[I]n a report released Monday, accreditation officials cited the Vermont Psychiatric Care Hospital in Berlin for 44 different regulatory violations found during a three-day inspection that started June 29.
The Joint Commission, which accredits hospitals and other health facilities across the country, says it found 25 “moderate risk” problems at the hospital, including 17 that were “widespread,” and 19 “low-risk” problems, eight of which were widespread.
The most serious citations say some of the patients were receiving “informal” treatment and question whether the state had adequately trained staff working at the hospital and whether staff were diagnosing patients correctly and keeping adequate records for patients.
The Joint Commission’s official accreditation report also says the hospital does not adequately keep infections from spreading, has not adequately credentialed some of its staff, and had not tested whether major machinery would work in case there were an emergency, such as a power outage.
Melissa Bailey, the deputy mental health commissioner, responded to the report: “The majority of the report is about documenting services that are happening or treatment plan documentation, and (there are) no current safety concerns related to patient care.”
Bailey said the department’s psychiatrist has been working with the staff on corrective actions and that department leaders “are confident that all of the deficiencies or corrective action will be in place by the time (the) Joint Commission returns” in the next two weeks. She said Vermonters should feel confident in the safety of the psychiatric hospital.
The Vermont Psychiatric Care Hospital opened in August 2014 with 25 beds. The Department of Mental Health has faced repeated challenges recruiting staff for the hospital, and some people awaiting psychiatric care have spent long periods in emergency rooms.
According to the report, staff at the hospital did not record individual patient symptoms for six patients. The diagnoses identified in those patients’ files were generic, according to the report, such as “psychosis” and “aggression in the community in the context of psychiatric illness.”
Another patient was listed as having “disorganized and dangerous behavior in the context of untreated psychosis,” while others were listed as having “anxiety in the context of psychosis and cannabis use” and “delusions/unrealistic beliefs in the context of violent history and lengthy incarceration.”
The report found that seven patients did not have individual treatment plans, and reviewers faulted the director of nursing for that. The director of nursing had experience in psychiatric nursing at the time, according to the report, but no documented proof of holding a master’s degree.
When patients were given plans, the goals that staff outlined for them were not measurable in seven of nine cases examined, according to the report. The plans asked the patients to “practice nonviolence and present more reality-based thinking,” “appear less distracted” and “continue discussions about his recent symptoms and perception of events leading to arrest.”
“For one patient chart reviewed, short-term goals were ‘Team feels his health may decline and his risk increase if hospitalization is prolonged. Process is best advanced by emotional management skill building,’” the report said, adding, “This goal is not measurable.”
The full report is available here.
