By Jenna Johnson
Washington Post Staff Writer
Thursday, July 26, 2007
Children at Riverside Hospital in Northwest Washington are at risk from "serious and persistent abuse and neglect," according to a report from an advocacy group, leading city mental health officials to start weekly visits to monitor conditions.
The psychiatric hospital for youths up to age 21 stopped accepting new long-term patients last week. But Riverside lawyers say the temporary halt in admissions has nothing to do with the report and was a "completely voluntary" way to provide patients with quality treatment as the hospital completes an "intensive program and plant renovation initiative." The lawyers said they did not know how long this initiative will take.
University Legal Services Inc., a federally designated advocacy group for District children with developmental disabilities, produced the 13-page report summarizing its observations, interviews and investigations at the hospital since April 2006. There have been previous allegations of abuse at the private, for-profit hospital, including one into the death in December of a teenage resident. In 1997, federal regulators threatened to cut Riverside, which opened in 1995, from the Medicaid program.
The latest report, obtained under the Freedom of Information Act, provides a grim description of Riverside: Youths were punched, choked, slapped, pushed and threatened by staff members. Children were highly medicated as a form of restraint or placed in seclusion for reasons such as "being playful with his roommate." A lack of supervision led to patients attacking fellow patients, grabbing bottles of medicines from nurses' stations and cutting themselves with shards of glass. Treatment plans were not fulfilled. The facility had broken windows and mold. It was too hot in summer and too cold in winter.
The report, dated June 6, offered several specific examples of abuse. It said that on April 24, a University Legal Services staff member witnessed a hospital worker punching a male resident "two times in the eye, calling him a racial epithet." The child was taken to nearby Georgetown University Hospital for treatment.
"Beyond these specific complaints, ULS receives many general complaints that staff purposefully take residents to the quiet room to assault them, and that violence against residents is a regular occurrence," the report said.
"We have raised all of these issues with Riverside directly, in one form or another, and requested remedies, but the response in the vast majority of instances has been inadequate," the report added. "Children at Riverside remain at risk."
Sanford M. Saunders Jr., an attorney for Riverside, said hospital officials had not seen or heard of the report until The Washington Post contacted them for comment. The report was sent to the D.C. Health and Mental Health departments, both of which have investigated past complaints and injuries at the hospital, said Jennifer Lav, staff attorney for the advocacy group.
"We've been very concerned about Riverside," said Mental Health Department Director Stephen T. Baron.
In a statement, Riverside officials disputed the report, saying it "fails to place matters into the overall context of Riverside's operation." Given that the hospital houses up to 50 teenage long-term patients with behavioral problems, "instances of peer-to-peer and patient-to-staff aggression are expected." The officials said that anytime an incident occurs, they conduct a full internal investigation, suspend suspected staff members and alert the necessary D.C. agencies.
The Department of Mental Health has not referred anyone since last week. Spokeswoman Phyllis Jones said the department usually refers youths to facilities outside the District for specialized treatment. Riverside patients are generally referred by private physicians, public schools or agencies such as Child and Family Services, she said.
The department has investigated several incidents at the hospital, she said, including the death of a 14-year-old girl. After being ill for several days in late November, the girl was transferred to Georgetown University Hospital and put on a ventilator, then flown to Inova Fairfax Hospital for emergency cardiac surgery. She died in December.
A department investigation concluded in late June that the hospital staff did not document the girl's vital signs, order basic tests, notify a physician of her worsening condition or note the girl's family history of heart disease. The "pattern of poor documentation" continued even after the girl was admitted to Georgetown, as the Riverside night shift continued to mark her chart the next day with comments such as "appeared to be sleeping all night" and "monitored every half hour," according to the report.
Riverside officials maintain that they properly cared for the girl and appropriately responded to her flulike symptoms. But the Mental Health Department recommended improved staff training and new policies for documenting care and notifying physicians.
This month, the Mental Health Department increased its monitoring of the hospital, Baron said. During weekly visits of at least five hours, a department representative talks with senior staff members and patients, reviews records and recommends improvements.
When asked whether children were safe at the hospital, Baron replied, "All that I can tell you is that we have not seen the need to decertify them."
Baron said the department hopes the hospital improves rather than loses its certification.
Staff writer Henri E. Cauvin contributed to this report.