Faced with a bill that Senator Jim Denning R-Overland Park, estimated at around $1M per month, the state of Kansas is now debating whether or not it should consider re-certifying Osawatomie State Mental Health Hospital, citing that the federal regulations that put limitations on how many patients can be served in the hospital.
Jim McLean at the Kansas Health Institute followed up on what this may look like:
http://www.khi.org/news/article/state-may-not-seek-recertification-of-osawatomie-state-hospital
“Part of the question for the agency, the administration, legislators and policymakers is what is the trade-off for the bed capacity versus the funding that comes with certification,” Bruffett said.
Renovations prompted by an earlier federal inspection have reduced the hospital’s capacity by 60 at a time when in-patient psychiatric beds are in short supply across the state. Recertification would require additional renovations, which Bruffett said would force the state to continue limiting admissions.
The state facility in Osawatomie has been the source of ongoing controversy, most recently being linked to the rape of a worker. The Center for Medicare and Medicaid Services notified the hospital and state that failure to meet the security and safety requirements at the hospital in a timely fashion had resulted in the hospital being de-certified, and would no longer receive federal funds for patient care.
Published in the
Osawatomie Graphic,
December 16, 2015)
PUBLIC NOTICE
Notice is hereby given that the agreement between the Secretary of Health and Human Services and Osawatomie State Hospital, located at 500 State Hospital Drive in Osawatomie, Kansas, as a provider of hospital services in the Health Insurance for the Aged and Disabled Program (Medicare) is to be terminated at the close of December 21, 2015.
Osawatomie State Hospital does not comply with Section 1861 of the Social Security Act which requires a hospital to provide services which are sufficient to meet the needs of its patients. Non-compliance was established during a survey completed on November 3, 2015.
The Medicare program will not make payment for hospital services furnished to inpatients admitted after the close of December 21, 2015. For inpatients admitted after December 21, 2015 or before, payment may continue for up to 30 days of inpatient hospital services furnished after termination. Payment will not be made for services furnished to outpatients after January 20, 2016.
Victoria Vachon
Branch Manager
Non-Long Term
Care Branch
Kansas City Regional
Office
Rather than re-certify, however, the State of Kansas is considering going it alone, in large part due to the loss of bed space within Osawatomie hospital. Using federal guidelines for safety and security, including renovations, the facility has been limited to 146 beds in use for patients. The state of Kansas notes the facility has been licensed for 206 beds, and, should they decide to forgo federal re-certification, they could house more patients who need care.
The question remains how safe this procedure would be.
Concerns about current levels of patient management were already rampant before changes in population.
http://www.khi.org/news/2014/aug/18/kansas-mental-health-system-under-increasing-stres/
With the patient count so high, many of the hospital’s direct-care staff were pressed into working one, two and sometimes three overtime shifts a week.
“The place is over census and understaffed,” said Rebecca Proctor, executive director at the Kansas Organization of State Employees, a labor union that represents many state hospital front-line workers. “Conditions there are really, really bad.”
Angela de Rocha, a spokesperson for Kansas Department for Aging and Disability Services, confirmed that the Osawatomie hospital’s patient count on July 15 was “an overall high for the past 10 years.”
In an August interview, Rebecca Proctor, director of Kansas Organization of State Employees informed me, “This kind of staffing is dangerous, not just for staff but patients too. People cannot work nonstop safely.”
The addition of new patients, combined with the loss of federal funding plus an overworked staff will certainly create a difficult work environment. The state’s failure to comply with federal safety and security guidelines will likely not make their facility attractive to new potential employees.
The state of Kansas is currently considering an entirely new direction, involving the privatization of emergency and short term mental health care.
http://www.khi.org/news/article/state-may-not-seek-recertification-of-osawatomie-state-hospital#sthash.Y8BnmOht.dpuf
“Any discussion of privatizing some or all of the hospital’s services, beds or whatever has to be tied to an increase in investment,” Bruffett said. “We’ve looked at other states where they’ve worked with private partners and got new hospital construction as part of the deal.”
Private investment groups in Kansas have been re-evaluating their positions and demanding the state consider expanding medicaid. In Independence, Kansas, the private Catholic hospital was forced into closure earlier, in part due to access of funds.
Finding an investment partner in a facility that will not receive federal support until significant renovation and security work is done will most certainly be a matter of incredible salesmanship on behalf of the state of Kansas.
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