HospitalInspections.org

Based on document review and staff interview, the acute care hospital's administrative staff failed to protect all patients from all forms of abuse, neglect, or harassment when they failed to notify the Department of Inspection and Appeals (DIA) of an allegation of dependent adult abuse for 1 of 1 patients (Patient #1) who was an inpatient on the medical/surgical floor. Failure to protect patients from all forms of abuse may result in significant mental anguish, physical pain, injury, long term disability or death. The hospital reported an average daily census of 64.

Findings include:

1. Review of "Child Abuse, Newborn Safe Haven, Dependent Adult Abuse, Domestic Violence and Sexual Assault", last reviewed 08/2019, revealed in part, "In the event the health practitioner examines attends, or treats an adult, or has reason to believe the adult, defined as dependent, has suffered abuse, the practitioner will meet the requirements of the law by making a report both verbally and in writing as follows: ... Immediately notify ... the Iowa Department of Inspections and Appeals ... within twenty-four hours of such notification, if there is a reasonable belief that the dependent adult abuse took place in a facility or program ... Complete a written report form (Suspected Dependent Adult Abuse Report Form). A copy of the written report will be made to the Department of Human Services within 48 hours after the verbal report." (The Iowa Department of Inspections & Appeals is responsible for reviewing allegations of dependent adult abuse allegations in hospitals, not the Department of Human Services)

2. Review of medical record revealed that on 06/08/20 Patient #1 was admitted to the acute care hospital due to altered mental status. Patient #1 was described as blind and very hard of hearing. Patient #1 lived in a care facility and was discharged back to that care facility on 06/12/20.

3. Review of the hospital's internal investigation, dated 06/15/20, revealed in part, "... received a phone call ... regarding a complaint one of their patients had regarding their care from us. [Patient #1] was discharged on 6/12 ... and was reporting on the morning of 6/12 around 0600 a staff member bit [Patient #1's] inner thigh to which the patient did have a bruise present. [Patient #1] identified the staff member as "short Korean man." [Patient #1] also reported to them that this person did inappropriately touch [Patient #1] by touching [Patient #1's] chest."

4. During an interview on 07/22/20 at 12:30 PM, the Medical/Surgical Director acknowledged they received a report of alleged abuse, that happened at the hospital, and had not reported that alleged abuse to any state agency
The Medical/Surgical Director revealed they felt there was nothing in the investigation that needed any further follow up.