Broughton Hospital News

Hospital shrinks to qualify for funds
Staff shortages, training at issue
Lynn Bonner, Staff Writer
http://www.newsobserver.com/news/story/789867.html
From the 24 November News & Observer

Broughton Hospital in Morganton, one of four state mental hospitals, has made itself smaller in an effort to restore federal money lost because of problems with patient care.

Officials have shut down parts of the hospital where short-term patients stay -- keeping vacant 38 beds in what has been a heavily used unit -- to concentrate staff in fewer areas.

Broughton lost its ability in August to collect about $1.3 million a month in federal insurance money after investigations into patient treatment found problems with hospital staffing and training. The hospital also no longer qualified for money from a related federal program that brought millions of dollars to the state last year.

The federal government cut insurance payments to Broughton after one patient died and another was seriously injured. In February, a 27-year-old man suffocated after staff members held him to the floor, with one person reportedly lying across his chest. Months later, a patient who was supposed to be closely supervised suffered a serious head injury in a fall.

The state sent in a team to try to fix problems at Broughton. Whittling away at the number of patients was a way to deal with a shortage of psychiatrists.

"We're doing this as a stopgap measure to get us ready for our recertification," said Mike Moseley, director of the state mental health division. "That's our only intent. We want to be recertified just as quickly as we can."

Moseley said patient space has decreased only temporarily, until the hospital can hire more psychiatrists.

In the meantime, he said, patients get better care.

"Psychiatrists have to run from building to building when you have major vacancies," he said.

Broughton is short six psychiatrists. The hospital Web site also posted jobs this week for 13 registered nurses and two staff psychologists.

Some patients are checking into local hospitals rather than going to Broughton, or traveling to state mental hospitals in Granville County, Raleigh or Goldsboro.

Under pressure

Liz Smith, a past president of the Western North Carolina chapter of the National Alliance on Mental Illness, said it is "horrible when people are diverted" to hospitals hundreds of miles from their homes. It's hard enough for people from some western counties to get to Morganton to visit relatives at Broughton, she said, never mind driving to Raleigh or Goldsboro.

The hospital has a longstanding shortage of psychiatrists, Smith said, one that's not likely to be solved in a few months. What's more likely to happen, she said, is that after inspectors come through, the hospital will start using those 38 beds again, whether or not they have enough psychiatrists to treat the patients.

"The pressure is on the hospital to accept people, because there's no place for them in their communities," she said.

Short-term admissions to the state mental hospitals have jumped in recent years, so much that this year the state division of mental health decided to stop new people from coming in when the admissions areas are at 110 percent of capacity.

Broughton was able to stop using 38 short-term beds because admissions dropped over the past month, said Dr. Michael Lancaster, a top administrator in the state mental health division. He is directing the hospital's reorganization.

The hospital is concentrating on filling key job vacancies, he said. But Lancaster said the need for fewer admissions beds could be long-lasting if communities have to cut back on their use of state hospitals to show the hoped-for results.

Depending on the outcome of the division's mock inspection next week, state administrators may ask federal inspectors to come back as soon as possible.
In the best case, Lancaster said, federal inspectors will return in mid-January and decide that the hospital can once again qualify for federal money.


lynn.bonner@newsobserver.com or (919) 829-4821