DHS

 

Wisconsin Department of Health Services

Client Rights Home

Intro to Client Rights

Client Rights Office

Client Rights Training Opportunities

Client Rights Limitation or Denial

Community Grievance Decision Digest

Confidentiality of Treatment Records

Guardianship

Minors

Informed consent

Centers for the Develop- mentally Disabled

Mental Health Institutes

Secure Treatment Centers

Outpatient treatment

Inpatient treatment

Model Grievance Procedure

Forms, publications and posters

Non-Wisconsin residents who are emergency detained

Community Grievance Decision Digest

RESOLUTIONS AND REMEDIES

These cases reflect various remedies and resolutions that were implemented or suggested in order to resolve patient rights complaints or where requested remedies were not available.

DECISIONS

  1. A hospital had a release of information allowing them to share information about the patient’s care with her family. However, they released records to the family that the patient did not want released. The hospital acknowledged they had exceeded the scope of the release of information they had and implemented a procedure to ensure that this error did not occur again. Nothing can undo the error, but the hospital’s actions were the proper remedy under the circumstances. That is all the grievance process can do. The patient could still take the hospital to court if she wished. This matter was considered resolved. (Level III decision in Case No. 97-SGE-01 on 5/27/97)

  2. A patient complained that the facility did not properly inform her of the increase in the charges for her cost of care. The Level II grievance decision found that she was not properly informed of the increased costs and her billing was adjusted to reduce the fees to the original costs. This was a fair resolution of the grievance. (Level III decision in Case No. 00-SGE-02 on 4/6/00.)

  3. The grievance procedure under HFS 94 has no authority to award damages. Monetary damages can be pursued in and awarded only by a court of law. (Level III decision in Case No. 00-SGE-02 on 4/6/00.)

  4. Where a hospital patient complained about an error in medication administration, the State Grievance Examiner referred the matter to the Bureau of Quality Assurance for investigation. [BQA subsequently issued the hospital a citation for violation of state and federal regulations.] (Level III referral in Case No. 00-SGE-07 on 4/17/00.)

  5. The meaning and applicability of the section of HFS 94.24(3) regarding "redress through the grievance procedure" is to assure that no one is deprived of using the grievance procedure to seek redress for an alleged violation of his or her rights. It does not allow for the award of punitive monetary damages in the grievance process. Only a court can award damages. The individual whose rights were allegedly violated must initiate any court action. (Level IV decision in Case No. 00-SGE-02 on 6/17/00.)

  6. A favorable grievance decision cannot be appealed by the prevailing party. (Level IV decision in Case No. 00-SGE-02 on 6/17/00.)

  7. A patient at a county psychiatric hospital complained about a seclusion incident. He raised issue about whether there was justification for the initial use of seclusion and whether he was released in a prompt and timely manner. There was a discrepancy between a verbal report of one staff and the documentation form that was completed while he was in seclusion. In the Level I grievance decision, the Client Rights Specialist (CRS) made a suggestion that staff more carefully document anything of concern that may be displayed while a patient is in seclusion. The improvements in documentation made by the hospital in response to his complaint were noted. The patient withdrew his complaint at Level III. (Level III decision in Case No. 00-SGE-13 on 8/2/00.)

  8. Where a developmentally disabled young woman ended up in an acute inpatient mental health setting, it was appropriate for the Level I Client Rights Specialist to recommend a potential "crisis intervention plan" for her in case the situation arose again. Such an approach is an element of ongoing quality assurance on the part of the county program, too. (Level III decision in Case No. 99-SGE-07 on 1/3/01.)

  9. A client who was about to be discharged from an inpatient facility felt she was not being given enough input or choices in terms of to where she would be discharged. She wanted to be placed in an apartment in the community. Facility staff were considering placement at other inpatient settings or a CBRF (group home) setting. Ultimately, she was transferred to a community supported living arrangement in an apartment. Since this was what she wanted, the grievance was dismissed at Level III as being "resolved". (Level III decision in Case No. 00-SGE-05 on 2/16/01.)

  10. Where violations of client rights are found, the matter may be referred to the Bureau of Quality Assurance Certification Unit to determine if any violations of certification requirements occurred. (Level IV decision in Case No. 00-SGE-08 on 2/21/01.)

  11. A patient received services from an agency contracted by the county. He felt he was not adequately informed of his patient rights because his rights were provided in a perfunctory way, without dialog or the ability on his part to ask questions or seek further clarification. He wanted clarification of the notification requirements and expectations. Given his requested relief, there was no conclusion made that the provider was out of compliance, but recommendations were made for further review of the service provider’s rights notification process. (Level III decision in Case No. 00-SGE-01 on 6/29/01.)

  12. A woman complained about her therapist because of cancelled appointments. The Level I decision found that her right to receive prompt treatment was violated by the high number of cancellations. The service provider implemented a formal plan and consistently followed up on it to reduce the number of cancellations. It was found at Level III that the frequency of cancellations did rise to the level of a patient rights violation and the Level I finding was upheld. The actions taken by the service provider remedied the rights violation. (Level III decision in Case No. 00-SGE-03 on 9/12/01.)

