Monday, April 29, 2013

Finally, No More Patient Dumping?

Well, that didn't take... Actually, it has taken this long. But nonetheless, something is happening. Just minutes ago, Governor Brian Sandoval's office announced this.

RalstonReports: INBOX: "Sandoval Announces Further Action Taken at Rawson-Neal..individuals who violated release policies have been or will be disciplined."

Wow. This looks serious. I wonder if this had something to do with it.

[The federal Centers for Medicare & Medicaid Services] gave the hospital 10 days to submit "evidence of correction." After that, a new survey will likely occur. If corrective action is not adequate, according to the letter, "we will notify you that we are initiating action to terminate the facility's Medicare provider agreement," a vital source of federal funding.

Rawson-Neal and its umbrella agency, Southern Nevada Adult Mental Health Services, have been under fire following a report in The Bee earlier this month showing that the hospital paid to transport about 1,500 patients to other states via Greyhound bus since 2008. About one-third of those patients were dispatched to California, and 19 of them to Sacramento, according to a review of Greyhound bus receipts purchased by the umbrella agency.

One of Rawson-Neal's patients, James Flavy Coy Brown, in February was bused 15 hours to Sacramento, a place he said he had never visited and where he knew no one.

Brown suffers from schizophrenia and depression and had been living in the streets and shelters of Las Vegas for years. Out of food and medication when he arrived in Sacramento, he spent three nights in a hospital emergency room before social workers found him temporary housing.

The Bee's report has touched off criminal probes by the city attorneys of San Francisco and Los Angeles into whether Nevada has engaged in cross-state "patient dumping." Los Angeles received 149 Rawson-Neal patients during the five-year period reviewed by The Bee, while 36 patients were sent to San Francisco.

As we discussed last Friday, CMS is serious about pulling federal funding from Rawson-Neal if its patient dumping fiasco isn't properly resolved. So now, finally, Governor Sandoval and Nevada mental health officials are feeling the heat. It's now just a question of how much change we'll see at Rawson-Neal.

Late last week, KVVU/Fox 5 interviewed a former Rawson-Neal nurse who shed some light on past practices there. She confirmed earlier accounts of patient dumping happening even before 2009. And on top of that, she added a new charge. Apparently before Rawson-Neal began stuffing mental health patients onto Greyhound buses, the hospital would simply give the patients Greyhound tickets upon discharge and leave them in Downtown Las Vegas!

FOX5 Vegas - KVVU

"Finding out, ‘Oh, he is originally from California. Do they have family there? We do not know. Give [him or her] a bus ticket.' So the patient is discharged from the hospital to make the bed available," a former Rawson-Neal nurse who wished to remain anonymous explained to FOX5.

Originally, this nurse said patients were given a bus ticket and discharged on their own, but many of the patients wound up back at Rawson-Neal.

"The patient, they found out, is making money out of the ticket. They sell it out there [Las Vegas Greyhound bus station]. Then the patient gets to buy their drugs or alcohol," the former nurse said.

So to fix that problem, FOX5's source said the patients were put in a state vehicle and driven to the downtown Greyhound Bus station, where a hospital employee made sure they actually got on the bus.

Over the weekend, the Las Vegas Sun's Andrew Doughman reminded everyone, and in particular the California media, of Governor Sandoval's habit of playing coy to the media and trying to avoid big actions on big issues. We saw him do this in the first few days after the story of James Flavy Coy Brown and his "Greyhound Therapy" from Rawson-Neal to Sacramento, California, began to make headlines. It really took continued ugly patient dumping headlines, threats of lawsuits from California municipalities, and now the threat of loss of federal funding for Rawson-Neal, for Sandoval to realize how serious this is and begin implementing solutions.

Again, we now must wait and see how serious Governor Sandoval and the Nevada Legislature are about solving this problem. It will clearly take more than just window dressing. It will certainly mean more funding for mental health care here in Nevada.

While The Sacramento Bee praised Governor Sandoval's recent steps to address the patient dumping scandal, it also noted that Nevada will actually have to restore funding for mental health services to truly fix the problem. So will he and the Legislature finally do it? That looks to be the $25 million question there.

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