Mental hospital deemed unsafe

Inspectors fault new Butner facility

Staff WriterDecember 3, 2008 

— After an on-site review last month, inspectors determined that a state mental hospital in Butner is unsafe for patients, citing the new $138 million facility with multiple violations and endangering its federal funding.

In the report released Tuesday, the inspectors, state employees working on behalf of the federal Centers for Medicare and Medicaid, specifically criticized the staff at Central Regional Hospital for improperly restraining a patient face down two weeks ago.

Security camera footage also showed employees falsified records indicating the restrained patient, a 24-year- old man with schizophrenia, was being constantly monitored when he was not, according to the 131-page report.

In little more than a year, all four of North Carolina's remaining state-run mental hospitals have now either lost or been threatened with losing accreditation because of patient deaths or incidents of abuse and neglect.

A fifth hospital, closed last summer, had also been cited after employees beat a female patient while she was strapped down.

"We clearly have to address this as a systemic issue," Dr. Michael Lancaster, co-director of the state Division of Mental Health, said Tuesday. "We are looking at new approaches to seclusion and restraint."

The newest violations further imperil the state's plan to close Dix Hospital in Raleigh and transfer the patients and staff to the new facility in Butner.

A law enacted this year bars the state from moving Dix patients until Dempsey Benton, secretary of the state Department of Health and Human Services, can show that the new hospital meets all federal accreditation standards.

Benton issued that finding in September, but the inspectors' report directly contradicts the secretary's contention the new hospital is safe.

Five workers involved in the improper restraint -- one nurse and four health care technicians -- have been fired, according to a spokesman for the N.C. Public Service Workers union.

Patricia Swann, the nurse who was fired, said Tuesday a strained system is to blame.

"I think our terminations are politically motivated," Swann wrote in an e-mail. "This is a way to scapegoat workers for the system's neglect and abuse of patients."

Inspectors also found that a stairwell door at the new hospital could not be unlocked from the inside, potentially trapping patients and staff in an emergency.

"The survey findings resulted in an immediate jeopardy identification in regards to staff's failure to provide care in a safe environment, failure to prevent patient abuse, and failure to prevent patient neglect," the report said.

A finding of immediate jeopardy is the most serious classification the inspectors can cite. It means patients in the hospital are in danger of immediate harm if the problems aren't corrected.

The regulators cited two serious violations involving fire and emergency procedures at Dix, which is now being operated as a satellite campus of Central Regional pending the merger.

Lancaster said he has taken quick action to address the most serious issues in the report.

Federal regulators gave the hospital until Dec. 14 to submit the plan to correct the violations. The inspectors will make a surprise visit to confirm that the problems have been fixed.

Beyond the regulatory hurdles, a Superior Court judge issued an order in September barring the state from moving Dix's patients following a lawsuit filed by Disability Rights North Carolina.

That order is still in place.

John Rittelmeyer, legal director for the advocacy group, said Tuesday those in charge of the state hospital system are well-meaning, but incompetent.

"They have demonstrated one shortcoming after another," he said. "I hope that Gov.-elect Perdue will make this very sad situation a No. 1 priority when she comes into office."

michael.biesecker@newsobserver.com or 919-829-4698

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