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7.008 Patient Abuse Allegation Reporting

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7.008 Patient Abuse Allegation Reporting OREGON STATE HOSPITAL POLICIES AND PROCEDURES SECTION 7: Patient Rights POLICY: 7.008 SUBJECT: Patient Abuse or Mistreatment Allegation Reporting POINT DIRECTOR OF LEGAL AFFAIRS PERSON: APPROVED: JOHN SWANSON DATE: OCTOBER 6, 2017 INTERIM ADMINISTRATOR I. POLICY A. Every Oregon State Hospital (OSH) patient deserves safe, respectful and dignified treatment. To that end, all health care personnel (HCP), including contractors and their employees, must conduct themselves in such a manner that protects patients from abuse. B. Abuse or mistreatment categories of prohibited conduct are: 1. abandonment, including desertion or willful forsaking of a patient or the withdrawal or neglect of duties and obligations owed a patient by a HCP; 2. physical harm to a patient caused by other than accidental means, self- defense, or that appears to be at variance with the explanation given of the injury by a HCP; 3. willful infliction of physical pain or injury by a HCP. 4. neglect 5. verbal abuse or mistreatment 6. condoning abuse or mistreatment 7. financial exploitation of a patient 8. Involuntary seclusion of a patient for the convenience of the HCP or to discipline the patient. 9. Wrongful use of a physical or chemical restraint upon a patient, excluding an act of restraint prescribed by a physician licensed under ORS chapter 677, physician assistant licensed under ORS 677.505 to 677.525 or nurse practitioner licensed under ORS 678.373 to 678.390 and any treatment activities that are consistent with an approved treatment plan. Restraint used in accordance with OSH Policy 6.003 is not considered to be abuse or SUBJECT: Patient Abuse or Mistreatment Allegation POLICY NUMBER: 7.008 DATE: Page 2 of 6 mistreatment. As indicated in the same policy, chemical restraint is considered abuse or mistreatment. 10. Any act that constitutes a crime under Oregon Revised Statute (ORS) 163.375, 163.405, 163.411, 163.415, 163.425, 163.427, 163.465 or 163.467. 11. Any death of a patient caused by other than accidental or natural means. C. Abuse and mistreatment allegations will be investigated by the Office of Adult Abuse Prevention and Investigation (OAAPI). All categories of prohibited conduct allegations will be examined as part of the OAAPI investigation. D. A HCP must report patient allegations of abuse or mistreatment as indicated in this policy. 1. Any HCP who witnesses or has reasonable cause to believe that a patient has been abused or mistreated at OSH, must immediately report the incident directly to OAAPI at 503-945-9495 or [email protected] 2. The HCP must also notify the Superintendent or Superintendent’s designee via hand-delivered memorandum, email, telephone call, or via the Superintendent Assistant during regular work hours. The HCP may report after-hours to the Superintendent via the OSH Reception, who will forward the report to the Superintendent. 3. If a HCP has reasonable cause to believe that an OSH patient was the victim of abuse when the patient was a child or a resident of a nursing home or other healthcare facility, the HCP must report that information to the child abuse hotline or contact the SAFELINE at 855-503-SAFE (7233), unless an exception below applies. 4. If a psychiatrist, psychologist, or clergy receives information about child abuse or adult abuse during communications that are subject to the doctor-patient, psychotherapist-patient, or penitent privilege, the psychiatrist, psychologist, or clergy does not have a duty to report the alleged abuse or mistreatment unless the alleged abuse or mistreatment occurred while the patient resides at OSH, regardless of the privilege. 5. If the HCP reasonably believes that information about alleged child abuse is already known by a law enforcement agency or the Department of Human Services, the HCP is not required to report the abuse. (See ORS 419B.010 [2].) E. Any person who in good faith reports alleged abuse or mistreatment and who has reasonable grounds for reporting has immunity from any criminal or civil liability that otherwise might be imposed based on the reporting or the content of the report per ORS 430.753(1), ORS 419B.025, and ORS 124.075. F. A HCP may not retaliate against any person who reports suspected abuse or SUBJECT: Patient Abuse or Mistreatment Allegation POLICY NUMBER: 7.008 DATE: Page 3 of 6 mistreatment in good faith. Any HCP or other person who retaliates against any person because of a report of suspected abuse or mistreatment may be liable pursuant to ORS 430.755. G. Persons or entities receiving confidential information pursuant to this policy must maintain the confidentiality of the information as required by state or federal law. The identity of the person reporting alleged abuse is confidential and may only be released as permitted by ORS 430.753(2), ORS 430.763, ORS 124.090, or ORS 419B.035. H. After a report of alleged abuse has been made, the following steps must be completed to enhance the investigation and protect patients: 1. The Superintendent or designee will implement protective measures, as appropriate. 