3,287 Comments for Danvers State Hospital

red but beautiful

LOCAL HISTORY SAYS THAT WHEN THEY SHUT DOWN , THEY FORGOT TO DRAIN THE WATER PIPES OR EVEN SHUT OFF THE MAIN SUPPLY FROM THEIR OWN RESVOIR[SIC] ON SITE .NOBODY NOTICED FOR OVER A YEAR WHEN SOMEBODY NOTICED WATER RUNNING OUT OF A DOOR.THEY FINALLY SHUT OFF THE SUPPLY[DAMAGE DONE] . SAY MOTTS,WHILE I'M HERE HOW ABOUT SOME PICS FROM "GRAY GABLES"? THANKS "MOE"

Caution: Rant Ahead. :-)

To get a better feel for the types of standards expected of various facilities, here are some examples. This does not cover facilities for people who have a mental illness, as I do not work in one currently and am less familiar with their regs.

If you run a facility for people who have intellectual disabilities you are funded by the Centers for Medicare & Medicaid Services or CMS - formerly known as HCFA (Health Care Financing Administration). These folks administer the Medicaid and Medicare programs. A facility that provides services to people with intellectual disabilities (formerly called mental retardation) is known as an Intermediate Care Facility for the Mentally Retarded, or ICF-MR. For more information about this, go to:
http://www.cms.hhs.gov/

People who receive funding for ICFs-MR are surveyed using the following set of regulations:
http://www.cms.hhs.gov/m...intermcare.pdf
These are the ones I personally am the most familiar with and which I use to do our monthly mock surveys.

A number of states have additionally asked their facilities and programs to be surveyed by The Council on Quality and Leadership (formerly The Accreditation Council for Developmental Disabilities). They have additional sets of guidelines - "Personal Outcome Measures" and "Quality Measures 2005":

http://www.thecouncil.org/misc/cdrom/

If you have a facility that is funded for people who have need of skilled nursing services (SNF) you are surveyed using the following regulations:

http://www.cms.hhs.gov/ma...107c07.pdf

The place I currently work has two separate sections of campus; one for folks under the ICF-MR regs, one for folks with skilled nursing needs (SNF). Our campus is surveyed by both agencies.

Many hospitals or facilities also try to get accreditation under the Joint Commission on Accreditation of Healthcare Organizations or JCAHO. JCAHO has differing sets of accreditation standards depending on the specific population being served.
For example, here are their standards for assisted living facilities:
http://www.jcaho.org/h...ted+living/index.htm
Here are their standards for long term care facilities:
http://www.jcaho.org/h...care/index.htm

Additionally, facilities must meet code for the following:
->OSHA (Occupational Safety and Health Administration):
http://www.ilo.org/pub...osha-gnh.htm
->HIPAA (The Health Insurance Portability and Accountability Act of 1996):
http://www.cms.hhs.gov/hipaa/
->National Fire Protection Association (NFPA) 101 Life Safety Code:
http://www.dads.state....L90.61.htm

As an FYI, I always chuckle when someone tells me they got 100% positive ratings on a survey. This usually means that money is tight and the surveying groups are being asked to be a bit loose with the regs, or it means that a larger pattern hasn't been discovered by the surveyors, which is what you really should have before you start issuing citations, given that all facilities will always have at least a handful of areas of noncompliance.

Surveyors are like police officers. It is impossible for most of us to get through a 24-hour period without breaking a law of some sort, especially those laws we aren't familiar with but are still on the books. A police officer is supposed to figure out whether any of the one million illegal things we all do every day is of sufficient magnitude to warrant an arrest or whether there is a pattern of things that occur that makes him or her feel the need to send out a message that this is a law that needs to be followed. Littering, changing lanes without a turn signal, not following antiquated blue laws that are still on the books, jaywalking, etc., occur every day. There is a reason for many of these laws. However, at what point do you actually enforce them or consider that someone is a criminal for breaking them?

Remember too, because of the recent increase in federal budget dollars directed toward Iraq, hurricanes Katrina and Rita, plus other exciting things that are happening in our world, the federal folks are discussing slashing the Medicaid and Medicare budgets or doing away with many of the programs altogether. Most facilities that serve people with these types of needs are not currently in a financial place to afford many of the things that they are asked to provide right now. How do you think things are going to look in ten years if they cut these programs? We will be right back to where we were 50 years ago when they realized why they needed to fund these sorts of programs, and ironically, this may be seen nostalgically as one of the few times we were able to provide programs, services, and safeguards to people with severe needs.

