N.C. Hospital Cited for Poor Communication, Coordination Between Staff and Security

Rex Hospital in North Carolina was recently given a citation by the U.S. Department of Health and Human Services that threatens to cut its Medicaid reimbursements.

A North Carolina hospital could lose federal Medicaid reimbursements if issues detailed in a citation by federal officials are not addressed soon.

The citation notes poor communication and coordination between Rex Hospital staff and security while they were caring for a psychiatric patient in the Raleigh hospital’s emergency department. Rex Hospital officials said the hospital has complied with the 281 page citation, which was issued by the U.S. Department of Health and Human Services, or HHS.

The department’s citation reviews the experience of a 24-year-old man with a history of violent behavior that was involuntarily committed to the hospital on January 24, a day after his prison release. In the 17 days the patient was at the hospital, he was forced to wear a spit mask, forcefully restrained every day and stunned with a Taser twice, according to the report.

The patient, who has a history of schizophrenia and post-traumatic stress disorder, was often physically and verbally abusive to hospital staff, including an incident where he punched two hospital security officers.

After the patient was transported on Feb. 10, hospital officials created an action plan for future encounters with involuntarily committed patients that featured risk assessments, crisis prevention training and auditing the “plan of care” for emergency room patients staying longer than 48 hours, according to wral.com. But HHS found the new action plan to be insufficient.

Rex Hospital has made several changes since receiving the citation, including no longer equipping security officers with Tasers.

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