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23515 HIGHWAY 190

MANDEVILLE, LA 70448

PATIENT RIGHTS

Tag No.: A0115

Based on interviews and record reviews, the hospital failed to meet the requirements of the Condition of Participation for Patient's Rights as evidenced by failing to take measures to seal off entry points to prevent bats from entering the building after recent sightings and securing patients once a new bat sighting was reported in a patient care area of the building. Bats were previously seen in the hospital on 06/14/19 and 08/12/19. This deficient practice presented a risk of patients being exposed to rabies from bat bites and histoplasmosis from bat guano (see findings tag A 144).


30364

PATIENT RIGHTS: CARE IN SAFE SETTING

Tag No.: A0144

Based on interviews and record reviews, the hospital failed to ensure patients received care in a safe setting as evidenced by failing to take measures to seal off entry points to prevent bats from entering the building after recent sightings and securing patients once a new bat sighting was reported in a patient care area of the building. Bats were previously seen in the hospital on 06/14/19 and 08/12/19. This deficient practice presented a risk of patients being exposed to rabies from bat bites and histoplasmosis from bat guano.
Findings:

In an interview on 08/26/19 at 10:12 a.m. with SF1Interim CEO, she said on 06/14/19 a patient and a staff member were bitten by a bat on Rampart Unit. She said on 08/12/19 a staff member and a patient stated they saw a bat in the Willow Unit day room.

Review of the hospital Pest Control policy #: EC-1058, Effective: 06/21/19. Revised: 07/25/19 revealed, in part:
Policy: The policy of Northlake Behavioral Health System (NBHS) is to manage pests according to established procedures. The presence of pests can be offensive, present infection hazards, contaminate foodstuffs, damage materials, building components and structures and also be a nuisance. Appropriate standards of pest control in both clinical and non-clinical areas are an integral part of providing an optimum environment for the delivery of quality patient care and the maintenance of staff health.
Appendix 1 - List and Description of Common Pests:
Bats: If a bat is flying around an interior space, remain calm, notify the Facility Supervisor and/or maintenance. If possible remove all people from the area. Always wear gloves when handling bat excrement (guano) and place in a biohazard bag. Remove patients from area where bats are found until cleared.

Review of the hospital incident report completed by SF3RN on 08/12/19 at 9:00 a.m. revealed, in part, SF3RN, SF4MHT, and a patient were in the hospital's Willow Unit day room when SF4MHT and the patient stated a bat flew into the window and went up in a hole that was in the ceiling above the patient's phone. SF3RN only saw something black go up in the hole in the ceiling.

In an interview on 08/27/19 at 12:07 p.m. with SF1Interim CEO, she said she reviewed video footage from the Willow Unit day room on 08/12/19 and did not see a bat in the video. She said maintenance came and searched the unit for the bat and no bat was found. She said maintenance fixed the hole in the ceiling tile. She said since no bat was seen or found, patients were not moved off Willow Unit.

In an interview on 08/27/19 at 1:08 p.m. with SF3RN, she said she was working on Willow Unit on 08/12/19. She said SF4MHT and a patient told her they saw a bat flew into the window and went up in a hole that was in the ceiling tile. She said she saw something black go up in the hole in the ceiling. She said maintenance came and searched for a bat and no bat was found.

In an interview on 08/27/19 at 2:01 p.m. with SF4Director of Plant Operations he said environmental tours were started for a period of time after a patient and a staff member were bitten by a bat on 06/14/19. He said the last hospital environmental tour for bats was on 07/05/19. He said screens were put in all interior ducts and vents inside Rampart Unit, Willow Unit, and Cypress Units. He said the hospital was told that nothing could be done until September to the exterior of the buildings to prevent bats from entering because bats were protected by law.

In an interview on 08/27/19 at 2:09 p.m. with SF4Director of Plant Operations, he said Wildlife Control Company A, who specializes in bat removal and remediation, was contacted today (08/27/19) and a representative was coming to the hospital to inspect Willow Unit, Rampart Unit, and Cypress Unit.

In an interview on 08/27/19 at 2:55 p.m. with Wildlife Control Company A representative, he said he was a member of the National Wildlife Control Operators Association and was Bats Standards Certified. He said he was a certified instructor for bat removal with eighteen years' experience. He said there were no restrictions on sealing the exterior of buildings to prevent bats from entering.

An observational tour was done of the exterior of the hospital's Willow Unit, Rampart Unit, and Cypress Unit with a representative of Wildlife Control Company A and SF4Director of Plant Operations on 08/27/19 at 3:10 p.m. Wildlife Control Company A representative found evidence that bats had entered the hospital's Willow Unit and Rampart Unit through building exterior points of entry. All three buildings were found to have potential points of entry for bats.

In an interview on 08/27/19 at 3:58 p.m. with SF1Interim CEO, she confirmed no measures had been taken to close off possible entry points for bats on the exterior of buildings. SF1Interim CEO said she was misinformed and found out today (08/27/19) that the hospital could take actions to prevent bats from entering through the exterior of buildings.


30364

INFECTION CONTROL PROGRAM

Tag No.: A0749

Based on record reviews and interviews, the hospital failed to develop a system for prevention and control of infections and communicable diseases as evidenced by failing to clean all areas, including air conditioner ducts and vents, in buildings of the hospital where bats were sighted. This deficient practice presented a risk of patients and staff being exposed to histoplasmosis from bat guano.
Findings:

Review of the hospital Pest Control policy #: EC-1058, Effective: 06/21/19. Revised: 07/25/19 revealed, in part:
Policy: The policy of Northlake Behavioral Health System (NBHS) is to manage pests according to established procedures. The presence of pests can be offensive, present infection hazards, contaminate foodstuffs, damage materials, building components and structures and also be a nuisance.
Appendix 1 - List and Description of Common Pests:
Bats: If a bat is flying around an interior space, remain calm, notify the Facility Supervisor and/or maintenance. If possible remove all people from the area. Always wear gloves when handling bat excrement (guano) and place in a biohazard bag. Remove patients from area where bats are found until cleared.

In an interview on 08/26/19 at 10:12 a.m. with SF1Interim CEO, she said the hospital had confirmed bat sightings on Rampart Unit in June 2019 in an air vent and in other areas of the unit. She said there was a reported bat sighting in the Willow Unit day room ceiling on 08/12/19.

In an interview on 08/27/19 at 2:46 p.m. with SF4Director of Plant Operations, he said the entire Rampart Unit was cleaned and attic was vacuumed after the June 2019 bat infestation. SF4Director of Plant Operations said the air conditioner ducts and vents were not checked for bat guano and cleaned on Rampart Unit and Willow Unit after the bat sightings.