A final FYI is this - we are trying to change the focus of our systems from "blame" to figuring out WHY problems occur. We now actually encourage the reporting of problems because if we always assume it is the person causing the problem and not the fact that the system may be faulty, we can't do anything to fix it. The danger in admitting a problem is that you often then have someone come in and play the finger-pointing game ("Oh look! They received a citation! They must be 'bad'!"), you are forced to be reactive and not proactive, and then you can't fix the problems:
http://www.ddssafety.net/...management.pdf
http://www.ahrq.gov/clinic/ptsafety/chap40.htm

I like to see history preserved as much as possible. I've seen too many historic buildings come down and replaced with artisticly confusing structures, such as happened in Atlantic City. Nature destroys enough history. Look at what Katrina did to New Orleans. Let us try to preserve what we have left.

Sorry, Puddleboy, you have to give up being your own self! 8`-)

No, kau, Puddleboy is a real person and he is correct.

What an odd thought! No, that is only for people on suicide watch who are unsupervised. Or for people in jail. Geez, if we took away the belts of everyone who lives in a mental health facility we would get abuse or neglect charges for letting peoples' hind ends show! 8`-)

Mattie,

First of all, you need to understand what those stats mean. What they mean is whether a facility has followed every single state and federal regulation to the letter. If you have a chance to read through the hundreds of pages of regulations an agency is supposed to follow you will find that this is pretty much an impossibility, and what your survey teams will tell you is that this is what the ideals are, rather than what they believe can always happen on a consistent basis. If every one of us in our own homes were held to the same standards we would have as bad or worse a rate. In truth, and as someone who does mock surveys on a monthly basis, if your survey teams surveyed to the absolute literal letter the rate would always be 100%.

Pull up a set of regs at some point and see what is being surveyed before you get too excitable about what those numbers mean. Neglect can be alleged if the person who does the monthly or quarterly paperwork reviews does not get their paperwork completed on time. It can be alleged if a person misses a single dose of medication or the medication is given 2 minutes past a particular window of time, whether or not it is an "important" medication or whether any negative condition occurs as a result of this action or inaction. It can be alleged if meals are given 10 minutes late, even if the person was at another activity or the stove breaks. It can be alleged if the water temperature is 1 degree above the prescribed range, whether or not anyone is taking a bath or shower. I have been an agencies where these specific "neglect" allegations have been made by a survey team. In each case they were technically correct citations, but they did not result in anyone being harmed.

The standards are incredibly tough, and for a good reason, but as I said above, I doubt there is anyone I personally know who could follow them in their own home on a consistent basis. You have to set tough guidelines so people know what "should" happen. If someone comes to your house unexpectedly and wants to make sure that you gave your children their dinner no more than a specified number of hours after the last one or whether you had a scald guard on every one of your water taps or whether every single bottle of cleaning material was secured and unreachable or every single thing you put in your refrigerator was signed, sealed, and dated, I am guessing you might not have a perfect record either.

The flip side is that if you are going to ask for standards to be set this high you are supposed to fund an agency so that they can carry out these standards. Federal and state regulators have a tendency to set high standards, as they should, and then legislatures have a tendency NOT to fund the agencies so they can carry these standards out.

So just because an agency has a neglect allegation does not mean that they are also being abusive, and it most certainly does not mean that one should jump to the conclusion that therefore everyone who ever lived in a facility was strapped into a chair. That is a leap across a chasm taking two jumps to get there.

less than 5% of geriatric care facilities and mental intitutions in the USA have a clean record of abuse or neglect violations by federal investigators over the past 5 years.

yes, that's right, of the over 10,000 facilities in the country, less than 500 have gone 5 years without neglecting or abusing a patient.

so you see however great the intentions of the people using these chairs, for all practical intents and purposes... it just doesn't seem to work out.

if you believe otherwise, I can only hope your destiny lands you in one of these in your future, helpless at the hands of another.

uh..... it is just me or is anyone else wondering why the hospital has need of thousands and thousands of 'belts?'

don't mental patients normally wear beltless trousers?

Yep, awesome. We'll be waiting for more.....

I honestly don'y believe puddleboy is who he says he is. This is my first time here so hello by the way. Im pretty sure a land-developer would know enough not to build condominiums on a site like this. Who would you rent units to? No if somone wanted to make money they would pick something a little less 'charged,'

I always had to pass Danvers State Hospital on my way to school. Got curious and found this site. Started to talk about the place with my mom and found out that when she was a nun (before she quit!) she had to teach religion at Danvers and was attacked in a hallway just like this one night on her way out. It took three orderlies to save her.

I feel like the only one who hasn't seen session 9. Gonna try and get it tomorrow..

THIS IS AWSOME,
sadistic in an Admin sort of way

everything about this photographer's thought processes and artist intuition is awsome!