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MCCAMEY HOSPITAL 2500 HWY 305 SOUTH MCCAMEY, TX 79752 May 6, 2015
VIOLATION: ABUSE (483.13(B)) Tag No: C0382
Based on review of documentation and interviews, it was determined the facility failed to ensure the pateint right to be free from sexual abuse, including sexual harassment. The Centers for Medicare Services interpretive guidelines states, "'Sexual abuse' includes, but is not limited to, sexual harassment, sexual coercion, or sexual assault."

Findings were:

The facility based "Personnel Policy and Employee Handbook" stated in part,

"F. Sexual Harassment: McCamey County Hospital District is committed to providing a working environment in which its employees are treated with courtesy, respect, and dignity ...
Sexual harassment is defined as unwelcome sexual advances, requests for sexual favors and other verbal, written, or physical conduct of a sexual nature by employees, supervisors, managers, medical staff, patients, visitors, contractors, salespersons, etc. where such conduct is either an explicit or an implicit term or condition of employment...

J. Rules of Conduct:..
18. Comply with the conduct standards of McCamey County Hospital District to include:
a. Treat all patients and guests in a proper service oriented manner."

Review of documentation and interviews, revealed that 2 patients (#1 and 2) had verbally complained to the facility that staff member #5 was behaving in an inappropriate and disrespectful manner towards them.

Patient #1 made allegations that staff member #5 touched them in an inappropriate manner while performing physical therapy.
* In an interview on 5/6/15, staff member # 2 stated, patient # 1 had informed that (patient #1) was uncomfortable around staff member #5 at times. She stated, " (Patient #1) told me that she didn't like the fact (staff member #5) could do things and act like she was stupid and didn't know what (staff member #5) was doing ...She told me once she was lying on the treatment table supine. (staff member #5) was at head of table, to do manual traction on her neck. While doing that (staff member #5) was rubbing the top of her head against his penis. She asked, 'why are you doing it that way?'. (Staff member #5) said, "That's the way I need to do it."
* This incident was reported to staff member #3, the human resource director. Per staff member #2, in an interview on 5/6/15, "(Patient #1) mentioned to (staff member #3) at times when laying supine or side lying, (staff member #5) would work on her hip and rub her leg against his penis. She could feel it wasn't flaccid. (Patient #1) told (staff #3) another thing... During an evaluation (staff #5) had her lay in prone positron without warning her or telling her what (they) was going to do (staff #5) grabbed her pants and underwear and pulled them down about mid-thigh. Her buttock was exposed. She got mad and asked 'why did you do that?' (Staff #5) said (they) had to examine her and she said, 'but not like that'. She says she felt no one will trust what she says or believe her. At first she was not confident enough to say anything because she thought no one would believe her.
* Staff member # 2 stated "Something I did see that (staff #5) did to (patient #1). There was visit where (staff #5) had her in supine position, last visit (staff #5) saw her, after that she refused. She was supine (staff # 5) was at her feet. I saw because I had the curtain pulled over enough. I saw (staff #5) grab one of her feet at the ankle. (staff #5) brought the bottom of the foot against (them) and rubbed it up and down. It looked to me liked the area of (their) penis. I was going to say something. But then (staff #5) moved away from her. After I asked if I had seen correctly and she said yes. "
* In an interview on 5/6/15,staff member #3, the human resource director, confirmed they were aware of this incident. They stated, "(Patient #1) came in with one of our employees. So I took (Patient #1's )statements and talked to a few people regarding her as an individual and the gentleman in question in terms of (staff #5) normal behavior around other folks to get an idea, to see if there were misinterpretations."
* In regards to his investigation, staff member #3 stated, "I could not find consistency in (Patient #1's) story or the witnesses she indicated. There was more consistency with (staff #5) story than hers.... (Patient #1) mentioned (staff #5) wanted her to be (their) girlfriend. It was kind of out there, her story. (Staff #5) was on administrative leave for 3 days while I did the investigation ...(Staff #5) showed me videos on YouTube where he gets some of his instruction for exercises. In the videos the instructors had patients positioned in ways (patient #1) talked about."
* The only documenting of an investigation that staff member #3 had were the following:
A typed document entitled "Complaint filed 2-5-2015" which listed the following occurrences of staff member #5 acting inappropriately towards patient #1: rubbing private parts on my leg, moving his private area closer to their head, placing their feet against his private until they could feel an erection, pull down their pants during an evaluation, and while having an adjustment on 2/5/15 placing their foot on his private area.
An email dated 02/10/14 from staff member #3 to staff member # 1 that stated in part, "On 2-5-2015 I was presented with complaint from a female that Mr. Smith had acted in an unprofessional manner by sexually harassing her ...After conducting several interviews with witnesses in an attempt to confirm the accused actions I was not able to confirm that the actions actually happened in the manner that was described by the female accuser ...."


Patient #2 also made allegations that staff member #5 touched them in in an inappropriate manner while performing physical therapy.
* Per a written account patient # 2 reported to staff member # 2 that"she was face down on the treatment table when (staff member #5) asked if it was okay for (staff #5) to get on top of the table for her massage because it would help (staff #5) back since it was hurting too ...(Patient #2) said (staff #5) got on the table and actually sat on her back while (staff #5) was massaging her shoulders ...(Staff # 2) asked her if (staff #5) had full contact of (their) legs and butt on her back and she answered yes, (staff #5) felt heavy and she was upset (staff #5) did that to her." This allegation of inappropriate behavior was reported to staff member #3, the human resource director.
* In an interview on 5/6/15, staff member #3, the human resource director, confirmed they were aware of this incident. They stated," there was an occurrence...(staff member #2) again came in with (patient #2). We discussed how (staff #5) was performing a stretching of the back. (Staff #5) did admit (they) had climbed up on the table straddled her to do the stretch, that made (patient #2) uncomfortable. Are other ways to do that? There are several ways to produce that result. I counseled (staff #5) that was not an appropriate method, even though he accomplished what (they) needed to accomplish. But if (staff #5) makes the patients uncomfortable we're not doing what we need to do. (Staff #5) was given the warning to find other ways of doing this."
* In an interview on 5/6/15, staff member #4 also confirmed that patient #2 made this allegation against staff member #5. Staff member # 4 stated, "(Patient #2) in break room told me she was uncomfortable with (staff #5), '(staff #5) had me lay down on table and (they) got on top of me to straddle me to massage me'. (Patient #2) didn't know if that was the right way or not."

Review of the personnel record for staff member #5 revealed no disciplinary action or written counseling for the above alleged incidents of sexual harassment and inappropriate behavior. Staff member # 5 resigned and has not been employed at the facility since 3/20/15.

Per the facility based policy, "Sexual harassment is defined as unwelcome sexual advances, requests for sexual favors and other verbal, written, or physical conduct of a sexual nature by employees..."The facility failed to ensure the right of these 2 patients' right to be free from sexual abuse, including sexual harassment.