Two alleged rapes involving patients at the Rawson Neal Psychiatric Hospital are under investigation by Las Vegas police, the state Bureau of Licensure and Certification and the Joint Commission, a national accrediting agency, a state official said Monday.
Harold Cook, administrator of the state Division of Mental Health and Developmental Services, said he does not know when the investigations will be completed. His staff "is cooperating in every way possible."
Las Vegas police were called to the hospital to investigate allegations of sexual assaults on Nov. 14 and Nov. 21, according to police spokeswoman Barbara Morgan.
Neither medical officials nor police would comment on the condition of the patients or on their whereabouts.
They also would not divulge whether the allegations of assault were reported to hospital officials, witnessed by employees or stopped by employees.
During a Monday night town hall meeting of state mental health officials at Rawson Neal, Gina Greisen, an organizer for the American Federation of State, County and Municipal Employees Local 4041, asked Cook whether the assaults were the result of reduced staffing.
"I would just like to go on the record because nurses' licenses are at risk,'' Greisen said.
Greisen also said the union, which represents Rawson Neal hospital workers, is concerned about "increased frequency of patient-on-staff as well as patient-on-patient assaults.''
Cook said preliminary reports from agencies' investigating the assault allegations indicate that staffing levels were not a factor.
Police refused repeated requests by the Review-Journal to see the incident reports. One assault is alleged to have involved two men and the other involved a man and a woman, according to hospital staffers who requested anonymity for fear of losing their jobs. Police did not disclose whether arrests have been made in connection with the assault investigations.
Some hospital employees contend that both patients and staff are at risk at the institution because budget constraints caused by the worsening state economy are leaving positions unfilled, creating less supervision than necessary for sometimes violent patients.
Though Cook agrees that budget concerns have caused some professional positions to go unfilled at the hospital over the past year, he does not believe that such a managerial decision has to lead to physical assaults.
Nor does he believe that a proposal to eliminate between 90 and 100 clinical positions from the nearly 600 at the hospital by July means there will be less safety at the hospital that sits near the College of Southern Nevada campus on Charleston Avenue.
He said the 2.4 ratio of clinical staff to each occupied bed at the hospital is actually better than the 1.4 to 2.1 ratio that is found at many other hospitals across the nation.
Clinical staff includes mental health technicians, nurses, psychiatrists, social workers and psychologists, he said.
It is possible, Cook said, that an improper utilization of staff could result in a lack of the proper supervision.
"I don't have enough evidence at this point to know whether staffing played any role in the alleged rapes even occurring," he said.
The question of how much staffing is enough for proper supervision of mental patients is one that is asked repeatedly by public officials, according to Ted Letterman of the Virginia-based National Association of State Mental Health Directors.
He said Monday that his organization is to conduct a national study that will try to find a proper ratio for staffing. He said the problem is few institutions are alike in the patients they accept. He noted that the Joint Commission does not set a standard but does tell an institution when the staffing on hand "is not doing the job."
Representatives of the Joint Commission did not comment Monday on the investigation that Cook said the agency is conducting.
A nurse who contacted the Review-Journal said hospital management has done everything possible to keep the public from learning about the sexual assaults allegations.
"We have been told not to talk about this dangerous situation from supervisors -- the implied threat is we could lose our jobs," one nurse said. "We received an e-mail not to talk to the media once everybody started talking about the rapes and employees getting hurt at the hospital. "
On Dec. 5 at 3:18 p.m., hospital administrator Mark Stetz sent an e-mail message regarding "media contacts" to staffers:
"Just a reminder. We will be getting more and more contacts from the media as the current economic situation escalates. If you or your staff are contacted by any media personnel, please refer them to my office for processing. Thanks."
Stetz was unavailable for comment Monday.
"We just don't have the people we need to keep an eye on people," said one mental health technician. "We have mixed in extremely high-risk patients with general population, and it's not safe."
Both the technician and a nurse noted that a patient recently punched one staffer in the back of his head and another staffer received two black eyes when a patient threw a hardback book in her face.
The technician said the staff can no longer leave the restroom doors open in the hospital.
"The patients were going in there and having sex," he said.
Part of the problem with violence at the hospital, the technician said, is that "it was meant to be a restraint-free building so the patients did not feel like inmates."
"That seems like a good idea but they can come right up to the desk and swing at us and throw things at us."
Contact reporter Paul Harasim at firstname.lastname@example.org or 702-387-2908.