Las Vegas psychiatric hospital gets a year to fix safety issues

The federal government has entered into an agreement with Montevista Hospital in Las Vegas that gives the psychiatric facility a year to “come back into compliance with federal health and safety requirements designed to protect patients” and regain eligibility for federal funding.

The Centers for Medicare & Medicaid Services (CMS) late last month entered into a “systems improvement agreement” with the 202-bed psychiatric hospital, the second largest in Nevada. The agreement requires the hospital to hire an independent quality improvement expert to perform a “root-cause analysis” of what caused it to fall out of compliance with federal standards, said Jack Cheevers, a spokesman for CMS, a branch of the U.S. Department of Health and Human Services.

“Based on the expert’s recommendations, the hospital will develop a corrective action plan,” Cheevers said. Once the plan is approved by CMS, the hospital will be required to implement it. The quality expert, whom the federal agency must approve, will give periodic reports on the hospital’s progress to the federal agency.

In August, citing concerns about patient health and safety, federal regulators terminated CMS’ agreement with the hospital and cut off Medicare and Medicaid funding. The federal agency cited the hospital for “immediate jeopardy,” defined as noncompliance with government regulations that “has caused, or is likely to cause, serious injury, harm, impairment or death.”

Drug transfers, escape

Regulators identified an “immediate jeopardy” situation on June 5 in relation to incidents of patients giving their medication to other patients, by hiding or “cheeking” it, according to federal documents. They also documented situations on June 5 and 12 where patients set off fire sprinklers, which resulted in patients escaping from the facility, including one who was not found and did not return. These immediate threats were abated June 12, according to the documents.

During its investigation, regulators determined that the hospital had failed to comply with requirements related to patients’ rights; quality assessment and performance improvement; nursing services; medical record services; and having an effective government body.

On Oct, 21, the federal agency signed the systems improvement agreement, which is effective for one year, after rescinding the termination of Montevista from its program.

“Under the terms of the agreement, CMS will closely monitor the hospital’s efforts to come back into compliance with federal health and safety requirements designed to protect patients,” Cheevers said. It also will respond to any patient complaints during this time period.

At the conclusion of the agreement, CMS will conduct a survey of the hospital. “Montevista will be eligible for federal funding again if a certification survey finds it in full compliance,” Cheevers said.

There are only a few psychiatric hospitals in the state offering both acute and long-term residential services for teens. “We are working with the hospital in hopes of ensuring continued access to those services for the state’s adolescent population,” Cheevers said.

The recent regulatory issues with Montevista have resulted in the need to “send more kids out of state” for psychiatric hospitalization, said Sheldon Jacobs, a licensed family and marriage therapist who advocates for more locally based mental health services.

“It’s a challenge,” said Jacobs, a board member for the Southern Nevada chapter of the National Alliance on Mental Illness. “Some of the families don’t have the resources to be able to travel to and from” an out-of-state facility. “We’re wanting to be able to keep our kids local. Kids tend to do better amongst their support system.”

Jacobs noted that even before Montevista’s regulatory issues, there had been a long waiting list at Desert Willow Treatment Center in Las Vegas, a state-run facility with 20 beds for adolescents. Montevista has 92 beds for adolescents, the most of any hospital in Southern Nevada.

Admissions ban lifted

Working with federal regulators, state regulators imposed a ban on new admissions to the hospital in late July. The ban was lifted a month later, after inspectors returned to the facility and determined that a plan of correction was being implemented, a spokesman for the state Department of Health and Human Services said this month.

“Montevista Hospital is open and our dedicated team is at work fulfilling our mission: To provide safe, high-quality care to our patients,” hospital CEO Steve McCabe said in a statement.

“We are fully licensed to admit patients by the state of Nevada and currently have an active provider agreement with CMS. We look forward to continuing to provide access to services vitally needed by our community.”

The hospital is owned by Strategic Behavioral Health, which operates facilities around the country.

Contact Mary Hynes at mhynes@reviewjournal.com or 702-383-0336. Follow @MaryHynes1 on Twitter.