River Point Behavioral dodges correction of AHCA citation by ceasing substance abuse patient admissions

River Point Behavioral Health was cited by the Florida Agency for Health Care Administration (AHCA) for violating regulations related to distinct beds, patient rights, and physician in charge during substantial allegation & state licensure complaint surveys. AHCA found that the facility failed to have an organized and separate unit for their adult substance abuse patients, even though state regulations require that “the beds assigned to the program must be physically separate from and not commingled with beds not included in the unit.”  AHCA found that instead of separating its substance abuse patients from its psychiatric patients, River Point Behavioral used rubberized mattresses on the floor of patient rooms for “overflow patients.” In the North Wing of the facility, for example, the patient census exceeded bed capacity and AHCA found three patient rooms with additional rubberized mattresses on the floor. In the Emergency Stabilization Unit, AHCA found two patient rooms with rubberized mattresses on the floor which did not have linens or pillows. The facility’s Director of Nurses confirmed this practice to AHCA, while the Compliance Officer stated that “it’s better than throwing a blanket on the floor for them.” Rather than directly addressing its cited deficiencies by designating separate units for its substance abuse and psychiatric disorder patients, River Point noted in its plan of correction that it “converted”  its existing 18 adult substance abuse beds to 18 adult psychiatric beds. Patients who have a primary diagnosis of Substance Abuse “will be transferred to another appropriate facility” and the facility “has ceased admitting any patients with a primary substance diagnosis.” AHCA  also cited River Point for patient rights violations after it found that the “facility failed to ensure that patients and/or family were involved in the discharge planning process for 6 of 11 sampled patients.” After revealing that discharge papers were signed prior to discharge day, AHCA asked the Director of Quality why the patient discharge papers were filled out before discharge. The facility Charge Nurse revealed “recently, we have been asking the patients to sign all their forms at their first team meeting, but I don’t know the reason.” A therapist indicated during an interview that “discharge planning starts at admission. If things change, then we put a line through them, but no, the patient is not asked to re-sign.” The Director of Social Services for the facility confirmed that the process described by the Charge Nurse and Therapist was correct and that the “discharge planning starts when the patient is admitted” and “patients sign their discharge papers in the beginning.” AHCA also cited the facility after it was revealed that the “facility failed to ensure telephone orders for restraints were authenticated by a physician for 2 of 3 patients.” AHCA revealed that “the physician never signed the telephone order for the physical and chemical restraints, or seclusion.” The Director of Clinical Services indicated that “physicians are aware that they are supposed to sign the telephone orders in 48 hours, but they just do not do it” and that “this has been an ongoing facility issue.” The facility submitted a plan of correction to address the cited deficiencies.