NC Psychiatric Hospital Fails Surprise Inspection, Could Lose Accreditation. Director Replaced

Report from Asheville, North Carolina.

A new director was appointed at Broughton Hospital on Monday after the hospital failed a surprise accreditation inspection last week.

Dr. Art Robarge, who was director of Broughton from 1986-89, has been named interim director, replacing Seth P. Hunt, who had been director since 1995.

Inspectors from the Joint Commission on Accreditation of Healthcare Organizations, an independent nonprofit, have notified Broughton they will recommend a preliminary denial of accreditation. That will give Broughton 45 days to address the problems found by inspectors, or it will lose its ability to receive payment from private insurance companies.

The hospital also did poorly in a recent mock run-through of a Center for Medicare and Medicaid Services inspection by N.C. Department of Health and Human Services staff.

Broughton cares for about 300 patients a month. It is the westernmost of the state’s four psychiatric hospitals and serves people from 37 counties.

The hospital lost certification to receive payment from Medicaid and Medicare in August, and the state has been paying roughly $1.3 million a month to make up for the federal money lost.

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Among the problems the Joint Commission found at Broughton Hospital:

Restrained patients

• There was insufficient proof that staff consistently does a daily physical exam on people who are in restraints to verify a continued need.

• The hospital had insufficient proof that staff had attempted nonphysical techniques before using manual restraint or seclusion.

Cleanliness and safety

• Infection control plans were inadequate, and there was inadequate risk analysis of infection-control data.

• The hospital provided insufficient documentation for fire alarm testing. Fire department connection tests had not been completed, and hospital plans did not show that the local fire department was called when a fire alarm sounded.

Documentation

• The hospital had inadequate proof that a patient had given informed consent for medication with psychotropic drugs.

• Legal guardianship of a patient was not always determined.

• Development of individualized treatment plans was inadequate.

• More than 50 percent of the discharge summaries that documented patient assessment, care, treatment and services were late.

Adobe Acrobat PDF Report from the state on the mock run-through of a Center for Medicare and Medicaid Services. (40 KB)