Kansas to seek recertification for Osawatomie State Hospital

Lawmakers raised concerns Thursday about low staffing levels at state mental hospitals after Osawatomie State Hospital lost its Medicare certification last month.

The state plans to seek recertification for the hospital that takes involuntary admissions from Sedgwick and other counties, said Tim Keck, the interim secretary of the Kansas Department for Aging and Disability Services.

But Keck struggled to answer lawmakers’ questions about how the agency plans to resolve safety issues cited by federal investigators. Those investigators found that the hospital had failed to supervise care, perform safety checks and protect suicidal patients.

Lawmakers blamed the safety problems on low staffing levels.

“I think we’re spinning our wheels if we don’t make a firm commitment to get that staffing level back up,” said Sen. Jim Denning, R-Overland Park. “… You can’t work the amount of overtime there. Somebody’s ready to go home at five and they’re told you’ve got to work another eight hours. You can’t do that long-term.”

State officials could not tell lawmakers at the hearing how many staffing vacancies the hospital had. Later, a spokeswoman for the Kansas Department for Aging and Disability Services said Oswatomie has 187 vacancies out of 483 positions, or a vacancy rate of 38.7 percent. That rate is 34.9 percent when 18 contract workers are included.

Keck, who is in his third week on the job, said the state has 60 days to appeal the decision by the federal Centers for Medicare & Medicaid Services but that it planned to apply for recertification instead.

He told the Joint Committee on Health that the agency would hire a consultant to help with recertification efforts and that it hopes to achieve recertification in about three to six months.

The loss of Medicare dollars is projected to cost the state about $1 million in federal funds each month until then.

Staffing levels

Sen. Laura Kelly, D-Topeka, asked Keck if the agency planned to seek more money to hire more people. He said the agency was assessing how much additional money might be needed to hire more staff and could not say now if it would ask for more funding.

Keck said after the hearing that he could not specify a dollar amount now because the agency’s human resources department is analyzing how much money in overtime pay could be saved by increasing staffing.

Rep. Les Osterman, R-Wichita, voiced frustration about the lack of specific answers.

“You haven’t answered the question in my opinion,” he said, contending that staffing was the problem identified by federal officials. “… You have to correct what they got you on.”

He said that he doubted the state would be able to obtain recertification unless it addressed staffing.

Bill Rein, the commissioner of behavioral health services at KDADS, told the committee that the biggest hurdle was recruitment and that Osawatomie has struggled to attract nurses when competing with hospitals in the Kansas City area.

Asked after the hearing about recruitment and retention issues, Keck replied that people he’s “talked to and heard from say it’s not the money. It’s the fact that they’re working a lot of overtime … the time they spend away from their families and those sort of things.”

Rep. Scott Schwab, R-Olathe, asked Rein how many unfilled positions the hospital has now. When Rein gave a lengthy response that did not directly answer the question, Schwab turned to a legislative staffer and asked her to find the number for him instead.

Asked again after the hearing, Rein could not say the number of vacant positions at the hospital.

Comparison with Larned

Rep. Jim Ward, D-Wichita, also asked Rein about concerns raised by federal investigators about a lack of patient supervision at the hospital and inaccurate record keeping. He asked what the agency was doing to resolve that.

“I agree with you,” Rein said. “That is the worst possible thing that could ever happen is altering a record. We do have individuals in there now who are looking at those records every single day … and making sure that things are documented the way they should be. But, you know, I’m not going to stand here and tell you that things don’t sometimes slip by, that there aren’t people who sometimes, you know, say they made checks they didn’t make.”

Keck added that he has “made it loud and clear” to the hospital’s staff that the agency won’t tolerate the falsification of records.

Schwab asked about the state’s other mental health hospital in Larned, where concerns about staffing also have been raised. “Is that going to be the next shoe to drop?” he asked. “… So this time next year we’re not going to have this conversation about Larned State Hospital?”

Keck replied that the agency has been working to address staffing issues at Larned to ensure that doesn’t happen.

Keck started work as interim secretary this month after former Secretary Kari Bruffett took a position with the Kansas Health Institute, a Topeka-based think tank.

He said his first three weeks have been focused on resolving the issues at both state hospitals.

This story was originally published January 21, 2016 at 4:42 PM with the headline "Kansas to seek recertification for Osawatomie State Hospital."