HospitalInspections.org

The hospital has failed to ensure that the medical staff is accountable to the governing body for the quality of care provided to patients.

Findings include

During an Interview with hospital Staff #13 was informed that hospital staff are sleeping on the shift, and they were identified as one of the staff sleeping. Staff #13 confirmed there have been times when they have knodded off for a minute, but it has not exceeded 3 to 5 hours as alleged. Staff #13, indicated there have been times, that I have closed my eyes, and meditated because the stress of the job, and there are times that I have said my prayers due to the job.

During an Interview with hospital Staff #13, was asked if they are pawning off responsibilities on other employees rather than being able to complete them themselves. Staff #13 indicated that we are supposed to be working as a team, and sometimes they are asked to complete other responsibilities, that I may feel I do not have time to do but I am not pawning off my responsibilities.

During an Interview with hospital Staff #11, Staff #12, and Staff #15 were all interviewed separately at different times of the day. Each staff confirmed they had worked directly with Staff #13, and has been identified as sleeping on the unit and then waking asking other staff to completing some of her responsibilities to ensure they are all completed before shift change.

Policy
The hospital policy on Neglect Abuse dated 07/17/2019 reflected, "Perimeter Healthcare promotes and requires professional, ethical and legal conduct of staff. The advocacy role of health care is maximized when addressing issues of conduct of staff. Perimeter Healthcare assesses the conditions of illegal, unethical and/or unprofessional conduct of staff. All health care services providers will immediately report to the appropriate supervisors, manager, or department head any suspected illegal, unethical and/or unprofessional conduct by another individual. Illegal, unethical and/or unprofessional conduct by any health care services providers are prohibited behaviors and will be grounds for disciplinary action and reporting to local and or state regulatory and/or legal authorities as mandated by statue, hospital policy and/or regulation(s). It is the responsibility of all staff members and health care professionals of Perimeter Healthcare to report concerns regarding illegal, unethical and/or unprofessional conduct to hospital administration."

The hospital Policy on Patient Rights dated 07/17/2019, reflected, "The rights, benefits, responsibilities, and privileges guaranteed by the constitutions and laws of the United States of Texas unless they have been restricted by specific provisions of law. The rights include, but are not limited to, the right to impartial access to and provision of treatment, regardless of race, nationality, religion, sex, ethnicity, sexual orientation, age, or disability; the right to petition for habeas corpus; the right to register and vote at elections, the right to acquire use, and dispose of property including contractual licenses, permits, privileges and benefits under law, the right to religious freedom and rights concerning domestic relations."

The hospital Policy on Nursing Services 07/17/2019 reflected, "In order to protect the safety of patients and employees, immediate response shall be initiated for any violence by visitors and or prospective patients. All program staff are responsible for recognizing and observing the signs of potentially violent behavior, reporting it to the appropriate staff and acting within the limits of their position descriptions to protect, with the least restrictive method, any prospective patient visitors and all patients. The staff will respect and maintain the rights of patients at all times as defined in hospital policies and regulatory statues. A Code ten (10) may be called for assaultive/aggressive management of visitors and or prospective patients."

The hospital Policy on Observation Rounds dated 07/17/2019 reflected, "An accurate record of the whereabouts and behavior of all patients will be maintained during each shift."

The hospital Policy on Quality of Treatment "Ethics of Patient Care" 07/17/2019 reflected, "Perimeter Healthcare shall operate using the standards for organizational ethics related to patient care decision making."


The hospital Assessment and Reassessment of Patients dated 07/17/2019 reflected, "An accurate record of the patient's condition, care, and treatment is provided throughout the hospital visit. Screening and admission assessments and histories are completed upon arrival to the hospital and during the admission proves on the inpatient units. Reassessments are documented when there is a a significant change in patient status, post procedure, etc. Patient information obtained during reassessment will be documented in the patient's medical record. The family, guardian and/or legally authorized representative will be assisted to be involved throughout the assessment proves and the in the provision of care of the patient for all children and adolescent/youth admitted to the facility.

