The Santa Barbara County Psychiatric Health Facility was found to be back in compliance with federal regulations last month after undergoing a major overhaul of its premises and services over the past year.
Following the death of a patient who was being held in seclusion in 2010, auditors from the Centers for Medicare & Medicaid Services visited the hospital several times between January and December 2011 and filed a 150-page report documenting numerous infractions including improper recordkeeping, missing prescription drugs and poor food quality. The 16-bed facility failed two consecutive audits before being deemed up to federal standards during a surprise CMS investigation last month.
According to the CMS report, some of the facility’s most pressing problems were omissions in patients’ medical records.
“Based on medical record review and staff interview it was determined that for 1 of 6 discharged patients (Patient N6), there was no recapitulation of significant events that had occurred during hospitalization,” the report stated. “This failure compromises the effective transfer of the patient’s care to the next care provider by not providing information that identifies either effective or ineffective treatment strategies for the individual patient.”
According to the document, one oversight included a situation in which a patient had been treated for infection after suffering a bite wound at the hands of another patient. The discharge papers, however, were marked as “uneventful hospital course.”
Following the CMS’s second audit in August 2011, Director of Alcohol, Drug and Mental Health Services Ann Detrick said the institution formed a plan to improve their facilities to meet and exceed federal standards.
“We made several improvements that allow our nursing and psychiatric staff to better monitor our patients’ conditions, as well as provide more specialized treatments to meet our patients’ needs,” Detrick said. “We are building in stronger monitoring mechanisms on documentation so that when people document patients’ interventions and plans, we have staff looking at the documents to make sure they are done properly.”
Detrick also said significant changes were made to the counseling and social work departments in order to provide more effective treatment.
“There was a need for more structured, more diverse group interventions during the day and weekend,” Detrick said. “We have revamped the programs offered during the day and made them much more active and vibrant. More groups are running and there are more activities for people in the unit to be involved in.”
Santa Barbara County Third District Supervisor Doreen Farr said county officials took the CMS audits very seriously and expected the facility to meet the required standards.
“It was my assumption that our staff would do whatever they needed to do to correct any deficiencies that were found,” Farr said. “This is an extremely important facility for the county, and I cannot imagine that we would be in the position where we would be out of compliance and unable to operate.”