A federal agency has found that a Portland hospital failed to protect patients from physical abuse on two occasions last summer in which a security guard and a nurse each allegedly struck patients who were acting violently.
In one case on July 10, a security guard at Maine Medical Center struck a mentally impaired patient multiple times after the patient, who had been admitted to the acute psychiatric unit, struck the officer in the face while being restrained, according to a report from the federal Centers for Medicare and Medicaid Services.
In another case on July 26, a registered nurse was attempting to give oral medication to an 83-year-old patient with dementia who was receiving treatment for broken ribs and a collapsed lung suffered during a fall. After the patient spit the medicine out and punched the nurse in the chin, the nurse yelled out, “You f***er” and punched the patient in the right rib area, according to a report from another hospital staff member that was provided to the federal agency.
The agency determined that Maine Medical Center violated the rules for participation in the federal Medicare program by failing to protect the two patients from abuse. In late September, it informed the hospital that it would be terminated from the program within three months unless it provided a plan of correction. After the hospital filed a corrective plan Oct. 4, the agency agreed to remove it from the termination track.
The federal agency relies on inspections performed by a division of the Maine Department of Health and Human Services.
In a statement, the hospital said that its corrective actions have included better training for staff in de-escalation techniques and proper reporting standards.
“Maine Medical Center is committed to ensuring the safety and well-being of its patients and staff,” Clay Holtzman, the hospital’s associate vice president of communications and public affairs, said in the statement. “These measures have been comprehensive, ongoing and are in compliance with regulatory standards. Maine Medical Center has no tolerance for any instance of abuse, neglect or exploitation against patients and staff.”
In addition, Holtzman said, “Health care institutions across the country, including Maine Medical Center, are facing an epidemic of violence against health care staff. While strong policies, training, support systems and proper reporting are critical for the protection of patients and staff alike, public awareness of this ongoing trend is critical to ensuring health care institutions continue to be a place of healing.”
The workers who were the subject of the complaints last summer no longer work for the hospital, according to Holtzman. The report detailing the inspection by the federal Centers for Medicare and Medicaid Services did not identify those workers, but it did say they were criminally charged after the incidents.
The nurse who allegedly punched the patient in the ribs was arrested and charged with a Class C felony of endangering the welfare of a dependent person, according to the report. The security guard was reportedly charged with assault.
Lt. Robert Martin of the Portland Police Department said that he could not find any record of Maine Medical Center employees receiving those types of criminal charges at the hospital during the timeframe of the complaints.
Martin said the state attorney general’s office may have investigated the complaints, but a spokesman for that office, Marc Malon, declined to comment on the case. The attorney general’s office has a health care crimes unit that investigates abuse, neglect and financial exploitation in facilities that are certified to receive funding through the state’s Medicaid program, according to its website.
The report from the federal agency identified a few problems with the hospital’s response to the two cases last July.
For example, it said that after the security guard allegedly struck the patient he was trying to restrain, the guard continued to work for another six hours of that shift and three hours the following day before being placed on leave. It also took nine days for the hospital to report the case to the Maine Department of Health and Human Services, in part because it took a week for the hospital’s director of security to report the alleged assault to the hospital’s director of accreditation and regulatory affairs, according to the report.
In the second case, the hospital suspended the nurse who allegedly struck the patient in the ribs after the case was reported within 15 minutes by a certified nursing assistant who witnessed it. Then, the hospital reported the case to the state the following day. But federal officials faulted the hospital for not giving the nursing assistant the authority to immediately bar the nurse from re-entering the room where the patient had been staying.