The information below comes from the statement of deficiencies compiled by health inspectors and provided to AHCJ by the Centers for Medicare and Medicaid Services. It does not include the steps the hospital plans to take to fix the problem, known as a plan of correction. For that information, you should contact the hospital, your state health department or CMS. Accessing the document may require you to file a Freedom of Information Request. Information on doing so is available here.

CAMDEN CLARK MEDICAL CENTER 800 GARFIELD AVE PARKERSBURG, WV 26101 Jan. 17, 2013
VIOLATION: NURSING CARE PLAN Tag No: A0396
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on review of documents, medical records and staff interview, it was determined the facility failed to ensure nursing staff evaluated the nursing care of the patient, by not evaluating/updating the plan of care in two (2) of ten (10) medical records reviewed (patients #1 and 5). This has the potential to negatively affect patients by nursing not being able to prioritize the care of the patient based on needs of the patient.

Findings include:

1. Hospital policy titled "Nursing Process Provision and Documentation of Nursing Care, Assessment, Planning, Education and Discharge Planning" states in part: "The Plan of care is initiated by the RN completing the initial nursing assessment. The nursing care plan will be evaluated each shift by the RN responsible for overseeing the patient's care and updated to reflect patient needs and progress."

2. Patient #1 was admitted on [DATE] and discharged on [DATE]. The nursing care plan was initiated on 11/14/12 and not evaluated or updated on 11/15/12, 11/23/12, 11/27/12, 11/29/12, 11/30/12 and 12/2/12 and 12/4/12.

3. Patient #5 was admitted on [DATE]. The plan of care was not evaluated or updated until 1/13/13.

4. During an interview with the Clinical Nurse Manager of 1E on 1/15/13 at 1550, these records were reviewed and she agreed with these findings.
VIOLATION: PATIENT RIGHTS: GRIEVANCES Tag No: A0118
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on review of documents and staff interview, the facility failed to ensure the complaint process identified in facility policy was followed in one (1) of one (1) complaint records reviewed (patient #1). This has the potential to negatively affect all patient's by leaving them unaware as to the outcome of the hospital investigation.

Findings include:

1. Hospital Policy titled Complaint Management states in part: "If a concern cannot be resolved within 7 days, if the investigation is not complete, or if the corrective action is still being evaluated, the Hospital's written response should address the hospital is still working to resolve the complaint and will follow up with another written response within twenty one (21) days from the time the concern was received".

2. The complainant filed a complaint with the hospital relative to the lack of care Patient #1 received during her hospital stay. The hospital sent a letter of response back to the patient stating an investigation was on going and she would receive a response with the findings within twenty one (21) days of receipt of the complaint. The complaint letter was received by the hospital on [DATE]. As of 1/17/13 the complainant had not received a response from the hospital.

3. During an interview on 1/14/13 with the Director of Patient Safety, she stated the patient should have received the second letter on 1/8/13. As of 1/17/13, the hospital still had not sent a response to the complainant with the findings of their investigation.
VIOLATION: PATIENT RIGHTS: CARE IN SAFE SETTING Tag No: A0144
Based on interview held with the Director of Operations/HR (DOHR) on 1/15/13 at 0955, it was determined the facility has no written policy or procedure in place to protect patients from staff abuse or harassment. This has the potential to negatively affect all patients by staff not being removed from patient care after allegations of abuse/harassment are reported and staff having the ability to continue the abuse/harassment.

Findings include:

1. The DOHR stated the facility does not have a written policy or procedure relevant to allegations of staff abuse/harassment towards a patient. He stated there are "unwritten" steps to the process. He revealed the first step was investigate the allegations. Then interview staff members, family members (of patient) and any other witnesses. If there is a credible issue, then the staff member would be suspended pending further investigation and when complete would return to patient care or be terminated. If the problem arises on night shift or weekends, then the Shift Resource Coordinator would remove the staff member from patient care "if a bad complaint."

2. The DOHR then stated he had not been made aware of this complaint or allegations of neglect/abuse filed against RN #1 until the State Agency (SA) arrived to investigate the complaint on 1/14/13.
VIOLATION: RN SUPERVISION OF NURSING CARE Tag No: A0395
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on review of medical records and staff interview it was determined the facility failed to ensure nursing documented the evaluation of the patient after the administration of pain medication in two (2) of two (2) medical records reviewed (patients #1 and 9). This has the potential to negatively affect patients by the nurse being unaware if relief was received or if there was an adverse reaction to the medication.

Findings include:

1. Patient #1 was admitted on [DATE]. Documentation in the medical record of pain medication given on 11/16/12 at 1416 and 2114 did not include a follow up reassessment one (1) hour post medication.

2. Patient #9 was admitted on [DATE]. Documentation in the medical record of pain medication given on 1/13/13 at 2245, 0017, 0623 did not include a follow up reassessment one (1) hour post medication.

3. During an interview with the Director of Acute Care on 1/14/13 at 1515, she stated when patients get pain medication, the expectation is the nurse will reassess the patient in one (1) hour and document the response to the pain medication.

4. These medical records were reviewed with the Clinical Nurse Manager of 5N on 1/15/13 at 1500 and 1/16/13 at 1115 she agreed with these findings.