Deficiencies jeopardize Rawson-Neal Psychiatric Hospital’s Medicare funding

Rawson-Neal Psychiatric Hospital faces the loss of millions of dollars in funding.

Its ability to participate in Medicare could be terminated on or before Nov. 6 if deficiencies found by a federal agency are not corrected or evidence of compliance is not submitted, according to documents released by the federal Centers for Medicare and Medicaid Services late Friday.

The state hospital has 10 days to respond to the federal agency to avoid termination action, although that doesn’t guarantee that Rawson-Neal’s eligibility to participate in Medicare would be maintained, according to letters sent to Southern Nevada Adult Mental Health Services, the agency that oversees the Las Vegas facility. The letters are dated Thursday , and outline problems at the hospital that were found during two separate investigations in May and June.

In fiscal year 2011-12, Rawson-Neal received $3.2 million in Medicare funding.

“With this notice we are initiating a process which could result in termination of the hospital’s Medicare provider agreement on or before (Nov. 6),” states the letter outlining problems identified during an inspection.

The public hospital lost its accreditation and was hit with a federal lawsuit in the aftermath of allegations of patient dumping and improper record keeping earlier this year. Scrutiny of Rawson-Neal intensified after the hospital discharged James F. Brown, 48, to Sacramento, Calif., in February with no support or family waiting for him.

Reached at home late Friday, Mike Willden, director of the Nevada Department of Health and Human Services, refused to comment and hung up. Dr. Tracey Green, the state’s chief medical officer, didn’t return late calls seeking comment.

Mary Woods, spokeswoman with the state’s Department of Health and Human Services, said Southern Nevada Adult Mental Health Services “is prepared to submit evidence of compliance” to the federal agency.

“The recent changes in practices and policy, along with the additional funding to mental health services have strengthened the facility’s capabilities to successfully comply with CMS certification requirements,” she said in a text.

Lawmakers earlier this week approved the release of $2.1 million for further improvements and expansion of services at Rawson-Neal. Officials also have submitted a new application for accreditation to the Joint Commission, an independent organization that accredits hospitals.

Officials with the Centers for Medicare and Medicaid Services were not available for comment late Friday.

On June 20, a full inspection was completed at Southern Nevada Adult Mental Health and Human Services by the Nevada Department of Health and Human Services at the behest of federal officials. After a careful review, the Centers for Medicare and Medicaid Services concluded that the agency was out of compliance with conditions of participation, according to one of the letters.

Hospitals have to be in compliance with 23 conditions of participation.

In a March inspection, Rawson-Neal was out of compliance with two of 23 conditions: discharge planning and administrative oversight. Hospital officials had 10 days to submit a plan of correction, which was accepted by the federal agency.

The Centers for Medicare and Medicaid Services then authorized the Nevada Department of Health and Human Services to complete another inspection, the one in June, to determine whether Rawson-Neal had come back into compliance. However, the hospital was out of compliance with three conditions: administrative oversight, issues with medical staff and nursing services.

Also, the Southern Nevada Adult Mental Health and Human Services was not compliant with provisions of the National Fire Protection Association’s Life Safety code, according to one letter.

“We have further determined that the deficiencies identified by the full survey substantially limit the hospital’s ability to render adequate care to patients or are of such character as to adversely affect patient health and safety,” one letter reads.

A separate investigation at Rawson-Neal that took place on May 9 and explored whether the hospital was meeting requirements of the Emergency Medical Treatment and Labor Act, found the hospital was in violation of four requirements. Those requirements include compliance with the policies and procedures, availability of on-call physicians, failure to provide appropriate medical screening examination and failure to provide stabilizing treatment.

Hospital officials have 10 days within the receipt of the letters to submit credible plans or evidence that the deficiencies have been corrected or do not exist. Officials can also appeal by requesting a hearing before an administrative law judge of the Department of Health and Human Services.

The hearing request must be filed no later than 60 days from receipt of the notice.

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