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.

OCEANS BEHAVIORAL HOSPITAL OF PERMIAN BASIN 3300 S FM 1788 MIDLAND, TX 79706 Sept. 7, 2018
VIOLATION: ORGANIZATION OF NURSING SERVICES Tag No: A0386
Based on a review of the clinical record and facility documentation, the director of the nursing service failed to be responsible for the operation of the service, including determining the types and numbers of nursing personnel and staff necessary to provide nursing care for all areas of the hospital.

Findings were:

Patient #1 fell on the following dates:
* 8-16-18
* 8-20-18
* 8-21-18
No post-fall assessment was performed by the nursing staff following the fall on 8-16-18 or the fall on 8-21-18.

Facility policy AS-12 titled "Fall Assessment/Re-Assessment and Precautions" states, in part:
"Policy:
Inpatient:
All patients will be assessed and identified for the potential of being at risk for falls within the first 8 hours of admission at the time of their initial nursing assessment, immediately after a fall and every 7 days if identified as moderate or high risk."

The above was confirmed in an interview with the DON and Director of Quality on 9-7-18.
VIOLATION: CONTENT OF RECORD - INFORMED CONSENT Tag No: A0466
Based on a review of documentation and a clinical record, the facility failed to ensure that informed consent was obtained prior to the administration of psychoactive medications.

Findings were:

Patient #1 was prescribed the following psychoactive medications during his stay:
* Risperdal
* Seroquel
No psychoactive medication consents were found for either medication. In an interview with staff #1, staff #1 confirmed that no psychoactive medication consents were present in the clinical record. The medication administration record provided documentation that patient #1 had been administered the above-listed medications during his stay.

Facility policy MM-02 titled "Psychoactive Medication Administration/Consent-Texas" states, in part:
"Policy:
" ...If psychoactive medications are prescribed by a LIP [licensed independent practitioner], a written informed consent must be obtained from the patient or legally authorized representative."

The above was confirmed in an interview with the DON and Director of Quality on 9-7-18.