‘Immediate Jeopardy’

‘Immediate Jeopardy’

Heads roll over Christus patient restraint snafu


A investigation by state health officials resulted in the resignations of two top Christus managers in Jefferson County. The state probe was prompted by a complaint on behalf of a patient at Dubuis Hospital,  long term acute care hospital (LTACH) facilities operated as a hospital within a hospital at Christus St. Mary in Port Arthur and Christus St. Elizabeth in Beaumont.

Christine Mann, spokesperson for the Texas Department of State Health Services, confirmed there was an investigation: “We did receive a complaint on this hospital and we did investigate.”

Mann told The Examiner the action was “recent” and said, “We just completed our investigation about a week and a half ago, very recently, so no (enforcement) action has been taken at this time.” Until the complaint is resolved, she said regulations characterize it as “private and not open to disclosure.”

Gary Kempf, interim administrator for Dubuis Hospital, was not so reticent.

“We had an issue with some restraints,” said Kempf. “The staff was trying to provide safe care for the patient. They did it the wrong way, there was some education needed. But the state, obviously they take that seriously – as we do – so they gave us an Immediate Jeopardy (violation).”

According to Kempf, patients are restrained “for medical reasons so they don’t pull tubes and drains out, so for patient safety. In order for us to do that, we actually have to do an assessment – a physician has to do an assessment and they have to sign an order within 24 hours.”

The violation that occurred in this incident was that “they just didn’t have a doctor sign the order” said Kempf, who refused to dismiss that as a technicality.

“It’s more of an education thing,” he said. “The nurses actually – as we investigated – really had the patient’s best interests at heart. … They just didn’t follow the appropriate procedures.”

Kempf said he was brought in to resolve the crisis. “I am the chief clinical executive for Christus continuing care, so I do other LTACHs, so yes, I am part of Christus but I don’t live in the Beaumont area.”

Acting almost as a first responder, Kempf arrived on the scene to extinguish the administrative conflagration.

“We had to come up with an action plan within 24 hours and submit that to the state. They had to accept it – which they did – and send it off to CMS. We’re waiting for them to come back and do another validation survey,” said Kempf.

CMS is an acronym for Center for Medicaid and Medicare Services, the federal funding source that provides critical funding for nonprofit and for-profit hospitals alike.

“Because we license hospitals, we do the complete investigation for the Center for Medicaid and Medicare (CMS),” said Mann, who added she did not know if federal investigators were also on the hospital premises.

Kempf described how this Christus restraint issue was resolved.

“Basically what we’ve done is put an action plan together to address the issues and make sure we’re doing things the appropriate way,” he said. “In the meantime, the director of nursing and the administrator turned in their resignations, and we accepted those.”
Kempf identified the departed employees as Tim Freeman and Troy Picard and said they were in charge of Dubuis Hospital operations at both Christus St. Elizabeth and Christus St. Mary, where the restraint incident took place.