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The failure to conduct routine maintenance and implement a water management program led a state agency to bar Insight Health System from reopening its Warren facility.

The Ohio Department of Health performed a licensure monitoring inspection Sept. 23 at Insight Hospital & Medical Center Trumbull, 1350 E. Market St. The meeting included Insight’s facility director.

This newspaper made a public records request Sept. 24 with the health agency for a copy of its survey. The request was fulfilled Monday afternoon.

When asked for comment on the survey, an Insight spokesperson said the health system would provide an update later this week.

Medical Properties Trust of Birmingham, Alabama, which owns the property, did not respond when asked for comment.

“The inspection identified violations of Ohio Administrative Code (O.A.C.) 3701-22-06(A) and O.A.C. 3701-22-07 (K)(3) that require immediate attention,” wrote James Hodge, state Bureau of Regulatory Operations, to Insight official Mitul Patel.

Hodge is the bureau’s chief of health care compliance.

In a public meeting with federal, state and local officials Aug. 5, Insight CEO Dr. Jawad Shah pledged to reopen Insight Trumbull “within weeks.”

The survey focused on two areas.

“Based on observation, record review and interview, the facility failed to ensure routine maintenance was provided for the fire alarm and sprinkler system, generator, piped oxygen and

vacuum systems, boiler system, elevators, radiology equipment, emergency lighting,” the report detailed.

The state then detailed the second deficiency.

“(The) facility failed to establish and implement an effective water management program and preventative measures to address the potential for Legionella growth.”

The state inspector noted that documentation revealed the last quarterly inspections of the sprinkler system occurred Dec. 26, 2024.

“The hospital was equipped with two electric fire pumps, and no documentation could be provided of the required monthly churn tests to ensure proper operation,” the inspector wrote. “The hospital could not provide any documentation for the annual sprinkler and fire pump inspections.”

The facility director, who was not named, told the inspector that “inspections were scheduled but could not provide a date of when the inspections were going to be completed.”

Other comments regarding the first finding include:

* No fire alarm inspection documentation. The last annual inspection was completed March 8, 2024.

“The main fire alarm panel showed there were 11 active troubles on the system,” the report said.

The facility director said there “was not a current biennial sensitivity, semi-annual or annual inspection completed on the system.

“(The) inspections were scheduled but could not provide a date of when the inspections were going to be completed,” the state investigator was told.

* No documentation was provided in regards to a required annual generator inspection to be performed by a certified contractor. Referring to the facility director, the report said “the contractor had just completed the annual inspection and fuel sampling but could not provide any documentation for review.”

* Panels connected to piped oxygen and vacuum throughout the building showed low or zero pressure.

“When testing and inspection documentation was requested, none could be provided,” the inspector wrote.

* Boiler inspection certificates showed an expiration date of Dec. 31, 2024.

“A request was made for the current boiler certificates, and none could be provided,” the survey said.

During an interview with the facility director, he said “the boilers were recently inspected but could not provide the date the inspection occurred or any documentation related to the

inspection.”

* One of 11 elevators was out of order. The elevator inspection certificates showed an expiration date of June 30, 2024.

“A request was made for the current elevator certificates, and none could be provided,” the state inspector wrote.

* The radiology equipment certificates had an expiration date of March 31, 2025. The inspector said he asked for current certificates but none could be provided.

* The state agency sought, but did not receive, the following inspection documentation: annual fire door inspections; annual receptacle inspections; required fire damper inspections; and weekly and monthly emergency light testing.

The hospital’s water management program also came under scrutiny. According to the survey, Insight is required to “take steps to manage the risk of occurrence and transmission of waterborne pathogens, including but not limited to Legionella, in building water systems …”

According to the U.S. Centers for Disease Control and Prevention, Legionella is a bacterium that contributes to a type of pneumonia. It is associated with Legionnaires’ disease.

The state sought “a copy of the hospital’s water management plan and Legionella surveillance was requested. No records were provided during the inspection. There were no previous water quality tests to review.”

During the Sept. 23 inspection, the facility director said the hospital would have an outside contractor manage the water program.

“(The) facility has not performed any precautionary measures such as flushing of all hot water distribution systems, adjustments to hot water temperatures or identifying areas of poor

water flow to prevent stagnation to prevent Legionella growth,” the state was told.

Michigan-based Insight paused its Trumbull County operations, including Insight Rehabilitation Hospital Hillside, in late March. That came seven months after it obtained the properties from Steward Health System in U.S. Bankruptcy Court.