DATE: Monday, November 17, 1997             TAG: 9711170055

SECTION: LOCAL                   PAGE: B9   EDITION: FINAL 

SOURCE: ASSOCIATED PRESS 

DATELINE: PETERSBURG                        LENGTH:   75 lines

ACCREDITING AGENCY INSPECTS STATE-RUN PSYCHIATRIC HOSPITAL, GIVES IT LOW MARKS

A state-run psychiatric hospital that was upbraided by the federal government also received low marks from a private accrediting agency in a number of areas, including the diagnosis, care and rehabilitation of patients.

The Joint Commission on Accreditation of Healthcare Organizations last month put Central State Hospital on probation by downgrading its accreditation to conditional. JCAHO gave the hospital six months to fix the problems.

The Chicago-based commission has not yet released a report on the findings of its unannounced inspection of Central State that resulted in the conditional accreditation.

But Charles H. Bair, the commission's executive vice president for accreditation operations, said in a letter to The Associated Press last week that Central State failed to comply or only partially complied with JCAHO standards for:

Initial assessment, including diagnostic tests, physical examinations and health histories, of patients entering the hospital.

Planning and providing of care and rehabilitation.

Training of staff members before they begin work and ongoing education to maintain and improve competence.

Participation of patients and their families in decisions about their care.

Performance of hospital leaders in improving clinical and support activities and performance of some department heads.

The hospital also received poor marks for its social environment, or how space, furnishings and even patient clothing contribute to patient dignity.

The commission scores a hospital's operations on a 1-to-5 scale, with 1 being the highest grade and 5 the lowest. The 10 categories cited at Central State in the surprise inspection were all rated 3 to 5. A 3 denotes partial compliance, 4 indicates minimal compliance and 5 represents noncompliance.

``JCAHO basically said the quality of care at Central is poor,'' said Valerie L. Marsh, executive director of the Virginia Alliance for the Mentally Ill.

JCAHO's stamp of approval is a virtual necessity for most hospitals to operate in the United States. Loss of accreditation severely injures a hospital's reputation and can mean a cutoff of Medicaid and Medicare disbursements. Most of the funding for Central State and other state mental facilities, however, comes from state tax revenues.

The state Department of Mental Health, Mental Retardation and Substance Abuse Services says it is confident Central State will regain full accreditation.

The joint commission awards accreditation to 98 percent of the hospitals it inspects. Only 1 percent receive conditional accreditation.

JCAHO had given Central State a clean bill of health in June, but its inspectors returned for a rare unannounced visit in August after the U.S. Justice Department issued a sharply critical report on patient care at the hospital.

The Justice Department accused Central State of failing to protect the rights of patients by subjecting them to inadequate care and abuse. It also charged that Central State provided inadequate psychiatric care, improperly used medications and used restraint and seclusion for punishment.

One patient, Gloria Huntley, died in June 1996 after being strapped down for 300 hours in the final month of her life, despite her physician's warning that restraints could kill her because she suffered from asthma, epileptic seizures and a heart condition.

Huntley died in the forensic unit, which houses patients charged with crimes ranging from misdemeanors to murder. She had been sent to the unit because of an attack on two staff members.

A recent tour of the forensic unit found patients staring blankly into space or at TV screens while others lay on the floor. In one ward, a nurse carrying a syringe rushed to attend to a patient who she said might be losing control.

The seclusion room in the women's ward where Huntley died contained a bed with a hard, plastic mattress. The only other furnishing was a bed pan.

The state is spending millions to hire extra staff and improve conditions in the forensic unit, which was built in the early 1950s. KEYWORDS: CENTRAL STATE HOSPITAL

Send Suggestions or Comments to webmaster@scholar.lib.vt.edu