HospitalInspections.org

28849

Based on record review and interview, the facility did not ensure privacy for 1 of 36 patients (Patient #11).

Findings include:

Patient #11 was admitted to the facility on 03/06/2011 with diagnoses that included suicidal ideation, anxiety, depression, and alcohol intoxication. Patient #11 was placed on a Legal 2000 (State of Nevada's involuntary civil commitment process). Her record was reviewed on 11/09/2011. Patient #11's "Application, Certification, and Medical Clearance For Emergency Admission of An Allegedly Mentally Ill Person To A Mental Health Facility" (also known as the Legal 2000), stated in part, "...recently lost her sister, ex-boyfriend, and is currently having relationship problems with her current boyfriend". On 11/09/2011, the Chief Nursing Officer, Employee #10, was interviewed on 11/09/2011 at 2:00 PM. She stated that the emergency personnel had access to the Legal 2000.

Patient #11's facesheet indicated that her "emergency contact" was the individual named in the complaint that was described as her "abusive ex-fiance" (unauthorized representative). Patient #11's unauthorized representative signed her "Treatment Authorization" and her "Consent to Treatment". A billing document provided by the facility on 11/09/2011 at 2:45 PM, indicated that "PTS FIANCE SIGNED SOME CONSENTS...".

On 11/09/2011, the facility's Risk Manager (Employee #1), was interviewed. He stated that if a patient cannot sign their own consents, their spouse, adult children, parents, or siblings can sign the consents. He further indicated that friends are not authorized to sign consents for patients. The employee provided the policy titled "Informed Consent", dated July 2010. The policy defined "competency" as "For purposes of consent, competency is defined as an ability to understand the nature and consequences of that to which one is asked to consent...It includes those who.... alcohol or drug abuse, incapable of giving consent". The document further defined those who are authorized to sign for an incompetent patient, and friends were not included in the policy.

Based on the findings of this investigation, complaint # NV00029581 was substantiated.