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JOHNS HOPKINS HOSPITAL, THE 600 NORTH WOLFE STREET BALTIMORE, MD 21287 Nov. 16, 2016
VIOLATION: PATIENT RIGHTS: PERSONAL PRIVACY Tag No: A0143
Based on a tour of the emergency department psychiatric pod, it was determined that 1) patients who occupy rooms are continuously monitored via video with no evidence to indicate patients are informed of this; and 2) it was also determined that the unit bathroom is continuously monitored which is a gross violation of patient privacy.

Observation in the emergency department behavioral health pod on 11/16/2016 revealed a number of curtained areas occupied by patients who were visually monitored by staff. A video monitor was noted at the nursing desk that showed continuous monitoring of two privately occupied patient rooms. Those patients appeared to be calm and/or sleeping. It was also observed that a non-clinical staff, a security guard, was sitting at the desk monitoring the video feed.

Interview with the monitoring security guard (SG#1) on 11/16 at approximately 1030 revealed that staff verbally inform patients when they are brought to the psychiatric pod that they may be video monitored. Clarification with the RN unit manager, minutes later, revealed no record of documentation exists, no evidence of a handout, or signage to show that all patients are informed that they are on continuous video monitoring.

It was also observed at the nursing station monitor that the unit bathroom was on continuous video monitoring. The toilet was observed on the monitor screen to have a whited-out square over the toilet seat. However, anyone using the bathroom who then stood up from the toilet seat to adjust their clothing, would be exposed to viewing by the security guard or anyone else viewing the monitor.

While close monitoring of behavioral health patients is a standard of care, each patient has a right to know when they are under video monitoring in their respective rooms. Additionally, video monitoring in a patient bathroom is a significant violation of patient privacy. Therefore, the hosptial failed to respect the right of the psychiatric patient rights to privacy.