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.

HAVEN BEHAVIORAL HOSPITAL OF PHOENIX 1201 SOUTH 7TH AVENUE, SUITE 200 PHOENIX, AZ 85007 Aug. 21, 2012
VIOLATION: PATIENT RIGHTS: PARTICIPATION IN CARE PLANNING Tag No: A0130
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**

Based on review of Pt #3's medical record, policy/procedure for the multidisciplinary treatment plan, and staff interview, it was determined the hospital failed to provide an opportunity for Pt #3's Mental Health Power of Attorney (MHPOA) to be included in the development of the multidisciplinary treatment plan.

Findings include:

Pt #3 was admitted on [DATE] with dementia and increasing agitation.

Consent for Admission was signed by the daughter / MHPOA and documents were in the medical record confirming the daughter had MHPOA. The Mental Health Power of Attorney Statutory Form was signed, dated, witnessed and notarized on 07/14/05. According to the Clinical Evaluator's Intake assessment dated [DATE] at 1420, the MHPOA was to sign for admission documentation/consents for treatment. According to the Quality Director the intake professional determines if the patient needs to have someone else sign for admission.

The Interdisciplinary Treatment Plan was developed on 02/26/12. The signature line on the form for the patient/family involvement was not signed by the MHPOA. A social worker's note dated 03/03/12, indicated the daughter (MHPOA) would like to stay informed of the changes to the patient's care.

The hospital's policy titled Treatment Plan dated 06/30/09 and revised 11/2011, required: "...The treatment team shall establish a plan for involvement of the family and/or significant others when appropriate...The patient and/or family, if indicated, signs the Treatment Plan after review with a member of the treatment team...The Treatment Plan shall be reviewed and updated as frequently as clinically indicated...but a minimum, the treatment plan is to be reviewed weekly...."

On 08/17/12 at 1630 the Director of Quality confirmed the treatment plan did not have an update according to the requirements of the policy, nor did the treatment plan document involvement with the family (MHPOA).

According to the patient's multidisciplinary treatment plan the patient's MHPOA/family did not sign the treatment plan to indicate their involvement with the development of the plan.

On 08/21/12, the DON confirmed the MHPOA/family were not apprised of the treatment plan and included in the development of the plan.