For the second time this year, state inspectors have cited 206-bed Durham (N.C.) Regional Hospital for nursing-care violations that could disqualify it from Medicare and Medicaid. The Centers for Medicare and Medicaid Services asked the North Carolina Division of Facility Services to conduct a four-day, unannounced "validation survey" of the hospital, which occurred last month, to follow up on violations discovered in February, said Jim Jones, spokesman for the facility services division. The inspectors found that nurses were not properly documenting their assessments of patients and were sometimes taking independent actions that required orders from doctors, Jones said. The inspectors also cited the hospital's management for failing to properly oversee a contractor operating the hospital's inpatient dialysis unit, he said.
Since last month's inspection, Durham Regional, which is part of three-hospital Duke University Health System, Durham, has updated a software program that nurses use to allow them to provide greater detail in their assessments, hospital spokeswoman Katie Galbraith said. The nurses have completed additional training as well, Galbraith said. The hospital also has made changes to the dialysis provider's contract to ensure more formalized communication with the provider and better documentation of the unit's work, she said.