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Based on observation, staff interview and record review, the facility failed to provide care in a safe setting on the Richard Young Hospital, acute psychiatric youth and adult facility campus. Potential hazards to patients included having large plastic trash bags in patient care areas and unsecured bulk powdered detergent found adjacent to the washing machines used by patients. The psychiatric census was 14. The total sample of 17 included 8 patients from the Richard Young Hospital campus.

Findings are:

A. Observations made from 3:30 PM to 4:15 PM on 7/14/14 of the Richard Young Hospital inpatient areas revealed 2 patient safety hazards in the patient care areas of both the adult and adolescent units. The adolescent unit had 1 kitchen area and the adult unit had 2 kitchen areas where large plastic garbage bags were being used to line the tall kitchen garbage containers. These areas are part of the open milieu on the units and are easily accessible to patients. Plastic bags present a potential threat to psychiatric patients as they can be used for homicidal or suicidal acts. The facility accepts Emergency Protective Custody (EPC) patients who present a threat to self or others. Both units had patients on suicide precautions on 7/14/14.

Observation of the patient laundry rooms during the tour on 714/14 revealed that each unit had a small locked laundry room containing 1 washer and 1 dryer for patient use. The adolescent unit had a locked cabinet in the laundry room. Sitting in an open box next to the washer was a bulk container of Ecolab Perma Brite Plus detergent. The adult unit also had a locked patient laundry room but no locked cabinet. Beside the washer was a bulk box with a heavy plastic liner containing Ecolab Perma Brite detergent. Once staff open the doors to the laundry area a patient could potentially scoop up detergent and ingest it. The laundry room doors are directly opposite the washer and dryer so staff may not be able to closely see what a patient is doing.

B. Record review of the Material Safety Data Sheet information provided by the facility on 7/15/14 for Eco-Brite Perma Brite Plus laundry detergent revealed it states "DANGER! Causes Digestive Tract, eye and skin burns. Causes Respiratory Tract irritation. Do not ingest. Do not get in eyes, on skin or on clothing. Avoid breathing dust. Use only with adequate ventilation. Keep container closed. Wash thoroughly after handling." Potential acute health effects included: "Corrosive to eyes; Corrosive to the skin; Severely irritating to the respiratory system; Causes burns to mouth, throat and stomach."

C. Staff interview with the Vice President of Patient Care Services on 7/14/14 at 5:10 PM revealed the plastic bags for the trash were brought into the facility within the last 2 weeks by environmental services to prevent ants. Further interview on 7/16/14 at 9:20 AM revealed Environment of Care rounds were made by the Director of Facilities on the Richard Young Hospital on 7/10/14. The Director did not not identify the plastic bags as a safety risk to patients. The Vice President of Patient Care Services stated the plastic trash bags were brought in without the psychiatric committee team's knowledge.