HospitalInspections.org

Based on record review and interview, the hospital failed to ensure that 1 of 12 sampled patients' (Patient 8) responsible party was notified of the "Certification Review Hearing" for the 5250 (the initiation of a 14 days detention for intensive treatment after the completion of an assessment and evaluation by the physician and prior to the expiration of the 5150 [an involuntary commitment of a patient for 72 hours for danger to one's self or others] or for a minor [a person under the age of full legal responsibility] to ensure that the patient met the criteria). This contributed in the responsible party not attending the hearing and filing a grievance (an official statement of a complaint over something believed to be wrong or unfair) with the hospital.

Findings:

On September 12, 2012, Patient 8's clinical record was reviewed. It noted that the patient was admitted to the facility on August 2, 2012 and discharged on August 7, 2012. The diagnoses included recurrent depression (a medical illness that causes a persistent feeling of sadness and loss of interest), psychosis (a symptom or feature of mental illness typically characterized by radical changes in personality, impaired functioning and a distorted or nonexistent sense of objective reality) and suicidal ideation (a medical term for thoughts about suicide).

A review of the face sheet (a form that included patient demographics and contact information) noted that Patient 8 was a minor. His mother was noted as his responsible party.

A review of the form titled, "Consent to Contact/Visitation", noted that it was signed by the patient on August 2, 2012 and included his mother and father to be contacted as needed.

A review of the hospital response to the grievance dated August 8, 2012, noted the following:

"...You expressed concerns regarding not being contacted about the date and time when your son would be having a certification hearing. A review of Policy and procedure was conducted, and the case was discussed with the Hospital patient Advocate. The (hospital) Policy for serving a patient with a 5250 Certification indicates that a patient (including minor patients) should be notified verbally of the date and time of their Certification Review Hearing at the time that they are served with the hold. Patients are informed that they have the right to have family members or other support attend the hearings if they wish. Patients are also given a fact sheet that indicates the day of the week and time that hearings are held...In the case of your son, he reported to the patient advocate that you would attend the hearing and indicated that you already knew about the hearing..." .

An interview was completed on September 12, 2012, at approximately 3:55 PM, with the Hospital Patient Right Advocate. She confirmed that she did not called Patient 8's parents to notify them of the hearing; she relied on the patient, a minor, to contact his parents. The Advocate stated that the patient reported that his mother was going to attend the hearing. On the date of the scheduled hearing, at 1:00 PM, when the mother was not present, the hearing was rescheduled to later that day to allow the patient time to contact his mother. The patient later stated that he was unable to reach his mother the afternoon of the hearing. The hospital policy for notifying parents of minors regarding certification review hearings was requested. The Advocate stated that there was not a specific policy that addressed the hospital responsibility for notifying parents of minors regarding the Certification Review Hearings.

An interview was conducted on 9/13/12, at approximately 7:50 AM, with the Corporate Director of Clinical Services. She stated, "I want you to know that the hospital has a policy in place for the notification of parents of minors for their Certification Review Hearing...The Advocate should have contacted the parents and notified them of the hearing and not relied on the minor to notify his parents."

A review of the hospital policy titled, "Involuntary Detention", initiated on December 1989, and revised on December 2011, included the following:
" 4. Upon receiving the information above, the hospital's patients' rights advocate shall:
a. Notify the patient of the date/time of the hearings;
b. If requested by the patient, notify the patient's next of kin or other family member/friend of the hearing date/time, after obtaining a release of Protected Health Information (PHI) must be completed;
c. Assist in providing information and guidance to the patient with regards to the scheduled hearing".