HospitalInspections.org

Based on record review and interview the facility failed to ensure the right of 1 of 13 patients (Patient #2) to make informed decisions regarding his care. Patient #2 was held at the facility for 81 days without an involuntary admission court commitment or informed consent.

Findings included:

Record review of Patient # 2 ...reflected the patient was admitted involuntary on 12/22/2023. An Affidavit of Facts Supporting the Physician's Application for Emergency Detention form was completed and notarized on 12/22/2022. The affidavit stated the patient "refuses medications," "yelling and pushing other patients," and making "verbal threats."

A Conditions of Admission and Application for Admission involuntary form was signed and dated by two employees on 12/22/2022, untimed. The space requiring the patient's signature reflected the comment "unable to consent." There was no evidence of other Conditions of Admission and Application for Admission forms in the patient's chart. There was no evidence of an emergency detention order (EDO), certificate of medical examination, or application for an order of protective custody found in the patient's chart.

Supplemental Contact Note dated 12/23/2022 at 10:30 AM by Personnel #7, Court Liaison, reflected the following, "During treatment team meeting on 12/23/22 this writer was first informed pt was admitted invol (involuntary) under a '[Facility] invol' status ... intake staff did not believe any application was completed within allotted time frame. At this time pt is within non-compliance to complete a '[Facility] invol application.'"

Personnel #7 acknowledged during an interview on 8/8/2023 at 11:10 AM, an EDO was never obtained on Patient #2. When Patient #2 was admitted a [Facility] Involuntary Admission was supposed to be filed with Denton County within 12 hours of admission. Unless filed request is not filed within the 12-hour deadline, the court would automatically decline the request. The legal paperwork was never completed for Patient #2 during his three-month long hospitalization.

The facility policy titled "Patient Rights," dated 11/2021 reflected patients had the right " ...of habeas corpus ...to be presumed mentally competent unless a court has ruled otherwise ..."

The facility policy titled "Appropriate Use of Involuntary Commitment" dated 05/2021 noted "Patients arriving to facility and are deemed a danger to self or others on a walk-in basis and refuse treatment can be involuntarily admitted per the order of the physician. At admission, CME and MH App along with a Magistrate's Warrant for immediate admission will be presented to Denton County Mental Health court for processing and potential involuntary commitment for continued Order of Protective Custody (OPC) ..."