North Dakota State Hospital trying to fix serious flaws after denial to renew accreditation
JAMESTOWN -- The North Dakota State Hospital in Jamestown is working to come into compliance with accreditation standards after a survey documented multiple deficiencies, including suicide prevention measures, maintaining a safe environment for p...
JAMESTOWN - The North Dakota State Hospital in Jamestown is working to come into compliance with accreditation standards after a survey documented multiple deficiencies, including suicide prevention measures, maintaining a safe environment for patients and proper use of restraints or seclusion.
A survey team for The Joint Commission, the accrediting body for hospitals, in March found multiple serious deficiencies that resulted in a determination of preliminary denial of accreditation for the state hospital’s inpatient service.
Since then, the hospital has been working with reviewers to resolve problems and bring the hospital back into compliance, Rosalie Etherington, the state hospital’s superintendent, said Thursday, May 30.
Many of the deficiencies have been addressed, she said, and Etherington expects the remaining problems will be fully resolved by September. “They have almost all been solved,” Etherington said.
Most of the deficiencies stemmed from new standards that recently took effect involving suicide prevention measures for an area of the hospital called “intensive care,” which serves a small number of patients who pose a risk to themselves or others, she said.
“It was for a very specific reason,” Etherington said, adding that multiple deficiencies in a variety of categories were deemed out of compliance as a result.
The new standards, called “anti-ligature” measures, are intended to prevent patients from hanging themselves. Door knobs that for years were considered safe, for example, recently were deemed no longer acceptable, she said.
“They believed we were secluding people unnecessarily,” Etherington said, “although people were not locked in rooms.”
In April, a 31-year-old male patient at the state hospital was charged with attempted murder after an attack in March on a female staff member who was cleaning bathrooms. The patient, Jason Benefiel, choked and dragged the employee, who suffered facial lacerations, a fractured septum and was unconscious at times, according to court records.
After the attack, Benefiel was secluded before state troopers took him into custody. Coincidentally, the assault happened during March, the same month of The Joint Commission accreditation survey.
Etherington forwarded documents from The Joint Commission showing progress has been made in follow-up surveys in April and May. Another survey will happen soon, no later than Tuesday, June 4, and the hospital has until September to resolve what Etherington said are a few remaining deficiencies.
“We’re expecting them any day,” she said.
In one case, the remaining issue was deemed of “moderate” risk to harm a patient, visitor or staff member, and in three other instances the risks were deemed “low,” according to a follow-up report dated May 6.
The state hospital provides inpatient psychiatric care for 90 to 100 patients at a time, and also provides residential treatment for another 100 to 120 sex offenders and patients with substance use disorders.
The residential treatment programs, also surveyed in March, were granted a standard three-year accreditation.
A spokeswoman for The Joint Commission said the only information the body could release publicly is a general summary report available online. Details are kept confidential by agreement; the accreditation process, intended to provide quality assurance for the public, is voluntary.
“That is all the public information that we can provide,” said Maureen Lyons of The Joint Commission. “The goal is always to put into place some kind of plan where they can correct areas.”
The North Dakota State Hospital is overseen by a seven-member board that includes a state legislator, Rep. Chet Pollert, R-Carrington, the House majority leader. Pollert wasn’t available Thursday for comment.
Rep. Kathy Hogan, D-Fargo, who is influential on social services and human services, said the accreditation report raises concerns, and could reflect the effects of several years of lean budgets.
“As an unintended consequence, we’ve jeopardized people,” she said. In recent decades, the focus has shifted from providing behavioral health care in the state hospital to providing community-based services.
As a result, Hogan said, the hospital might have been overlooked. The adequacy and safety of the state hospital could be addressed by an interim legislative committee, she said.
Sen. Tim Mathern, D-Fargo, has long been an advocate of increasing community-based services, and said providing behavioral health services at the state hospital is “old style medical practice” at best.
Mathern sponsored a provision in the human services budget bill for an interim study to develop a statewide plan to address acute psychiatric and residential care needs.
Issues to be studied include the size and use of the state hospital and the potential need for state-operated or private acute facilities outside of Jamestown.
In this year's legislative session, lawmakers rejected a proposal by Gov. Doug Burgum to build a new state hospital, and instead decided to study the hospital and options for delivering psychiatric care.