HospitalInspections.org

Based on observation, document review and staff interview it was determined the Director of Inpatient Services failed to ensure adequate staffing of a registered nurse (RN) on one (1) of three (3) units toured. This failure has the potential for all patients to have an incomplete ongoing assessment of their needs.

Findings include:

1. A tour of the Residential Treatment Center (RTC) was conducted on 8/17/16 at 9:55 a.m. with the Nurse Manager of the unit. Upon entry to the unit it was noted one (1) Mental Health Service Worker (MHS #1) was sitting at the nursing station talking with a patient. During the tour no other staff was seen.

2. Review of the policy titled, "Chestnut Ridge Center Staffing Plan Policy", last revised 6/2015, revealed it does not give a clear directive as to the type of licensed personnel to be staffed on the RTC.

3. An interview was conducted with MHS #1 during the above noted tour and when asked if an RN was scheduled to be on the unit he stated, in part: "No, they are on the other unit. We call if we need them."

4. An interview was conducted with the RTC Nurse Manager during the tour and when asked if an RN is scheduled to work the unit she stated, in part: "No, they are through this door in the Adolescent Unit."

5. An interview was conducted with the Director of Inpatient Services on 8/17/16 at 10:30 a.m. When asked if an RN is staffed on the RTC unit she stated: "No, as a Psychiatric Residential Treatment Facility (PRTF) we were informed from a previous surveyor we only needed an RN on our acute units and not on the PRTF because it's not an acute unit, it is a residential facility. An RN only needs to be available in house and our supervisor is available on every shift to those units." West Virginia Department of Health and Human Resources Residential Child Care regulations [78CSR3- 22.3.a] indicate the average employee ratio for a psychiatric residential facility shall be one (1) employee to three (3) patients - not identifying specific roles.