Rocky start for private forensic psych facility

A bit more detail emerged on fines recently levied against a public-private forensic psychiatric hospital operated by the GEO Group in Montgomery County (see earlier coverage) in a report froms the Houston Chronicle ("Conroe psychiatric hospital may face big fines," July 28). The story by Lomi Kriel, opened:

Texas health officials recommended levying more than $100,000 in fines against the state's first publicly funded, privately run psychiatric hospital in Conroe for violations including the improper restraining and inadequate monitoring of patients and other infractions committed in its first year.

County leaders who oversee the Montgomery County Mental Health Treatment facility and officials with GEO Group, a prison company running the center for mentally incompetent defendants, met with state health officials last week. The company, based in Fort Lauderdale, Fla., contracts with the county, which has a two-year, $15 million-per-year agreement with the state. Since company officials said they have fixed the problems, the state tentatively agreed to halve the fines. 

The GEO Group portrayed the violations as mostly related to paperwork, but there were also allegations of under-qualified managers, improper restraints used on patients/inmates and "several" policies that "violated patients' rights":

According to a July 19 notice of alleged non-compliance and a May 11 notice of licensing violation, state investigators outlined a range of issues it deemed troublesome.

Among them: Half of 50 incidents where officials restrained or secluded patients were not accompanied by an "appropriate" doctor's order. Investigators found a "significant lack of compliance with physician orders for initiating restraint." State law says restraint can only be used when ordered by a doctor and when evidence of imminent harm exists.

Several hospital policies violated patients' rights, state officials found, including a prohibition on possessing items for reasons other than patient safety. Investigators detailed spotty record-keeping, including gaps suggesting patients were not properly monitored, and a lack of documentation related to patient consent for receiving psychoactive medications. The director of psychiatric nursing, meanwhile, had only an associate's degree, not the required master's degree in psychiatric mental health or related experience.

To be fair, state-run mental hospitals have certainly had their own problems. As the Austin Statesman recently reported, "Last month, former Austin State Hospital psychiatrist Charles Fischer was indicted by a Travis County grand jury on charges that he sexually abused five patients under his care at the facility." Still, for a project spawned in a back-room budget deal, the private facility in Montgomery County has gotten off to a rocky start.