The hospital failed to ensure patient has the right to receive care in a safe setting.

Findings include;


During an Interview with hospital Staff #13 was informed that hospital staff are sleeping on the shift, and they were identified as one of the staff sleeping. Staff #13 confirmed there have been times when they have knodded off for a minute, but it has not exceeded 3 to 5 hours as alleged. Staff #13, indicated there have been times, that I have closed my eyes, and meditated because the stress of the job, and there are times that I have said my prayers due to the job.

During an Interview with hospital Staff #13, was asked if they are pawning off responsibilities on other employees rather than being able to complete them themselves. Staff #13 indicated that we are supposed to be working as a team, and sometimes they are asked to complete other responsibilities, that I may feel I do not have time to do but I am not pawning off my responsibilities.

During an Interview with hospital Staff #11, Staff #12, and Staff #15 were all interviewed separately at different times of the day. Each staff confirmed they had worked directly with Staff #13, and has been identified as sleeping on the unit and then waking asking other staff to completing some of her responsibilities to ensure they are all completed before shift change.

Policy
The hospital policy on Neglect Abuse dated 07/17/2019 reflected, "Perimeter Healthcare promotes and requires professional, ethical and legal conduct of staff. The advocacy role of health care is maximized when addressing issues of conduct of staff. Perimeter Healthcare assesses the conditions of illegal, unethical and/or unprofessional conduct of staff. All health care services providers will immediately report to the appropriate supervisors, manager, or department head any suspected illegal, unethical and/or unprofessional conduct by another individual. Illegal, unethical and/or unprofessional conduct by any health care services providers are prohibited behaviors and will be grounds for disciplinary action and reporting to local and or state regulatory and/or legal authorities as mandated by statue, hospital policy and/or regulation(s). It is the responsibility of all staff members and health care professionals of Perimeter Healthcare to report concerns regarding illegal, unethical and/or unprofessional conduct to hospital administration."

The hospital Policy on Patient Rights dated 07/17/2019, reflected, "The rights, benefits, responsibilities, and privileges guaranteed by the constitutions and laws of the United States of Texas unless they have been restricted by specific provisions of law. The rights include, but are not limited to, the right to impartial access to and provision of treatment, regardless of race, nationality, religion, sex, ethnicity, sexual orientation, age, or disability; the right to petition for habeas corpus; the right to register and vote at elections, the right to acquire use, and dispose of property including contractual licenses, permits, privileges and benefits under law, the right to religious freedom and rights concerning domestic relations."

The hospital Policy on Nursing Services 07/17/2019 reflected, "In order to protect the safety of patients and employees, immediate response shall be initiated for any violence by visitors and or prospective patients. All program staff are responsible for recognizing and observing the signs of potentially violent behavior, reporting it to the appropriate staff and acting within the limits of their position descriptions to protect, with the least restrictive method, any prospective patient visitors and all patients. The staff will respect and maintain the rights of patients at all times as defined in hospital policies and regulatory statues. A Code ten (10) may be called for assaultive/aggressive management of visitors and or prospective patients."

The hospital Policy on Observation Rounds dated 07/17/2019 reflected, "An accurate record of the whereabouts and behavior of all patients will be maintained during each shift."

The hospital Policy on Quality of Treatment "Ethics of Patient Care" 07/17/2019 reflected, "Perimeter Healthcare shall operate using the standards for organizational ethics related to patient care decision making."


The hospital Assessment and Reassessment of Patients dated 07/17/2019 reflected, "An accurate record of the patient's condition, care, and treatment is provided throughout the hospital visit. Screening and admission assessments and histories are completed upon arrival to the hospital and during the admission proves on the inpatient units. Reassessments are documented when there is a a significant change in patient status, post procedure, etc. Patient information obtained during reassessment will be documented in the patient's medical record. The family, guardian and/or legally authorized representative will be assisted to be involved throughout the assessment proves and the in the provision of care of the patient for all children and adolescent/youth admitted to the facility.