HospitalInspections.org

Based on interview, record review, review of the facility's documents and policy, it was determined the facility failed to ensure it maintained an emotionally safe, respectful, and dignified environment for patients for one (1) of ten (10) sampled patients (Patient #1).

Patient #1 and his/her Power of Attorney (POA) were exposed to disrespectful language and behavior by a staff member.

The findings include:

Review of the facility's policy titled, "Notification of Patient Rights and Notification of Admission to the Facility," policy number P29, effective date 02/2014, revealed each patient admitted to the facility was to be informed of his/her rights and the facility would provide the patient an unsigned written notice of his/her rights in their admission packet. Continued review revealed the patient would sign and date the document to acknowledge receipt of these rights which would be scanned into the electronic admission chart and the original filed in the hard copy medical record.

Review of the facility's document titled, "Inpatient Bill of Rights," document number 10-125, dated 01/22/13, revealed each patient had the right to considerate and respectful care in a safe setting.

Review of Patient #1's medical record revealed the facility admitted the patient on 01/22/14, with a diagnosis of Aftercare for a Total Knee Replacement. Continued record review revealed a "Durable POA" dated and notarized on 08/20/2007, which named an individual as his/her POA. In addition, the record revealed a signed acknowledgement of receipt of the "Inpatient Bill of Rights" by Patient #1 dated 01/22/14.

Interview with Patient #1 on 03/20/14 at 4:24 PM, revealed on the day of discharge from the facility, 02/05/14, his/her POA was escorted to his/her room by a security guard and told to shut their mouth. Patient #1 stated the security guard told the POA that if he did not stay quiet, he would remove him and have him arrested. Patient #1 reported the security guard said his "Durable POA" was not a valid, legal document because it had not been signed by a Judge. In addition, Patient #1 stated he/she felt the security guard was threatening, mean, and nasty to his/her POA which caused him/her to be emotionally upset and scared.

Interview with the Security Guard on 04/03/14 at 11:44 AM, revealed he had escorted Patient #1's POA to his/her room on 02/05/14, during the discharge process. He stated he had been called to the floor by staff because the POA was being unruly and belligerent to staff. The Security Guard stated when he and the POA went inside Patient #1's room, he was shown the "Durable POA" by the POA. According to the Security Guard he told the POA if the instrument was not court ordered it was not a legitimate document. The Security Guard stated he had not been instructed that a "Durable POA" was not valid unless court ordered. He further revealed he told the POA to sit and "zip" his "lip" or he would remove the POA from Patient #1's room. The Security Guard stated however he was not threatening to the POA and did not say he would send the POA to jail or have him arrested.

Interview with the Compliance Officer on 04/04/14 at 3:15 PM, revealed there was no policy or procedure on security guard behavior in responding to patient incidents. She stated there was not a written report or documentation of the contact between the Security Guard, Patient #1, and Patient #1's POA. An additional interview with the Compliance Officer on 04/04/14 at 5:55 PM, revealed the facility had not questioned the validity of Patient #1's "Durable POA." She stated her expectation would be for staff to use respectful language and demeanor when dealing with patients and their families. The Compliance Officer stated the Security Guard in this situation should have used more professional language and a less confrontational approach.