Former Holly Hill employees share concerns about patient safety, citing escapes and understaffing

Understaffing, inexperienced employees, underreported escapes, worries about patient safety — all concerns from two former high-ranking employees of Holly Hill Hospital in Raleigh.

Over the past several months, since the escapes of five patients from the mental health facility in March, WRAL Investigates has been telling the stories of patients and their parents who have concerns about the care at Holly Hill.

Now, for the first time, we’re hearing from former high-ranking employees at Holly Hill. They agreed to speak with WRAL Investigates as long as we protected their identities.

“A chart is supposed to tell a story. You could never find the story. There were a lot of missing pieces,” the first former worker told us when asked about red flags she first noticed at the hospital. She told us patient records were “terrible.”

She also says efforts to fix the paperwork problems and issues with care were often dismissed by those above her, “Patient safety is the utmost and like I said you have to err on the side of the patients but a lot of times it’s ‘They are here and they are crazy and what they are saying is not true.’ They would discount that.”

The other former employee also had issues with Universal Health Services, Inc. (UHS), the for-profit company that runs Holly Hill. “[There were] competing priorities. From corporate it was always about filling the beds and financials. They would override the priorities of patient and staff safety at the facility level. It made it difficult,” he told WRAL Investigates.

Both former employees tell us the facility suffered from a lack of qualified staff — and staffing levels overall. “I think a big part of it was they had a lot of inexperienced people. Inexperienced people need more training. They were giving the same amount of training to someone with 20 years of experience that you were with someone with 20 days experience,” the second former employee said.

Staffing shortages led to concerns about patient and employee safety. Both say it also played a role in several elopements, or escapes by patients. “A lot of the elopements occur and going back to lack and adequate trained staff,” one of the employees said.

The first former employee said the protocol for escapes starts with calling 911 and the patient’s guardian. However, when WRAL Investigates asked if she was encouraged to under report or not report escapes, she answered, “I was encouraged to put them as ‘found in unauthorized spaces.’ We put patients on elopement precautions… You don’t notify the media. That’s how you know. It’s happened before when they didn’t get off the campus and they were in sight. They told me it was ‘found in authorized area.’ That is how it was classified.”

Former patients and their parents also raised concerns with WRAL Investigates about over-medicating, instead of providing meaningful therapy. Neither former worker saw or was aware of concerns about over-medicating, saying all drugs were administered with the approval of a doctor. However, one of the former workers said the drugs had another use. “The medication was used as a threat. ‘You better get in line or you are going to get some booty juice’ which is what they called it.” The other former worker admitted that the lack of quality patient records led to late notification or no-notification to parents.

Neither former worker had a simple solution to fix the problems they saw at Holly Hill and pointed to what they say is a “profit over patient” mentality at UHS.

WRAL Investigates has been reaching out for months to UHS to address the specific issues raised by the former employees, including staffing concerns, escape procedures and patient care. WRAL has not received a statement from UHS.

Holly Hill released the following statement:

The safety of patients and staff is Holly Hill Hospital’s primary goal. The protocols we follow are extensive and include regular training of all staff on appropriate evidence-based behavioral healthcare treatment interventions.

We support staff with education/training courses to meet regulatory requirements and ensure proficiency in patient care activities. We have many staff training and development opportunities all year long. We have daily huddles to review staffing, patient acuity, clinical programming, and maintain a positive staff and patient engagement on all units.

To ensure patient safety, Holly Hill Hospital is staffed to regulations, and staffing is reviewed routinely. We increase staff to meet the needs and acuity of the patients we serve on a daily basis.

Located in Raleigh, North Carolina, Holly Hill Hospital is a fully licensed inpatient and outpatient psychiatric facility serving individuals of all ages. We have been serving this community for 40 years.