09/13/07 — Officials give hospital list of violations to fix

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Officials give hospital list of violations to fix

By Phyllis Moore
Published in News on September 13, 2007 2:00 PM

Cherry Hospital's certification and federal funding status were placed in "immediate jeopardy" this week after several complaints prompted a state investigation into practices at the hospital.

Cherry has until Sept. 30 to comply with recommendations, which include staff retraining, said Dr. Jack St. Clair, hospital director.

"Last week we were visited by two survey teams -- one from the Division of Health Services Regulations, formerly the Division of Facility Services, and the Joint Commission," he said Wednesday. "Visits by these two survey groups were prompted by complaints they received."

The review teams were at the hospital from Tuesday through Friday evening, he said. Their time was spent reviewing records and policy procedures, interviewing staff and observing patient activity.

Officials did not specify the number of complaints received nor the source, and St. Clair said he could not speculate on their origination. He did, however, receive a fax from the state office Monday citing the three conditions that led to the state being put in "immediate jeopardy," he said.

These were "improper use of handcuffs, failure to provide observation and documentation which resulted in the elopement of a patient and failure to provide timely care of a patient needing emergency care," he said.

All involved safety of a patient, prompting the state's sanction and giving the facility 23 days to comply with recommendations.

In that time, Cherry must "demonstrate that we have a plan in place and that we're monitoring compliance to that plan to make sure those violations are not repeated," St. Clair said, adding, "I don't think we're going to need 23 days.

"We started a course of action Friday evening even as they were leaving our campus, worked into the weekend to put a system in place. I think we'll be in place before those 23 days are up."

The 284-bed hospital, which serves 33 eastern counties, stands to lose federal funding if not in compliance. This comes on the heels of another mental health facility in the state, Broughton Hospital in Morganton, having federal funds yanked less than a month ago.

State officials said while Cherry's situation is "serious," it is not as severe as the situation at Broughton.

"Cherry will make the necessary corrections and have no further problems," said Mark Van Sciver, a spokesman for the Department of Health and Human Services.

St. Clair said every effort is being made to address problem areas before extreme measures are required. On average, he said, Cherry receives $700,000 a month in Medicaid and Medicare reimbursements, which represents 4 percent of the population.

The news is just another wrinkle to the challenges faced since the 2001 mental health reform changes were introduced. Hospital emergency rooms and private offices have borne the brunt of the overflow, but Cherry has likewise shown an increase in admissions.

"About this time last year, about 47 percent of the time we exceeded our capacity on our adult acute unit, so it does put added pressure on staff when we're over census," St. Clair said.

And that, said state Sen. John Kerr, D-Wayne, is exactly why a new Cherry Hospital is so desperately needed -- to take some of the pressure off the staff and patients so these kinds of errors don't occur.

"Our people at Cherry are working in an environment that's at least 50 years old, and until we get them a new facility, it's going to be difficult for our good employees to meet every rule and regulation," he said. "I have all faith everything will be fixed. This has happened before, and I'm sure that if anything was wrong, they've corrected it.

"I think all the people at Cherry Hospital do a terrific job with a difficult group of people to handle."

He does not think this latest development will hinder the move toward a new hospital by 2011. Schematic designs are scheduled to be done by Nov. 1.

"This is not going to have anything to do with the construction," Kerr said. "In fact, if anything, it should make the reasons to do it even more important."

St. Clair, however, refused to allow the need for a new facility as an excuse for inadequate care, saying that he stands behind his staff as it responds to ongoing changes to the system.

"We have got a committed group of folks who are very concerned about providing care to our patients," he said. "I need to reinforce efforts that our staff do here.

"The work is very difficult, there's no question about it. It's a population that's very difficult to deal with or else they wouldn't be here. I just admire that the staff is doing this kind of work and hanging in there with us."

-- Staff Writer Matthew Whittle contributed to this report.