- Associated Press - Sunday, October 11, 2015

SEATTLE (AP) - Federal regulators said conditions at Washington state’s largest psychiatric hospital were so dangerous for patients that they threatened to cut millions of dollars in funding three times this year.

The state agency that oversees Western State Hospital said Thursday that they are addressing the problems, but they need more money and staff to make the facility safe.

The federal Centers for Medicare and Medicaid Services sent 90-day termination notices to the hospital in January, March and September after inspectors found it failed to ensure the safety of patients. The violations ranged from failing to supervise violent patients to broken fire alarms and smoke detectors, according to documents obtained by The Associated Press.

The loss of federal funds would be significant: The 800-bed hospital receives $4.7 million from Medicaid and $11.2 million from Medicare each year.

Federal regulators’ series of threats in such a short period of time reflects serious problems with the state Department of Social and Health Services’ mental health division, said David Carlson, a lawyer with Disability Rights Washington.

“It’s operating at its limits right now,” Carlson said. “When there’s not appropriate staffing, bad things happen.”

Carla Reyes, acting assistant secretary for the department’s Behavioral Health and Service Integration Administration, which oversees the state’s mental health services, said patient safety is a priority, but the agency needs more than the $9.4 million added to the latest budget.

The department is asking for supplemental funding to hire staff needed to maintain accreditation status and operate safely, Reyes said.

The warnings are among a list of troubles facing the state’s mental health system. In April, a federal judge issued a permanent injunction against the agency for failing to provide timely competency services to mentally ill people charged with crimes. And the brother of a patient who died after choking on an orange in the hospital’s dayroom while staff walked by has sued several workers.

The federal violations in March resulted from a surprise fire inspection that found broken fire alarms; problems with walls and doors that should stop smoke and fire from spreading; and the absence of a fire-watch system for some buildings.

Another March survey resulted in 57 pages of violations, including problems such as failure to monitor restrained patients; medical supplies that were years beyond their expiration dates; unsafe electrical outlets; and soiled showers and bedding, regulators said.

In the other two notices, regulators said staff failed to properly respond to violent patients - problems that were reportedly fixed the first time.

The January notice came after two patients attacked three employees. Under hospital policy, the patients should have been transferred to a special unit. One was kept on the ward, not properly supervised and threatened more violence before being moved five days later.

The hospital resolved the problems after the January warning to “make sure it didn’t happen again,” said Stephanie Magill, a spokeswoman for the Centers for Medicare and Medicaid Services.

But two patients got in a fight Aug. 15. One was placed in restraints and sedated, and the other was able to walk past staff and attack him with fists and a shoe.

That incident resulted in the September notice. A correction plan has been submitted and is under review, Magill said.

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Follow Martha Bellisle at https://twitter.com/marthabellisle .


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