Medication errors repeated and child needing daily exercise told to "burn calories" in her room

Harbor Point Behavioral Health Center was cited by the Virginia Department of Behavioral Health and Developmental Services (DBHDS) for 18 deficiencies related to staff training, staff supervision, medication administration, and case management services. DBHDS found that a patient was given Wellbutrin over a period of 19 days after a doctor had ordered it discontinued. The inspection report noted: “Record also indicated that the MD’s d/c of Wellburtin was discussed/reviewed with interdisciplinary team, including a nurse present, during treatment planning meeting. Multiple medication errors of this oversight occurred, from 2/13/13 until 3/4/14, where medication was given and signed for without anyone verifying MD order.” DBHDS went on to state: “this is a serious oversight and an issue that has been previously cited in reviews past.” DBHDS also found evidence of required training sessions was missing for two employees, and that supervision notes for two therapists “appear to be written by staff and then signed off by Supervisor. This puts in doubt if appropriate supervision is being delivered to staff.” A third therapist had “no evidence of on-going supervision” in the previous 2.5 months. Additionally, DBHDS found no evidence that case management services were provided to seven residents on a weekly basis, as required by the facility’s policy. In its plan of correction, Harbor Point argued that case management services were provided during individual therapy sessions and proposed “to remove the frequency of case management services from its Individual Service Plan” so that the policy would allow case management to be provided on an “as-needed” basis. DBHDS determined that the facility did not meet the standard for a structured program of care. A resident who had a treatment plan to “exercise 60-90 minutes per day” had no documentation of exercise on a day-to-day basis. In its response, Harbor Point noted that:
“Recreational therapy department provided 1 activity/exercise groups per week. … RT also completed a consult and provided resident with exercises that she could complete on her own in her room on the unit to improve her mood and burn calories.”
Harbor Point was also cited for failing to meet nutritional standards, as there was no proper documentation of whether or not residents ate their meals and snacks. The facility also failed to meet the requirements for seclusion and restraint, as one resident’s Seclusion/Restraint Order form “was not signed by the Physician, Nurse, Administrator, or the Director of Nursing.” In the Corrective Action Plan, Harbor Point agreed to provide the required staff training and supervision. In its summary notes, DBHDS suggested that the facility institute additional cleaning processes to ensure sanitation in the kitchen.