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Federal Surveyors Cite Osawatomie State Hospital Again

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For the second time in three months, federal officials have notified Osawatomie State Hospital that it’s on the brink of losing its Medicare payments because it is out of compliance with health and safety standards.

The latest warning, issued Jan. 30, stemmed from a Jan. 23 inspection that resulted in the hospital being cited for deficiencies in medication management and infection control, and for not doing enough to prevent suicidal patients from hanging themselves.

The hospital, according to state reports, is expected to receive $6.88 million in Medicare receipts for the current fiscal year. That’s almost 23 percent of the facility’s total budget.

Osawatomie State Hospital is the largest of the state’s two inpatient facilities for adults with severe and persistent mental illnesses.

Kansas Department for Aging and Disability Services Secretary Kari Bruffett, during an appearance Wednesday before the House Social Service Budget Committee, said hospital officials had submitted a plan to correct the deficiencies, most of which involve “environmental issues.” The plan includes changes such as replacing or modifying furniture, removing closet doors, sealing electrical outlets and taking down framed pictures and glass mirrors.

“We believe that the hospital remains in compliance,” Bruffett said. “But it’s also very important to comply with the survey findings and ensure that we have removed any jeopardy for patients.”

In keeping with the hospital’s correction plan, she said KDADS will spend $250,000 on new beds.

The money, Bruffett said, will be taken from the $1.9 million received from the recent sale of the former Rainbow Mental Health Facility property in Kansas City.

The total cost for implementing the correction plan, she said, is not yet known.

Security concerns raised during inspections last month and last fall have caused the hospital to enact policies directing staff to check on each patients’ well-being every 15 minutes, KDADS spokesperson Angela de Rocha said in an email.

KDADS has not yet released copies of the Jan. 30 inspection report.

Since 2008, de Rocha said, Osawatomie State Hospital has reported one patient suicide.

In November, the Centers for Medicare and Medicaid Services regional office in Kansas City, Mo., warned the hospital that its Medicare funding was in jeopardy after surveyors cited it for being overcrowded and for not doing enough to ensure proper medical care.

In an effort to reduce the hospital’s census, KDADS in December suspended voluntary admissions and launched a concentrated effort aimed at finding residential alternatives for approximately 50 patients.

“Some of these folks had been in the hospital for years and years,” Bruffett said. “Sometimes that’s appropriate, and sometimes it’s because there’s not a place to discharge them to, or it’s difficult to discharge them and get them the services they need because of the complexity of their diagnoses.

“What we’re seeing more and more is that as patients age, their medical fragility increases as well,” she said. “And finding places that can care for both their physical and mental health needs can be challenging.”

The search for residential alternatives, Bruffett said, resulted in most of the 50 patients being discharged to community-based settings in a “span of a few weeks.”

CMS officials later accepted the hospital’s plan for reducing its census and improving medical care, allowing its Medicare receipts to continue.

Bruffett said CMS officials are expected to conduct a follow-up inspection on the latest correction plan sometime before Feb. 23.

Dave Ranney is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team.

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