Failures at state hospital are shocking

As difficult as it could be on the state’s budget, the federal government was correct to decertify the Osawatomie State Hospital. Security and other “systemic” failures at the mental health facility are serious and shocking.

The Centers for Medicare and Medicaid Services sent inspectors to the hospital southwest of Kansas City last month after the reported Oct. 27 rape of a mental health technician by a patient. The worker was attacked when taking gowns to the patient’s room. Two other patients eventually came to her rescue before other hospital staff arrived.

Among their findings, the inspectors determined that “failure to supervise the provision of care, to perform required safety checks and to protect suicidal patients from hanging risks placed all patients receiving services at risk for harm.” For example, video logs showed that security staff did not conduct the mandated 10-minute safety checks of the man who raped the worker.

Inspectors returned this month and identified additional problems, including that nursing staff placed another patient, a male sex offender, in a section of the hospital for women. The man “displayed inappropriate sexual behaviors including kissing other patients, attempting to kiss other patients, hugging and inappropriately touching other patients, and having another female patient place her hands down his pants,” according to the inspection report. He had sex with one of the patients who had suicidal behaviors.

Nursing staff also assigned a violent female patient to share a room with a vulnerable woman in a wheelchair.

As a result of these findings, CMS cut off federal Medicare funds for new patients, starting last Monday.

There were only 14 Medicare-billable patients in the hospital as of Wednesday, according to the Kansas Department for Aging and Disability Services. Federal reimbursement for those patients will continue for up to 30 more days, but if the hospital isn’t recertified soon, the funding loss could become significant.

Medicare payments to the hospital from July through November of this year totaled $1.8 million, KDADS spokeswoman Angela de Rocha said. Certification also affects the calculation of extra funding the hospital receives for serving a disproportionate share of uninsured patients. That could cost the state an additional $600,000 per month.

CMS had already raised other serious concerns about Osawatomie, including chronic overcrowding. Earlier this year CMS found the hospital out of compliance with federal safety standards, which prompted KDADS to close parts of the facility in order to make repairs and improvements. That created waiting lists for admissions in Sedgwick County and other counties in Osawatomie’s service area.

The hospital has taken some steps to improve security, including providing each worker with a personal alarm button. But it needs to increase and improve staffing – which could be challenging, given the relatively low pay and the safety concerns.

KDADS and Osawatomie officials are still reviewing their options. In order for the hospital to be recertified, CMS inspectors must survey it again and ensure that the problems have been resolved and the hospital meets federal standards.

The state must fix these failures as soon as possible. The safety and well-being of patients and staff depend on it.

This story was originally published December 26, 2015 at 6:05 PM with the headline "Failures at state hospital are shocking."