Second Nevada psych hospital under investigation by Medicaid

August 22, 2013

RENO, Nev. (AP) — A second Nevada psychiatric hospital is under investigation by a federal agency for alleged violations of patient treatment and discharge standards.

Dini-Townsend Inpatient Facility in Sparks was served notice Aug. 12 by the Centers for Medicare and Medicaid Services for various deficiencies, the Reno Gazette-Journal (http://on.rgj.com/173zo31 ) reported Wednesday.

Deficiencies include failure to report and keep appropriate medical records, examination delays, and not providing appropriate medical screening and stabilizing treatment.

Dini-Townsend also was cited for inappropriate patient transfer, a charge also levied against Rawson-Neal Hospital in Las Vegas, the newspaper reported.

The violations at Dini-Townsend were discovered during a May 16 survey of the facility following allegations of noncompliance with the Emergency Medical Treatment & Labor Act, the Reno newspaper reported. The federal law requires hospitals that receive Medicare funding to abide by a set of standards, which include providing proper medical screening and ensuring that patients are transferred properly when discharged.

Mary Woods, spokeswoman for the Nevada Department of Health and Human Services, said the state intends to question the alleged deficiencies cited under the Act.

She said in the agency's view that law "does not apply to this facility and we question and appropriateness of requiring a psychiatric facility to adhere to regulations for a medical emergency room," Woods told The Associated Press.

Still, she said a plan of correction and response would be submitted to the federal agency Wednesday.

Woods added that a review of records show that from December 2007 through March 2012, seven patients discharged from Dini-Townsend received transportation to California.

"In each instance the client identified California as his or her previous place of residence and had a support system in California," Woods said.

Dini-Townsend is overseen by Northern Nevada Adult Mental Health Services. The federal agency warned that failure to address the problems could lead to the termination of the facility's participation in the Medicare program, though such action is rare.

The investigation comes as California officials threaten to sue Nevada for allegedly giving patients at Rawson-Neal in Las Vegas one-way bus tickets to California.

An investigation by The Sacramento Bee earlier this year found the Las Vegas hospital had bused nearly 1,500 patients out of state over five years, with roughly 500 sent to California. That investigation was triggered after James F. Brown, who suffered from schizophrenia and depression, was given a one-way bus ticket in February to Sacramento, Calif., where he knew no one. The American Civil Liberties Union and a Sacramento attorney have since filed a federal civil rights lawsuit on his behalf.

A subsequent review by the Nevada Department of Health and Human Services found that of 31,043 people admitted to Rawson-Neal during a five-year span, 1,473 patients were provided bus transportation to other states. The review identified 10 cases where documentation was insufficient to determine whether hospital staff had checked to ensure a released patient had family or a support system waiting for them in the new state.

Two Rawson-Neal staff members were fired and three others were disciplined. In April, Gov. Brian Sandoval also announced new procedures requiring two physicians instead of one to sign a discharge order for patients, as well as a hospital administrator. Also, a chaperone is required to travel with patients being bused out of state.

Source: "2nd Nevada psych hospital under investigation," Houston Chronicle, August 21, 2013.