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Tampa General Hospital Passes Inspection

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By SHERRI ACKERMAN

The Tampa Tribune

Published: September 6, 2008

TAMPA - Tampa General Hospital psychiatric patients no longer are considered to be in imminent danger following a federal inspection that ended Friday.

"The surveyors informed us we had addressed all the issues and the immediate jeopardy no longer existed," hospital spokesman John Dunn said.

The findings come a little more than two weeks after federal health authorities warned the hospital it would lose tens of millions of dollars in Medicare reimbursements if quick action wasn't taken to ensure patients' safety.

Two psychiatric patients committed suicide in the same room less than two days apart in July, prompting an investigation by the Centers for Medicare & Medicaid Services. Investigators said conditions were so bad they posed "an immediate and serious threat to the health and safety of patients."

Tampa General officials submitted an 85-page corrective action plan last week that included removing closet and bathroom doors, which were used by the two patients to hang themselves. Video monitoring also was installed in all patient rooms, the dining room, television area and group therapy rooms.

A charge nurse on duty during each shift now must "monitor the environment of care, safety and door locks" along with making unannounced assessments that will be reported daily to a manager.

Those reports will be shared monthly and quarterly, rising through the chain of command to the hospital's board of directors.

All patients requiring constant visual observation will be assigned a dedicated staff member. Patients will sleep in their room unless they request permission to sleep in the hall. If that happens, they will be reported to a physician who will help develop a plan to make the patient feel comfortable in the room.

Video monitoring will provide continuous observation of patients even while they sleep. A full-time psychiatric clinical nurse with a master's degree will oversee monitoring and assessments. Additional mental health counselors will be hired to provide seven-day-a-week coverage.

If necessary, supplemental staffing will be provided and overtime pay offered. Ongoing education will be provided as needed and at a minimum on a monthly basis.

Seven state surveyors spent the past four days making sure the plan was in place and working, Dunn said.

The hospital could undergo future inspections, Dunn said, "but the immediate jeopardy is lifted."

"No conditions were out of compliance," confirmed Lee Millman, spokeswoman for the Centers for Medicare and Medicaid Services.

That agency oversees reimbursements of Medicare and Medicaid payments and had threatened to yank its contract with Tampa General by today unless the hospital addressed problems in its psychiatric ward. The hospital received $168 million in Medicare reimbursements last year.

Problems cited in the initial investigation included lapses in patient oversight and discrepancies in documentation. Cleaning chemicals were left in an unlocked closed. Patient checks, required at 15-minute intervals, either weren't done or weren't documented, and the ward appeared to be understaffed.

Ron Hytoff, the hospital's chief executive officer, would not comment on TGH's corrective plan. But this statement was included in the documents:

"The Governing Body, Senior Management, Nursing Services, and the entire TGH community accept responsibility for the untoward events related to the care provided to our psychiatric patients and have put together a comprehensive plan that will restore the public trust by providing a safe environment for these patents."

Reporter Sherri Ackerman can be reached at (813) 259-7144 or sackerman@tampatrib.com.

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