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Portland mental health emergency room accused of retaliation; new problems crop up

TRIBUNE FILE PHOTO - A nurse who blew the whistle on unsafe conditions at the regional mental health emergency room called the Unity Center for Behavioral Health has filed a retaliation complaint against Legacy Health, which operates it.A whistleblower who alerted state health care officials about hazardous and neglectful conditions for patients at Legacy Health's Unity Center for Behavioral Health has quit and filed a complaint claiming the hospital system's management retaliated against him for raising concerns.

Filed by longtime Legacy nurse Christopher S. Lambert, the complaint to the state Bureau of Labor and Industries makes new allegations about how the Portland-based hospital system has responded to the investigation by the Oregon Health Authority, the one Lambert helped spark. Specifically, it suggests that Legacy management sought to punish him after he complained of safety issues, and also sought to cover up problems on more than one occasion by keeping him from talking to state investigators.

Lambert's complaint comes even as Legacy officials are scrambling to be removed from a "termination track" that would block it from receiving federal funds if the problems at Unity Center are not cleared up by Oct. 31. A state inspection earlier this month discovered a new round of problems at Unity — problems that Legacy says it has already addressed.

On Friday, after the Portland Tribune shared a copy of the complaint with Legacy and asked for comment, the hospital system posted an anonymous statement on its website that did not directly respond to Lambert's claims of retaliation and cover-up.

"Legacy Health was recently made aware of an individual complaint brought by a former employee with the Oregon Bureau of Labor and Industries," said the statement. "Many of the allegations already have been the subject of review by other agencies. As with any investigation, Legacy Health and Unity Center for Behavioral Health will fully cooperate with BOLI."

Rosy vision

After years of lobbying, and with some public funding and local and state support, the center was set up to great public acclaim by Adventist Health, Legacy Health, Kaiser Permanente, and Oregon Health & Science University. It's goal: to divert people in mental health crisis from emergency rooms where they had often been warehoused without appropriate care.

The Northeast Portland facility opened in January 2017 as a 24-hour hospital overseen by Legacy to provide mental health emergency services for adults and adolescents. It is available for walk-ins, transfers from other hospitals, and for police to drop off people who may be dangerous to the community or themselves, but don't belong in jail.

According to his complaint, Lambert warned Legacy in advance that its plans would create hazardous conditions.

Later, when that came true, he was one of two nurses who went to the Oregon Health Authority with patient safety concerns starting in February 2018, even as the state Occupational Safety and Health division was wrapping up a separate and scathing investigation into complaints of unsafe conditions for employees.

A copy of the nurses' complaint to OHA shows that the employees' specific concerns were largely borne out by the state's subsequent investigations. One likened the facility to a "'hell hole.'

Scathing reports

In two reports released thus far, the state found a slew of problems, including that:

• Unity had created an "immediate jeopardy" situation for patients based on "numerous hazards in the physical environment, a lack of patient supervision, and lack of clear protocols for response to medical emergencies."

• Two patient deaths in the past year followed inadequate care or oversight by Unity employee.

• Reports of abuse, self-harm and sexual assault and other assaults were not followed up on properly.

Based on the state's findings, the federal Centers for Medicare and Medicaid Services placed the Legacy facility on a "termination track, "meaning if it did not fix the problems it would no longer be eligible to receive federal reimbursement.

Legacy has made two rounds of changes to address the problems and says it recently got approval of a third round.

State investigators visited Unity on Oct. 3, 4 and 5 and found a new round of problems detailed in a new report, as was first reported by the Portland Business Journal. The state called the remaining problems "narrow."

According to Legacy, the state has already accepted its plan of correction for the new problems found: "We are focused and engaged in a full implementation of improvements to our physical environment, our practices, and procedures."

Regardless, the Lambert whistleblower complaint suggests Legacy may soon be facing a new lawsuit.

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