Hospital reports sexual incident

Employee fired; 2nd suspended

Saturday, February 9, 2013

— One State Hospital employee was fired and another was disciplined after two patients were discovered half-dressed and “engaged in inappropriate behavior” in a bathroom at the public psychiatric hospital last month.

An internal investigation, released Friday by the Arkansas Department of Human Services, which operates the hospital, revealed that the employees did not follow patient monitoring policies in the time leading up to the Jan. 13 incident.

The incident comes shortly after the hospital finished more than a year of improvement and federal monitoring necessary to maintain its ability to receive Medicare and Medicaid funding. That improvement plan, conducted in cooperation with the federal Centers for Medicare and Medicaid Services, came after several documented cases of patient mistreatment or neglect at the hospital.

As the hospital worked to improve, patients’ advocates complained about how it addressed sexual interactions between patients.

Human Services Department spokesman Amy Webb said that, after the incident, the hospital is satisfied it does not need to ad-just its policies or implement new ones.

“We had the systems in place that we needed,” she said. “They were there, and they just weren’t followed. We had to take the necessary steps to address that with our staffers.”

In a bathroom attached to a patient seclusion room, staff found a female patient, who had been directed away from a men’s-only hallway several times that day, buttoning up her shirt while a male patient, who “was constantly trying to seduce any female [patient] he might have a chance with,” sat naked on the sink, the investigation report said.

The patients said they’d attempted to have consensual sex, but they were interrupted by other patients, the report said.

Hallway camera footage showed security officer Daquan Bryant did not complete required 15-minute rounds to determine the location and safety of patients on the unit, the investigation report said. Bryant was fired after the investigation, Webb said.

Video footage also showed that behavioral health aide Ida Lawson “may have been lax” in watching security monitors used to track patients, the report said. Lawson was given three days of unpaid suspension after the investigation, Webb said.

Three other staff members completed counseling or training after the incident, she said.

The hospital’s internal police department did not press any charges, an incident report said. Webb said the hospital turned its findings over to the Pulaski County prosecuting attorney’s office and to the Centers for Medicare and Medicaid Services, which she said closed its investigation without taking action.

A spokesman for the federal agency did not return phone calls Friday.

The State Hospital does not prohibit sex among consenting patients, but staff members attempt to prevent such encounters by redirecting patients, leaders have said.

In an interview, the charge nurse on duty at the time of the Jan. 13 incident said he was “aware of the attraction hazard presented by these two patients and yet the event transpired on his shift,” the investigative report said.

After a patient sexual incident at the hospital last year, the federally funded Disability Rights Center of Arkansas, which monitors patient treatment there, criticized the hospital’s lack of a written policy to determine if patients are capable of consenting to sex.Patients with developmental disabilities, acute mental illnesses or histories of sexual assault may not fully understand their actions, advocates said.

The hospital has since adopted a policy for addressing sexual incidents and consent, Webb said. She did not provide a copy of that policy Friday.

Neither patient involved in the January incident is developmentally disabled and neither is a forensic patient, Webb said. Forensic patients are in the hospital after being arrested on criminal charges and being found incompetent to stand trial or to be sentenced.

Staff members separated the two patients after the incident, and the man has since been discharged, Webb said.

Staff adherence to newly overhauled policies is a great concern to hospital administrators because past problems put millions in dollars of federal funding at stake. Administrators project that the hospital’s current fiscal year’s $44.2 million budget will include about $8.16 million in Medicaid funding and $3.8 million in Medicare reimbursements.

After a completing an extensive improvement plan that included several rounds of staff changes, policy evaluations and facilities improvements, the hospital’s staff learned in October that it was once again in “substantial compliance” with federal standards for Medicare and Medicaid providers.

The hospital’s improvement plan came after federal inspectors identified multiple cases of “immediate jeopardy” that threatened the health and well-being of patients there dating back to 2010.

Those situations included a suicidal adolescent who was taken to the emergency room after he bloodied his nose by beating his head on the door of a seclusion room. Federal inspectors also called for a “culture change” in the way staff members relate to patients and one another.

Arkansas, Pages 9 on 02/09/2013