Reminder-Joint Commission and Texas DHHS Reports for GRMC/2014 Have been Online for Over 2 YearsSomervell County Salon-Glen Rose, Rainbow, Nemo, Glass....Texas

Safety-Quality-Personnel Non-Compliance at Glen Rose Medical Center

Reminder-Joint Commission and Texas DHHS Reports for GRMC/2014 Have been Online for Over 2 Years

27 March 2017 at 9:49:41 AM

Update: Opinon back from AG.

The last Somervell County Hospital District meeting on January 26, 2017 had a reference to the most current Joint Commission Report. I put in an open records request in March to view the report and got this reply from Ray Reynolds, CEO of Glen Rose Medical Center on March 15, 2017. 

We are of the opinion that the Joint Commission Survey document is the result of a survey conducted by a licensing or accreditation entity and is therefore not available through an open records request.

Ray Reynolds

Glen Rose Medical Center

There was no indication of who *We* is, nor, apparently, did Ray Reynolds write to the Texas Attorney General to get an opinion from them as to whether he could withhold this public record. A taxpayer funded entity representative can't simply put forward his or her own opinon as a justification for denying records.

If the governmental body wishes to withhold information from you, it must:

Seek an attorney general decision within ten business days of its receipt of your request and state the exceptions to disclosure that it believes are applicable. The governmental body must also send you a copy of its letter to the attorney general requesting a decision within ten business days. If the governmental body does not notify you of its request for an attorney general decision, the information you requested is generally presumed to be open to the public.

Did you see that part? Since Ray Reynolds did NOT say he was going for an attorney general decision rather than his own personal opinion about withholding information, "the information you requested is generally presumed to be open to the public."

Within fifteen business days of receiving your request, the governmental body must send the attorney general its arguments for withholding the information you requested and copies of the information you have requested. You are entitled to receive this notice, however, if the letter to the attorney general contains the substance of the information requested, you may receive a redacted copy of the letter. If the governmental body does not send you a copy of this letter, you may request it from the attorney general by writing to:

Lauren Downey, Public Information Coordinator Office of the Attorney General P.O. Box 12548 Austin, Texas 78711-2548 FAX (512) 494-8017 If the governmental body does not timely request an attorney general decision, notify you that it is seeking an attorney general decision, and submit to the attorney general the information you requested, the information is generally presumed to be open to the public.

What's interesting about this, to me, is that the Joint Commission and Texas DHHS reports that were done after Glen Rose Medical Center had a surprise investigation at the end of 2014 have been published online since January 2015, thus over 2 years. Certainly Ray Reynolds had no issue with making that report available, which not only could, and as of this morning, can be, viewed online as well as freely downloaded as a PDF file. So why, at this point, is Ray Reynolds not wanting to make the most current Joint Commission report available? Does it include criticisms of Glen Rose Medical Center for non-complaince in some areas that he doesn't want the public to see? 

On a related note, at one point, Ray Reynolds directed a previous Somervell County Hospital District board member to go look for a piece of information on Somervell County Salon. Now, mind you, the person who fufills public information requests is not supposed to direct people to an external website, other than, since 2015, one managed by the govt entity,  but simply supply the information (or challenge to the AG). Given that Ray Reynolds is wrong about that aspect, another part of his reply in that case is interesting. 

You notice that Mr Reynolds says "Once information is available on the public domain it is no longer subject to disclosure under the Texas Public Information Act". So what does the public information act actually say? (highlights mine) -(this part was amended in 2015). 


Sec. 552.221. APPLICATION FOR PUBLIC INFORMATION; PRODUCTION OF PUBLIC INFORMATION. (a) An officer for public information of a governmental body shall promptly produce public information for inspection, duplication, or both on application by any person to the officer. In this subsection, "promptly" means as soon as possible under the circumstances, that is, within a reasonable time, without delay.

(b) An officer for public information complies with Subsection (a) by:

(1) providing the public information for inspection or duplication in the offices of the governmental body; or

(2) sending copies of the public information by first class United States mail if the person requesting the information requests that copies be provided and pays the postage and any other applicable charges that the requestor has accrued under Subchapter F.

(b-1) In addition to the methods of production described by Subsection (b), an officer for public information for a political subdivision of this state complies with Subsection (a) by referring a requestor to an exact Internet location or uniform resource locator (URL) address on a website maintained by the political subdivision and accessible to the public if the requested information is identifiable and readily available on that website. If the person requesting the information prefers a manner other than access through the URL, the political subdivision must supply the information in the manner required by Subsection (b).

(b-2) If an officer for public information for a political subdivision provides by e-mail an Internet location or uniform resource locator (URL) address as permitted by Subsection (b-1), the e-mail must contain a statement in a conspicuous font clearly indicating that the requestor may nonetheless access the requested information by inspection or duplication or by receipt through United States mail, as provided by Subsection (b).

Referring people to a website in the public domain is ONLY okay to a website *maintained* by the political subdivision* and only IF the person who requests the information is fine with not receiving it any other way. And not referring people to any non-governmental website (imagine if you were referred to a website that was loaded with malware, for example). Again, Reynolds is completely wrong about directing people to an external website for information (even one as great as my Somervell County Salon) , which is a shame since he is the public information officer in charge of Texas Public Information Requests for Somervell County Hospital District/Glen Rose Medical Center. But the documents discussed above, have been on the website and in the public domain for over 2 years, so they are public. Because these are public and Ray Reynolds had no concern about these, I believe any further Joint Commision, etc reports should presumably also be available to taxpaying citizens. 

