State will not appeal denial of accreditation to Rawson-Neal

Nevada’s Rawson-Neal Psychiatric Hospital will no longer be accredited by a national hospital accrediting organization effective Friday, state officials said late Thursday afternoon.

The Joint Commission issued a preliminary denial of accreditation for Rawson-Neal, which has been in the national spotlight for allegations of patient dumping. That decision, posted late Monday on the commission website, allowed the hospital the opportunity to appeal the decision before a final ruling was made.

However, state officials on Thursday decided not to go through the appeals process, said Mary Woods, spokeswoman for the Nevada Department of Health and Human Services. She said it was a collective decision by state officials, and the Joint Commission was notified Thursday.

“We still feel very positive about the work that has been done at Rawson-Neal,” she said. “We’ve made such big strides and improvements... Our understanding is that they would look at the initial findings” during the appeal.

The lack of accreditation won’t have an impact on the hospital’s operation or the care and treatment that’s offered to patients, Woods said.

Rawson-Neal came under scrutiny in February for discharging James F. Brown, 48, to Sacramento, Calif., with no support or family waiting for him.

Southern Nevada Adult Mental Health Services, the agency that oversees Rawson-Neal, plans to request a “new accreditation review in the near future when the hard work and great effort to improve services for our patients will be considered and recognized by The Joint Commission,” Mike Willden, director of the Nevada Department of Health and Human Services, said in a statement.

“As I stated previously, we are disappointed by the Joint Commission’s decision to move for a preliminary denial of accreditation, which appears to be based on the original “for cause” survey information and is not an accurate reflection of the hospital’s current practices and policies,” he said. “Moreover, the appeal process does not allow the consideration of new information such as changes and improvements to discharge processes, treatment programs, and oversight accountability.”

The appeal process also does not take into account the follow-up surveys conducted by the Joint Commission itself which concluded the facility is in compliance with Centers for Medicare and Medicaid Services’ Conditions of Participation, according to Willden.

Reached late on Thursday night, Elizabeth Eaken Zhani, spokeswoman for the Chicago-based Joint Commission, said she didn’t know how common it is for hospitals that get a preliminary denial of accreditation to choose not to appeal.

Accreditation is voluntary and won’t affect the hospital’s funding or ability to bill Medicare and Medicaid, according to Willden. The facility remains certified by the federal Centers for Medicare and Medicaid Services and licensed by the Nevada Bureau of Health Care Quality and Compliance.

Officials at the Centers for Medicare and Medicaid Services have completed a full validation survey of Rawson-Neal, but the results are still being reviewed.

Hospital operations will continue as usual. Oftentimes, hospitals use accreditation as a “marketing” tool, Woods said. “A lot of times, private and (public) medical hospitals like to have the Joint Commission’s accreditation as a way to promote the hospital to get more patients to come to their hospital as oppose to another hospital,” she said.

And what would state officials tell patients in need of services? “It won’t have any impact on the care or treatment that they receive,” Woods said. “They will still receive quality and compassionate care.”

Allen Lichtenstein, general counsel for the American Civil Liberties Union of Nevada, said Rawson-Neal and the state in general have refused to take this issue seriously.

“This is an example,” he said of them choosing not to appeal.

That’s the reason why a lawsuit was needed, he said. A civil rights lawsuit was submitted to U.S. District Court in Las Vegas early last month by Mark Merin, a civil rights lawyer in Sacramento, Calif., and the ACLU of Nevada.

The decision by state officials not to appeal the preliminary denial of accreditation won’t help the lawsuit’s case, Lichtenstein said, because the case will be based on facts and what the hospital has done.

Sue Gaines, president for the National Alliance on Mental Illness of Southern Nevada, said she was surprised to hear state officials chose not to appeal. “They worked so hard to get it (the accreditation,)” she said.

But added that it didn’t bother her nearly as much because they plan to seek accreditation at a later time.

“I know that they’ve had a lot going on, a lot of changes, a lot of additions,” she said. “There’s been a lot of things going on that I think will reflect very well on them.”

And most importantly, the hospital won’t close its doors.

“At the point when they (patients) are in crisis and they need mental health services, the hospital without accreditation is better than no services at all,” Gaines said. “They probably aren’t thinking about whether the hospital is accredited or not.”

Dr. Dale Carrison, chief of staff and head of emergency services at University Medical Center, said the decision by state officials was a “disappointment” for him.

State officials keep saying they’ve made several improvements and changes, he said.

“If that’s true, then why aren’t they appealing it?” Carrison said.

An accredited hospital would still be able to transfer patients to a non-accredited hospital, he said. Rawson-Neal not being accredited wouldn’t prevent his facility from transferring patients, including those on Medicare.

He said officials ask to send patients with private insurances to private hospitals.

About 85 percent of Rawson-Neal’s patients don’t have an ability to pay, Woods said.

“No one is turned away,” she said.

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