, and review of BHU documents, it was determined the facility failed to ensure the personal privacy of patients in the BHU. This resulted in patients under video surveillance and recording without their consent and had the potential for violations of patients' privacy during personal hygiene activities and treatments. Findings include:

Policies regarding the use of security cameras and videotaping were requested on 2/21/18 at 10:50 AM. Two policies regarding the use of video surveillance and recording were provided for review at 1:00 PM. The first policy "Security Services Closed Circuit Television and Video," revised 10/02/17, stated "This policy applies to only those video or image capturing devices that are located in public areas (i.e. parking lots, hallways) or where there is no expectation of patient privacy or treatment." However, the policy stated behavioral health services were an exception.

The facility policy "Behavioral Health Security," revised 11/22/16, stated "Cameras will monitor common areas such as hallways, group rooms, the courtyard, gym, as well as patient rooms." The policy stated the cameras will not be viewed while the patient was attending to personal care or toileting. Additionally, the policy stated "Patients will be informed of the use of cameras as part of the admission process."

This policy was not followed. Examples include:

1. A patient admission packet was requested at 8:25 AM on 2/21/18. The admission packet was received at 10:05 AM. The packet included a brochure about patient rights and responsibilities, a patient information form, and a consent form for photo identification and video recording. The admission packet did not include information regarding security cameras in patient rooms and included information which contradicted what was observed during the facility tour.

The brochure for patient rights and responsibilities included a section "Personal Privacy." This section stated patient privacy would be provided during an exam by closing the door to the room, closing curtains, and asking for visitors to step out of the room. There was no information in the brochure regarding the use of cameras or video recording at the facility.

The patient information form, updated 9/01/15, stated "In order to maintain a safe environment at Canyon View cameras and video recordings are used in common areas such as the group room, dining room and hallways. Camera surveillance is also used in seclusion and observation rooms to ensure patient safety with appropriate privacy provided for personal care. There are no cameras in the general patient rooms."

The consent form for patient photo identification and video recording, dated 11/04/15, included the statement "I also understand that common areas as well as observation/seclusion rooms are under video surveillance and recording." There was no statement included in the consent form regarding the use of cameras and video recording in patient rooms.

2. On 2/21/18, beginning at 8:25 AM, a facility tour was conducted with the DON. While touring the facility the DON stated they treated adults from age 18 to 64, and there were 28 patient beds. Upon entering the patient care area, the nursing station was in the center with 3 hallways going out from the nursing station, in a wagon wheel formation. The DON stated there was a male hallway and a female hallway, and therapy and activity rooms down the other hallway.

The nursing station was circular with 1 side of the nursing station close to 2 observation rooms. An MHS was sitting at the nursing station in front of 4 computer monitors with a privacy screen behind him. The DON stated the monitors displayed the camera views of all cameras in the unit. He stated an MHS was assigned to monitor them 24 hours a day 7 days a week.

The DON stated the observation rooms were used when a patient required closer observation by staff due to behaviors or if a patient stated they were suicidal. The 2 rooms were connected by a bathroom. Upon entering an observation room there were 2 security cameras viewed on the ceiling. One camera was in the back corner of the room, the second camera was above the door of the room. When asked if the other observation room had 2 security cameras the DON stated it did.

An unoccupied patient room was viewed in the female hallway. The patient room had 3 cameras on the ceiling. One camera was in the corner of the room, a second camera was above the door, and a third camera was in an area to the left of the room entry which had a sink with a mirror and cupboards. When asked if all patient rooms had security cameras the DON stated they did. When asked whether he knew how long they have had security cameras in patient rooms he stated he was not sure. The DON was then asked if the cameras were recording video and he confirmed they were. The DON stated there was no auditory monitoring or recording.

An MHS was interviewed on 2/21/18 beginning at 1:20 PM, in the presence of the DON. The MHS stated part of his training included viewing the computer monitors for the video surveillance and what to watch. He stated each MHS was assigned 2 hour increments at the computer monitors. When asked if he had the ability to turn the video cameras on or off, he stated he did not have that ability.

The Security Supervisor was interviewed on 2/21/18 beginning at 2:55 PM. He stated the video cameras were installed in the patient rooms around 4 to 5 years ago. The Security Supervisor stated the video cameras in the area of the patient rooms, with the sink and cupboards, were not used. He stated they had not been used "for years." He stated the video cameras cannot be turned off at the nursing station by the MHS. The Security Supervisor stated the video cameras must be turned off at the main facility. He stated he was not aware of the ability to shut off individual video cameras at the off-site facility.

When asked if the MHS had the ability to shut off an individual camera view at the computer monitor, the Security Supervisor stated they could not. He stated he had the ability to reset the camera views on the monitor but it was a timely process and he had "never done it." When asked why the video cameras, which were not used, were not removed the Security Supervisor stated he believed it was due to the expense.

The Director of Accreditation and Patient Relations was informed of the observations and interviews conducted by surveyors at 3:00 PM on 2/21/18. She confirmed all patient rooms had video cameras and were recorded 24 hours a day. She stated when a patient performed personal hygiene or cares the MHS at the monitors was notified and would place a "sticky note" over the camera view for that patient.

The DON was interviewed at 3:35 PM on 2/21/18. He confirmed the facility policies were not followed and patients were not informed of the use of video cameras and surveillance in their rooms. He also confirmed the admission packet did not inform patients of the use of video cameras in their rooms and they did not consent for the use of video cameras and video recordings in their rooms. The DON confirmed there were video cameras in patient rooms which allowed view of the toilet and shower area when the bathroom door was open.

The facility failed to ensure the personal privacy of patients admitted to the BHU.