Friday, September 14, 2007

2nd N.C. mental hospital may lose federal funds (from N&O) 9/12/07

Michael Biesecker, Staff Writer RALEIGH

- Less than three weeks after federal officials cut off money to a state psychiatric hospital in Morganton, a second hospital is being threatened with the same punishment.
State officials were notified this week that the federal agency that oversees Medicaid and Medicare payments is considering the withdrawal of support from Cherry Hospital in Goldsboro. That could leave two of the state's four psychiatric hospitals unable to claim federal insurance reimbursements and force state taxpayers to pick up the cost of care for more poor and elderly patients -- a bill that could run into the tens of millions of dollars.
The move came after patient complaints about the quality of care at the Goldsboro hospital triggered a four-day visit last week by inspectors from the state office that enforces federal regulations. The team found several violations and recommended that the hospital's certification be revoked if the problems are not fixed and staff retrained by Sept. 30. The federal Centers for Medicare & Medicaid Services, which can impose the suspension, is considering the recommendation.
Dr. Jim Osberg, who oversees the state hospitals for the N.C. Department of Health and Human Services, said Tuesday he was still awaiting a full written report of the findings, but that he had been told of three recent incidents under investigation at Cherry:
* A patient escaped from the hospital, and the staff failed to "respond appropriately," Osberg said, adding that there was "inconsistency" in how the matter was reported.
* A patient was "improperly restrained" with handcuffs while being transported from the psychiatric facility to a nearby emergency room for medical treatment.
* A patient in the hospital's admissions office suffered a "delay" in receiving needed oxygen.
Osberg said that none of the incidents resulted in patient injuries.
Admissions at state psychiatric hospitals have soared since the implementation of a 2001 reform plan mandating that county-run mental health clinics be closed in favor of private facilities. Though the burden on the state's four psychiatric hospitals has grown, officials are pushing ahead with plans to close Dix Hospital in Raleigh and Umstead Hospital in Butner early next year.
Osberg said he is confident that issues at Cherry can be corrected quickly enough for the hospital to avoid the loss of its federal certification at the end of the month. "Cherry has already begun the process of fixing those problems," Osberg said Tuesday. "We're moving forward to ensure compliance."
On Aug. 25, the federal Centers for Medicare & Medicaid Services stopped payments to Broughton Hospital in Morganton following an investigation of the February death of patient Anthony Lowery. Lowery, 27, stopped breathing after being held down by seven staff members, one of whom was lying across his chest, according to the federal report.
Though it is not unusual for federal authorities to threaten cutting off money to a hospital, it is rare for such a serious sanction to be imposed. The Morganton hospital will still treat Medicare and Medicaid patients, but state taxpayers will have to pick up the tab. Federal authorities could not be reached for comment Tuesday.
This isn't the first time there have been problems at Cherry, a 284-bed hospital that serves patients from 33 eastern counties. Janella Williams died last year after being restrained by the staff. Another patient's leg was broken while he was being restrained. Both incidents are now the subject of lawsuits.
Osberg said he was aware of deaths at Cherry in 2005 and 2006 that triggered federal reviews. In one case, a patient got hold of a sheriff's deputy's gun, shot a staff member and then shot himself. In each case, the state was able to resolve the problems found by investigators before federal support was revoked.
While saying it is unfortunate that two of the state's four psychiatric hospitals are being scrutinized at the same time, Osberg said he was not concerned that the reviews indicate more widespread problems. "This does happen from time to time," Osberg said. "I see these as related. The only thing I think is systemic is that our four hospitals treat very challenging patients."
Staff writer Michael Biesecker can be reached at 829-4698 or

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