[NYAPRS Enews] IG: Kingsboro Director Made Staff Falsify Discharge Forms

[Harvey Rosenthal]

IG: Psych Center Director Made Staff Falsify Discharge Forms

By Casey Seiler Albany Times Union  September 27, 2012

 

Another day, another report about bogus documents from the state
Inspector General's office - although this one has much more serious
implications than the case of the maybe-not-so-handicapped DOH employee.

The IG's latest concludes that officials at the Kingsboro Psychiatric
Center in Brooklyn failed to create discharge plans for patients before
putting them on the street, and that a director at the facility ordered
employees to fake records to make it seem as if that work had been done:

... Tanya Priester, then Acting Deputy Director of Program Operations at
Kingsboro Psychiatric Center, compelled staff to sign resident discharge
forms in an effort to deceive [the state Commission on Quality of Care]
that policies had been followed. Although Kingsboro PC advised CQC in
September 2010 that a new policy to address obvious deficiencies in the
discharge process would be instituted, Kingsboro PC failed to do so. The
Inspector General's investigation further found that discharge policies
at a number of OMH facilities fail to comply with OMH regulations.

It's likely that this is the sort of work that will be taken up by the
new Justice Center scheduled to go on line next spring. The legislation
creating that entity is awaiting Gov. Andrew Cuomo's signature.

If you're wondering why the IG's office is suddenly so active on the
release front, consider that the end of September marks the conclusion
of Catherine Leahy Scott's second full quarter as acting IG following
the departure of Ellen Biben to become executive director of JCOPE. That
watchdog panel, by the way, will receive a copy of this latest report
for possible action, along with the Kings County DA.

Here's the full release from the IG:

Acting New York State Inspector General Catherine Leahy Scott announced
the completion of an investigation which found officials at the
Kingsboro Psychiatric Center allowed the release of residents from the
facility without a required discharge plan. The investigation also
revealed that the acting Deputy Director of Program Operations later
directed staff to falsify discharge plan records to cover up the lapse
in procedure.

The Inspector General's office is referring the case to the Kings County
District Attorney and the State Joint Commission on Public Ethics. The
Inspector General has also recommended that the state Office of Mental
Health (OMH) strengthen discharge procedures and discipline staff
implicated in the investigation.

"Discharge plans exist for a reason," said Acting Inspector General
Scott, "to protect the health and safety of residents being released.
This failure put innocent people at risk, and that is unacceptable."

The investigation stemmed from a July 2011 complaint to the Inspector
General by the State Commission on Quality of Care and Advocacy for
Persons with Disabilities (CQC), that following its investigation into
improper discharges, it received documents falsely claiming that
discharge procedures were followed, when they were not.

As a result of its findings at Kingsboro PC, the Inspector General's
office conducted a system-wide review of OMH facilities and found
inconsistent and sometimes deficient discharge procedures.

OMH regulations on patient discharge require the development of an
initial discharge plan upon a resident's arrival. According to Kingsboro
PC policy, plans are reviewed weekly and revised when necessary.
Residents' progress and the availability of housing options are supposed
to be discussed at these weekly meetings.

As part of its care delivery system, Kingsboro PC maintains Transitional
Living Residences, one of which is Mary Brooks TLR. TLRs provide on-site
lodging, care and treatment for residents preparing to transition to the
community. Residents may live at a TLR anywhere from a few weeks to
several years. During their stay, OMH assesses residents' housing,
financial and psychiatric needs, and formulates plans for community
placement.

In a May 2010 investigation of a complaint regarding an April 2010
resident discharge, CQC determined Kingsboro PC had inappropriately
discharged a Mary Brooks TLR resident on a street corner near a shelter.
The Inspector General's investigation began after CQC's discovery of the
falsified discharge documents in a 2011 follow-up review of its own.

After this egregious discharge, the Inspector General's investigation
found that Tanya Priester, then Acting Deputy Director of Program
Operations at Kingsboro Psychiatric Center, compelled staff to sign
resident discharge forms in an effort to deceive CQC that policies had
been followed. Although Kingsboro PC advised CQC in September 2010 that
a new policy to address obvious deficiencies in the discharge process
would be instituted, Kingsboro PC failed to do so. The Inspector
General's investigation further found that discharge policies at a
number of OMH facilities fail to comply with OMH regulations.

The Inspector General recommended that OMH:

*	Discipline Priester and other Kingsboro PC officials as
appropriate;
*	Promulgate uniform discharge policies that include a verifiable
review and pre-approval requirement by management;
*	Review Kingsboro and Mary Brooks TLR discharge plans; and
*	Conduct periodic audits to ensure compliance at all the TLRs it
oversees.

OMH has indicated it has disciplined Priester and other Kingsboro PC
staff. In response to this report OMH is reviewing for implementation
the Inspector General's recommendations with respect to discharge
policies. OMH will advise the Inspector General within 90 days on its
implementation.
CQC Chair Roger Bearden said: "We appreciate the Inspector General's
thorough investigation into the falsified documents provided to our
investigators. To improve the quality of care for persons with
disabilities, it is vital that the agencies we oversee provide truthful
and accurate information to our investigators."

The Inspector General has referred its report to the Kings County
District Attorney and the State Joint Commission on Public Ethics, as
Priester's actions may constitute a violation of New York State's Penal
and Public Officers laws.

 

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