2. If the allegation is determined to not fit the definition of abuse or mistreatment, the Superintendent or designee may take other appropriate action such as a referral to Human Resources for review as a potential performance issue; 3. Copies of all OAAPI investigation reports must be maintained by the Superintendent in a place separate from personnel files of employees. I. Upon completion of the OAAPI investigation report, the Superintendent or designee must immediately notify the following, stating whether the allegation was substantiated, unsubstantiated, or inconclusive: 1. the patient or guardian; 2. the HCP or other person accused of abuse or mistreatment; and 3. the Oregon Health Authority (OHA) designee. J. A HCP may be subject to disciplinary or other appropriate action up to and including dismissal if found responsible for: 1. abusing or mistreating a patient; 2. failing to report abuse or mistreatment when the HCP has reasonable cause to believe that abuse or mistreatment occurred; or 3. refusing to give information, or giving untruthful information during an investigation of alleged abuse or mistreatment. K. Any HCP dismissed or separated for violating this policy may not be rehired by OSH in any capacity. The HCP or former HCP may not be allowed to visit or otherwise have contact with a current patient. L. In all situations where abuse or mistreatment or the failure to report abuse or mistreatment has been substantiated, the consequences must be commensurate with the seriousness of the conduct and any aggravating or mitigating circumstances, and may include consideration of previous conduct of record SUBJECT: Patient Abuse or Mistreatment Allegation POLICY NUMBER: 7.008 DATE: Page 4 of 6 (e.g., official personnel file). 1. Any HCP found violating this policy may be referred to the appropriate law enforcement or regulatory agency. 2. Any contractor found violating this policy is at risk of immediate termination of the contract. Any employee of the contractor found in violation of this policy may be excluded from OSH grounds, and may be referred to the appropriate law enforcement or regulatory agency. M. The OHA designee must report a substantiated allegation of abuse or mistreatment to the Medical and Allied Health Professional Staff Executive Committee if the accused is a licensed independent practitioner. N. Upon admission, each patient must be informed of this policy. O. Each HCP must be provided a copy of this policy during new employee orientation and once a year thereafter. Each HCP must sign a form acknowledging initial receipt of this policy. II. DEFINITIONS A. "Abuse or mistreatment” means any act or absence of action toward a patient by a HCP inconsistent with prescribed treatment and care and falls within the definitions of abuse found in ORS 419B.005 and ORS 124.050, or as outlined in applicable policies, rules and protocols and violates the well-being of the patient. Examples of abuse or mistreatment include, but are not limited to: 1. “Physical abuse or mistreatment”, such as hitting, kicking, scratching, pinching, choking, spanking, pushing, slapping, twisting of head, arms, or legs, tripping, the use of physical force which is unnecessary or excessive, or other physical contact with a patient inconsistent with prescribed treatment or care. 2. “Verbal abuse or mistreatment”, such as threat of significant physical or emotional harm to the patient through use of yelling, ridicule, harassment, coercion, threats, mental cruelty, inappropriate sexual comments, intimidation, cursing, foul language or other forms of communication which are derogatory or disrespectful of the patient, remarks intended to provoke a negative response by the patient, or nicknames not requested by the patient or which are demeaning or ridiculing. 3. “Neglect”, such as failure to provide the care, supervision or services necessary to maintain the physical and mental health of a patient that may result in physical harm or significant emotional harm to the patient as determined through interviews with attending physician, supervisor and/or patient as appropriate; the failure of a HCP to make a reasonable effort to protect a patient from abuse; or withholding of services necessary to maintain the health and well-being of a patient which leads to physical harm of the SUBJECT: Patient Abuse or Mistreatment Allegation POLICY NUMBER: 7.008 DATE: Page 5 of 6 patient. 4. “Sexual abuse or mistreatment”, such as sexual harassment, sexual exploitation or inappropriate exposure to sexually explicit language or material, any sexual contact between a HCP and a patient, failure to discourage sexual advances by a patient, or any sexual contact that is achieved through force, trickery, threat or coercion. 5. “Condoning abuse or mistreatment” such as permitting abusive conduct or mistreatment toward a patient by any other person.
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