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METHODIST DALLAS MEDICAL CENTER 1441 NORTH BECKLEY AVENUE DALLAS, TX 75203 Nov. 6, 2012
VIOLATION: PATIENT RIGHTS: CARE IN SAFE SETTING Tag No: A0144
Based on review of documents and interviews with staff, the facility failed to ensure care in a safe setting for 1 of 1 patient whose record was reviewed. Allegations of physical abuse of the elderly Patient #1 were reported and no occurrence report was filed; also, the facility does not have a procedure for investigating abuse allegations of elderly patients filed against hospital staff, which could affect patient safety.

Findings included:

An in-person interview was conducted the morning of 11/6/12 with Staff #2, Nurse Manager for the unit where Patient #1, an elderly individual, was inpatient. Staff #2 stated the patient's family member reported that Patient #1 appeared withdrawn, and the family member alleged that the patient was "handled roughly" by a Patient Care Technician (PCT), Staff #4. The Manager added that there was no evidence of abuse outwardly upon examination of Patient #1 and the PCT was removed from caring for the patient at the family member's request. The Nurse Manager stated that the allegations of physical abuse were not discussed with the PCT.

Review of a handbook given to new employees entitled, Risk Management, Your Important Role as a Methodist Employee, states under the section Occurrence Reporting, that "Anything out of the normal for a patient ...should prompt an Occurrence Report." No report was found documenting the allegations of "rough handling" by a Methodist employee, which had been reported to the employee's supervisor, Staff #2, by the patient's family member.

Review of the medical record for Patient #1 revealed that the patient was elderly and also had a psychiatric diagnosis. There was no documentation of the allegations of abuse. The patient remained stable with no complaints throughout the hospital stay. There was no documentation of bruising or other signs of abuse.

In-person interviews were conducted the morning of 11/6/12 in a facility conference room with the hospital Director of Quality and the hospital Risk Manager. The Quality Director, Staff #1, acknowledged that there was no occurrence report filed regarding the allegation of abuse of Patient #1 as reported to the unit Nurse Manager by the family member. The hospital Risk Manager, Staff #3 acknowledged that the hospital does not have a policy about how to proceed if an employee is accused of abusing an elderly patient.