  13. A patient wanted to bring a friend to her therapy sessions. The service provider agreed that there are times that it may be appropriate, especially if the person is a primary support person for the client. Bringing another person to a therapy session requires a signed release from the patient. Since the requested remedy was provided, this issue was considered resolved. (Level III decision in Case No. 00-SGE-03 on 9/12/01.)

  14. A complainant wanted to appeal the county’s Level II grievance decision made under HFS 94. He was incorrectly referred to the Division of Hearings and Appeals instead of the State Grievance Examiner. The county agreed that a mistake had occurred in this process. They revised the county manual and added the correct standard appeal language to the end of the grievance decisions that the county issues. Thus, the violation of rights was remedied and the issue was considered resolved. (Level III Decision in Case No. 03-SGE-05 on 1/23/04.)

  15. An ex-patient complained about a lack of individualized treatment at a psychiatric hospital. These concerns were meaningfully addressed when the hospital responded to his observations and concerns about the manner in which patients are assessed and treated. The hospital was planning a specific training session for staff to address indicators, features, and treatment approaches for Post Traumatic Stress Disorder and Parkinson’s Disease. The training would also address the variables that could arise with men’s issues during treatment. This staff training should lead to an improved awareness and create a better standard of care, greater dignity and respect for patients, and more individualized treatment decision-making. Given the training initiatives planned, this issue was considered resolved. (Level III Decision in Case No. 03-SGE-07 on 4/22/04.)

  16. A psychiatric hospital erred by not also informing the patient’s wife when his cost of care exceeded his insurance coverage, as she requested. The hospital needed to revise its admissions policies and procedures to cover release of billing information to those who may be responsible for it. The couple requested that the remainder of their outstanding bill for psychiatric care be waived. While it is concluded that his rights were violated, the remedial action requested exceeds the scope of the grievance process. If the couple wants to pursue that resolution independently, they would need to contact the facility to request a settlement or a private attorney for civil litigation. (Level III Decision in Case No. 03-SGE-07 on 4/22/04.)

  17. The sister/guardian of a woman filed a grievance about the care the woman had received while she was living in her own apartment. She had been receiving supportive home care services from an independent service provider under a general contract with the county. The guardian alleged abuse and neglect because of failure to report theft of monies and possessions and fraud and/or misrepresentation of funds. These issues were properly referred to other authorities. (Level III Decision in Case No. 03-SGE-04 on 6/15/04.)

  18. The sister/guardian of a woman filed a grievance about the care the woman had received while she was living in her own apartment. She asked for $500 per year replacement of the ward’s homestead money, which she previously received because she was in an apartment instead of an Adult Family Home, where she now resides, and $300 for moving expenses because the county did not move her. The grievance procedure does not have authority to award monetary damages. (Level III Decision in Case No. 03-SGE-04 on 6/15/04.)

  19. A service provider where the individual picks up his medications has inadequate parking, making it inconvenient for him at times. The service provider attempted to resolve this by offering him alternative times in which he could pick up his medication when the parking lot would be less crowded. These accommodations included: a) suggesting he pick up his medication on a Friday when the parking lot is less busy; b) picking up his medication in the afternoon when the staff parking lot is less full; or c) speaking with his case manager to arrange picking up his medication at a different time than the set times. They were also willing to arrange for him to pick up his medication when he meets with his psychiatrist every three months for his psychiatric medication check up, thus saving him four trips a year. These accommodations were reasonable and sufficient. (Level III Decision in Case No. 03-SGE-08 on 7/14/04.)

  20. The service recipient wanted to receive his medications in the exact form the pharmaceutical company sends it and as soon as they send it. However, the service provider has the need to double-check all medications being given to patients through the Patient Assistance Program (PAP). They do so through a local pharmacy. When they receive medications from any drug company they immediately send it to the pharmacy where it is checked, repackaged and dispensed. The pharmacy does not mix lot numbers or expiration dates, therefore each patient receives the same medication (with regards to freshness and lot number) as was sent from the drug company. The individual’s desire to receive his medication just as it was sent from the drug company is understandable; however, so is the service provider’s liability to make sure that he is getting exactly what medication he was prescribed from the drug company. The service provider agreed to have their professional staff open the medication, check its content, and dispense the medication as prescribed by his psychiatrist in order to avoid his medications having to go through the pharmacy, as requested. (Level III Decision in Case No. 03-SGE-08 on 7/14/04.)

  21. The confidentiality rights of a client at a methadone clinic were violated when she was called by her first and last name in the waiting room. The appropriate and professional way to address her would be to only use her first name when other clients are present. The clinic remedied this confidentiality breach by conducting a staff In-service on confidentiality. (Level III decision in Case No. 04-SGE-02 on 12/20/04)

  22. The information contained in response to a client’s grievance included personal and subjective observations that were not appropriate.  Here, the provider was informed of the appropriate information to include in the program level review of a grievance and this concern was considered resolved.  (Level III Decision in Case No. 05-SGE-003 on 6/8/06)

Last Updated: October 30, 2006