Company’s plan to buy Las Vegas facilities debated

Assemblywoman Sheila Leslie, D-Reno, worries that the acquisition of residential mental health treatment centers in Nevada by a major for profit hospital chain that already has a large presence in the state could have a harmful effect on the delivery of psychiatric care.

Another legislator, Assemblyman Joe Hardy, R-Las Vegas, thinks such treatment could be improved by the purchase.

In the world of politics, of course, that is a perfectly sane -- if not particularly enlightening -- response to last week's announcement that Universal Health Services, one of the nation's largest hospital chains, plans on a $3.1 billion purchase of Psychiatric Solutions, the nation's largest operator of owned or leased psychiatric inpatient facilities, which includes two residential treatment centers in the Las Vegas Valley.

If the sale goes through, four of the five private residential mental health treatment centers in Las Vegas will be owned by UHS: Spring Mountain Sahara, Spring Mountain Residential Treatment Center, Montevista Hospital and Red Rock Behavioral Health Hospital.

Only the 55-bed Seven Hills Behavioral Institute in Henderson will be under separate ownership.

UHS, which operates the five acute care hospitals that comprise the Valley Health System in Las Vegas -- Summerlin, Valley, Centennial Hills, Spring Valley and Desert Springs Hospitals -- also will own both of the private mental hospitals in Reno.

Harold Cook, the administrator of the state's Division of Mental Health and Developmental Services, said it is "too early to tell" whether the planned acquisition is a plus or minus for the state.

Cook oversees the state's largest public mental health facility, the 212 bed Rawson-Neal Psychiatric Hospital, near Jones and Oakey Boulevards, which often makes headlines.

In recent weeks state investigators found the hospital failed to document and disclose the use of drugs to subdue out-of-control patients in each of 10 randomly selected cases. And in January investigators fined the hospital for not protecting a female patient who was reportedly raped by a male patient with known violent tendencies.

"Our private mental institutions are crucial to our health care system because we don't have many public facilities," Leslie said. "We have a real shortage in this area."

Hoping to get a better handle on what an increased UHS presence in behavioral treatment might mean to Nevadans is State Sen. Valerie Wiener, D-Las Vegas, chair of the state's Legislative Committee on Health Care.

"We'll probably have hearings on the purchase to try to find out what it means," Wiener said. "At this point, we really don't know."

Repeated attempts to speak with UHS representatives about what the purchase could mean as far treatment was concerned were unsuccessful.

"I think the main concern we will have is that we're going to have less leverage to negotiate a good price for our Medicaid patients that go to private treatment centers," Leslie said. "It could develop into an 'access to care' issue. We may be forced to send our kids out of state."

Hardy doubts that will happen because he said UHS values its relationship with Nevadans. He believes that UHS will not only negotiate in good faith, but also bring more modern "electronic record keeping to what they do. That's crucial to good care."

Because UHS will own a large number of mental and acute care hospitals, it could lessen the burden that mental patients place on acute care hospitals, Hardy said.

Steven Kalas, a marriage and family counselor with Clearview Counseling and a Review-Journal columnist who specializes in behavioral issues, thinks an increased UHS presence is good for Las Vegas.

"I feel good when I refer someone to (UHS run) Spring Mountain Residential Treatment Center," he said, stressing that he is impressed with the attention to detail and caring by staffers. "In this case, I think a monopoly could be good."

Psychiatric Solutions is currently the subject of an investigation by the U.S. Department of Justice regarding executive compensation. In early May Florida authorities halted admissions to a mental health facility run by the company there after finding that administrators had not made promised safety improvements.

In recent years, hospitals run by Psychiatric Solutions across the country have been the subject of Chicago Tribune and Los Angeles Times reports detailing violence, sexual abuse and neglect.

However, the two Psychiatric Solutions-operated hospitals in Las Vegas -- the 80 bed Montevista Hospital and the 21 bed Red Rock Behavioral Health Hospital -- were not included in the negative reports.

In prepared releases Pennyslvania-based UHS has repeatedly said its planned purchase of Psychiatric Solutions' properties, which is expected to be approved later this year, will increase "shareholder value."

In a document released by the company to investors, the transaction is described as highly attractive because there is "minimal exposure to uncompensated care" -- unlike private acute care hospitals, private mental health hospitals provide almost no care without insurance.

"We've seen private psychiatric facilities just kick people out," Leslie said.

Private mental health facilities are often criticized for pronouncing a patient "cured" or "well on the way to recovery" right about the time his insurance runs out.

"I think that's probably too cynical, but it's also not groundless," said Kalas. "They can't do their work for free."

At present, according to state mental health authorities, there is no formal system for a private hospital referring a patient to a public institution if the patient still needs help.

"I'm sure the administrators talk," said Ben Kieckhefer, a spokesman for the Nevada Department of Health and Human Services.

UHS is no stranger to mental health treatment in the Las Vegas Valley, currently operating Spring Mountain Sahara, a 30 bed facility at 5460 West Sahara Avenue that is dedicated to helping adults over 55 as well as the 82 bed Spring Mountain Residential Treatment Center at 7000 Spring Mountain Road, which is designed to help both adolescents and adults with behavioral problems.

Leslie isn't sure it's beneficial to Nevadans that UHS adds more mental health hospitals in Las Vegas and Reno.

"I'm just not sure so much power in one company's hands is ever good for people," she said. "I think regulators have to look at this closely."

Reporter John Edwards contributed to this report. Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.