Reynolds has not contested this, AS HE WAS SUPPOSED TO DO RATHER THAN SIMPLY RELYING ON HIS OWN PERSONAL OPINION, to the Attorney General, re: allowing me to see and inspect the most current Joint Commission Report. So I have, I sent in a complaint to the Attorney General's Public Information office on March 20, 2017 regarding Ray Reynold's arbitrary denial of information. 

Incidentally, I wrote before about the Joint Commission and Texas DHHS report that came out after the surprise inspection by same of Glen Rose Medical Center in a post entitled "Followup on that Texas State DHHS Services Visit to Glen Rose Medical Center in Dec 2014". I pointed out that I had received the board packet for January 29 2015 meeting from the board president, Chip Harrison, and also that anyone in the public could go look at the results themselves on the Glen Rose Medical Center website. I further put in some of my own comments on some areas that were highly disturbing to me, about how GRMC had insufficient compliance in a number of areas. For example, here are a few things, written out that showed GRMC to be in insufficiant compliance. 

During review of the 2014 Board Quality Committee minutes from 2014, it was noted that a hospital staff Employee Culture of Safety Survey was conducted in 2014. The results of the survey showed the lowest scores involved Non-Punitive Response to Errors, Teamwork across departments, and Hand-offs and Transitions. During discussion with the hospital leadership, it was noted that there were no concrete plans formulated yet to improve these deficiencies. 

Observed in Tracer Activities at Glen Rose Medical Center... During tracers involving one or more interviews with healthcare staff in the medical surgical ward and the manager and nursing staff of the Emergency department, it was noted that there was a high level of distrust by the ED personnel of the abilities of the healthcare staff in the medical surgical ward, for example, in the area of code blue resusitation. Likewise, the staff in the medical surgical ward expressed great anxiety and disappointment over these perceptions. The 2014 Employee Culture of Safety Survey conducted by the hospital revealed a low score on the staff perception of teamwork across hospital departmental units.

Observed in Tracer Activities at Glen Rose Medical Center... During staff interviews in the medical-surgical ward and Emergency Department, the staff interviewed all expressed that they could freely speak up to leadership regarding issues involving adverse patient events and reporting errors. However, the 2014 Employee Culture of Safety Survey showed poor scores in this area, with the reason given that such reporting meant "tattling on each other". 

Infection Prevention and Control- Insufficient Compliance

The STANDARD is not met as evidenced by. Based on record review and interview, the Hospital's Quality Assessment and Performance improvement program failed to measure, analyze and track adverse patients events, in that the 1/08/14 through 11/12/14 Quality Meeting Minutes did not document the reporting of incidents to the Quality Committee. 

There was no incident report for the 11/28/13, 10/10/14 and 10/13/14 unsuccessful code blues.

The 1/08/14 through 11/12/14 Department Director and Quality Management minutes were reviewed. The 1/27/14 through 11/04/14 "Board Quality Committee"" were reviewed. There was no evidence in the minutes that incidents are tracked, trended or analyzed for improvement opportunities except for falls.

During a telephone interview in 12/16/14 ending at 4:24 pm, Personnel #6 was asked about the incidents not being reported through Quality Personnel and acknowledged they were not being reported through Quality and stated "We knew that it was a need and I hadn't gotten to it fast enough". 

The March 2013 "Incident Reporting Protocol" required "all incidents, patient, personnel, or visitor.. Unsuccessful Code Blue.. all sectors of the incident report must be completed.. Risk Management to supply the .. committee with a quarterly summary of patient incidents"

This STANDARD is not met as evidence by . Based on record review and interview, the facility failed to have a registered nurse supervise and evaluate the nursing care in that A. 1 of 3 coded patients (Patient #1) did not have an initial admit assessment B. 2 of 3 coded patients (Patient #2 and #3) had at least one missing shift assessment by their nurse. C. 3 of 3 coded patients (Patient #1, #2 and #3) had adnormal vital signs (Blood Pressure -BP, Heart Rate - HR, Respitory Rate - RR, Oxygen Saturation - Sa)2 without documented physician notification of patients issue. D. 1 of 3 coded patients (Patient #3) was administered Dopamine and had no blood pressure and heart rate documented by the staff. E 1 of 3 coded patients (Patient #3) had no nursing documentation and/or code blue record of what occurred during the code and no documentatoin from the physician who directed the code

And it just goes on and on, and on. I'm going to paste in screen captures from all pages from the 2 reports from the website, taken TODAY, again showing that this information has been in the public domain on Glen Rose Medical Center's website for over 2 years. READ FOR YOURSELF all the pages about how Glen Rose Medical Center, in 2014, had a number of non-compliant issues, including safety ones.

I believe it's entirely reasonable for me, as a citizen, to want to see the Joint Commission report for THIS time around, to see if and what has changed. Will see what the Texas AG's office says.

Screen Caps from 3/27/20179(note the URL in the navigation bar.


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