Accrediting officials investigating psychiatric hospital in wake of patient dumping allegations

Allegations of patient dumping at Rawson-Neal Psychiatric Hospital gained the attention of federal and independent agencies that sent investigators to the Las Vegas facility Thursday and Friday.

Mental health advocates, civil rights leaders, and even U.S. Sen Harry Reid, D-Nev., say the Rawson-Neal investigation — conducted by the federal Centers for Medicare and Medicaid Services and the Joint Commission, an independent organization that accredits hospitals — touches on a much larger problem: the state of Nevada’s mental health system, which they called one of the worst in the nation.

“Nevada for years now has put mental health backwards,” said Reid on Friday, adding that he faults the state for that, not individuals such as Republican Gov. Brian Sandoval. “They have just given mental health a really short shrift.”

Mary Woods, spokeswoman for Nevada’s Department of Health and Human Services, said Rawson-Neal administrators knew an unannounced visit from federal officials would happen at some point and that their expertise is welcome.

“Ultimately we want to make sure we provide the best care possible to our patients,” Woods said in a Friday statement.

Elizabeth Eaken Zhani, spokeswoman with the Joint Commission, said officials also are reviewing Southern Nevada Adult Mental Health Services, which oversees the hospital. When asked whether the agency could lose its accreditation, she said it’s possible.

However, this visit was just the first step of a process. “It just means that something was brought to our attention that was concerning,” she said.

The concerns that sparked the investigation are rooted in how Rawson-Neal provides care, treatment and services, Zhani said.

The hospital came under scrutiny after a Rawson-Neal patient was discharged and bused to Sacramento, Calif., with no support waiting for him. A state review of 1,473 cases in which patients were bused out of state in the past five years found 10 that may have involved an improper discharge.

Two Rawson-Neal physicians were fired and three other personnel face discipline for their roles in the 10 cases. Nine employees in total were involved in improper patient discharges, but four no longer are employed at the hospital.

Zhani said should investigators identify problems, the parties will be told to take corrective actions, which will have deadlines. Investigators had the ability to review documentation and speak to staff during their visits to Rawson-Neal.

Jack Cheevers, spokesman for the Centers for Medicare and Medicaid Services, could not be reached Friday.

The Centers for Medicare and Medicaid Services sent a letter April 25 to the state agency that oversees Rawson-Neal asking for a plan of correction within 10 days, or it would risk losing its federal funding. As of Friday, the federal centers had not received a report.

Woods said the agency would submit the report in time to make the deadline.

California lawmakers have also sought federal intervention, writing a letter asking the U.S. attorney general and officials with the U.S. Department of Health and Human Services to investigate whether any violations were committed by the state of Nevada, Southern Nevada Adult Mental Health Services or Rawson-Neal.

Regarding Thursday’s and Friday’s inspections, Woods said the findings won’t be known until those agencies issue reports.

Reid, who was in Las Vegas Friday, said the lack of attention on mental health is an issue that is the responsibility of the Legislature.

“If the state Legislature doesn’t do something to address this problem, they’re all to blame, but the state Legislature doesn’t listen to me very much,” he said.

Keith Uriarte , with the state’s American Federation of State, County and Municipal Employees, said budgetary cuts to Nevada’s mental health services have taken a toll the last few years.

“Patient levels increased, while staff levels decreased,” he said.

Sandoval and state officials should take responsibility for that, but haven’t, he contended.

Instead, they “strategically took political cover and blamed the few number of dedicated staff who remain at Rawson-Neal,” a Friday statement released by the union said. “Employees fear retaliation if they come forward publicly with the facts of what has caused these unfortunate events.”

There is no justification for the practice of patient dumping, said Allen Lichtenstein, general counsel for the American Civil Liberties Union of Nevada.

“It’s absolutely unacceptable and illegal, and California is absolutely right to be furious with Nevada,” he said. “We have one of the worst mental health systems in the country.”

It’s the state’s responsibility to provide adequate care for these patients, said Lichtenstein, calling for a thorough investigation. “You just can’t take the state’s word for it.”

Sue Gaines, president for the National Alliance on Mental Illness of Southern Nevada, acknowledged that mental health has been neglected in the state. There just aren’t enough beds for the mentally ill.

“One in four families are affected by mental illness,” she said, adding there’s more need than people realize.

For the last eight to 10 years, there’s been a push for a 24-hour mental urgent-care facility, she said, which would help alleviate the problem for Clark County emergency rooms. On Monday, University Medical Center declared an “internal disaster” because of the high volume of mental patients coming into the emergency room in the wake of controversy at Rawson-Neal.

The proposal for an urgent-care facility failed because of lack of funding.

Lawmakers need to see behavioral health programs are important, she said, because the lack of services is making the situation worse for children as well as adults.

“We have a lot of children and they need a lot of help as well,” Gaines said.

Contact Yesenia Amaro at yamaro@reviewjournal.com or 702-383-0440.