Can medical facilities delay the start of a 5150?

[TBTmemes17]

Was on scene yesterday for a client from a detox program. Paperwork said 5150 hold issued last Sunday...almost 5 days ago! Nurse at the medical only facility said hold hasn't "started" because the place isn't psych certified. That just doesn't add up for me. Are facilities allowed to hold patients that long without initiating the 5150 window?

 

[Jens0n]

A 5150 hold is supposed to be for up to 72 hours, and it needs to start officially once the person is in a qualified facility, they can't and shouldn't really hold someone under that code if the place isn't psych certified, I dont really know so much but I know it shouldn't stretch past the legal 72-hour limit for a 5150.

 

[TBTmemes17]

A 5150 hold is supposed to be for up to 72 hours, and it needs to start officially once the person is in a qualified facility, they can't and shouldn't really hold someone under that code if the place isn't psych certified, I dont really know so much but I know it shouldn't stretch past the legal 72-hour limit for a 5150.

Yeah, that's what threw me. If it's been almost 5 days and they're still claiming the hold hasn't started, something's off. If the paperwork says the 5150 was issued, shouldn't the legal window be ticking from that point? I'm gonna look into facility transfer logs and see what kind of delay might've pushed the timeline. If you've run into anything similar, was the hold ever reset once the person reached a psych-certified unit?

 

[Tise7]

Isn't it a huge legal and ethical issue if facilities can delay starting a 5150 hold just because they're not psych-certified? Doesn't that kinda sidestep patient rights and due process altogether?

 

[Cod3Blu3Runn3r]

You're right, the timeline is a problem. A 5150 hold begins the moment it's issued, not when the person gets to the facility. Long waits without a psych evaluation break patient rights and can get facilities into legal trouble.

 

[TBTmemes17]

You've both hit on exactly what felt wrong about the situation from a legal and patient rights perspective. I'm still digging into our transfer logs to map out the exact delay from the initial call. My working theory is a major breakdown in interfacility communication or a severe shortage of psych beds is causing a system wide backlog. I plan to bring it up with my supervisor and the receiving hospital's charge nurse to clarify their protocol.