Out-of-state mental health transfers rare in Northern Nevada, records show

CARSON CITY — Out-of-state patient transfers have been rare in Nevada’s northern mental health inpatient facility in Sparks, public records requested by the Las Vegas Review-Journal show.

There were only nine relocations, including eight to California, from 2008 through this year, according to records provided by the state Department of Health and Human Services.

The few cases of out-of-state transfers from the 40-bed Dini-Townsend Inpatient Facility appears to suggest that there is no statewide issue with such relocations.

The transfers, by bus and train, pale in comparison to the 1,473 out-of-state discharges reviewed by the agency at the 190-bed Rawson-Neal Psychiatric Hospital in Las Vegas from 2008 through 2013.

The Northern Nevada transfer records show one Greyhound bus ticket to York, Pennsylvania, with the other eight trips to Northern California locations including Stockton, Oakland, San Francisco and Sacramento.

In all nine cases the records show a referral to a specific facility or agency, such as the Walden House Group Home and St. James Infirmary, both in San Francisco.

The transfers have been reviewed to ensure that the state followed agency policy and no issues were found, said Mary Woods, spokeswoman for the Department of Health and Human Resources.

Nevada’s state-funded mental health system has been under fire for some of the transfers from the Las Vegas facility.

The state agency launched its own reviews of the Rawson-Neal discharges after the Sacramento Bee newspaper published stories about James F. Brown, a patient who was sent to Sacramento by bus with no provision of services in violation of the state’s policy for such relocations.

Brown told social workers he didn’t know anyone in Sacramento and that he was forced to leave the Rawson-Neal hospital. The incident prompted California elected officials to ask for a federal investigation.

The internal reviews by Nevada Health and Human Services officials resulted in two physicians at the hospital being fired and others being disciplined.

On Wednesday a 49-page report detailing a March hospital review of the Rawson-Neal hospital by federal officials was released by the federal Centers for Medicare and Medicaid Services. The March report detailed examples of poor practices, faulting the facility’s discharge planning and its inadequate governing body.

The report says “the hospital failed to provide an appropriate safe discharge plan for patients,” a problem that was identified in an earlier review by Nevada officials.

The hospital must have a discharge planning process that applies to all patients, according to the report.

The report also detailed a new case that violated state policy, that of a mentally ill diabetic patient who was bused to Oklahoma from the hospital in February without medication or the equipment needed to check blood-sugar levels.

Woods said the review of the 1,473 out-of-state discharges, from a total of 31,043 discharges from Rawson-Neal, identified 10 that did not include enough documentation to know for certain if the state’s policy for such transfers was followed.

At least two are now known to have failed to follow policy.

Those cases are being followed up to determine if there were violations of policy, which have always required confirmation of housing and a support system at the destination, she said.

Based on the agency’s own investigations, the discharge policy was changed to require a chaperone for any out-of-state transfers, as well as more oversight by hospital staff.

The goal of the out-of-state transfers is to return former patients to their home communities where they can receive family and other support, Woods said.

Gov. Brian Sandoval has strongly disputed the patient dumping allegations.

“Let me be clear, improperly discharging one patient is one patient too many,” Sandoval said in a statement issued last month. “I take the concerns regarding Rawson-Neal Psychiatric Hospital very seriously, and it is not the policy of the state of Nevada to engage in ‘patient dumping’ as (has) been alleged. Rather, patients have a right, and a desire, to return home to their friends and families.”

Contact Capital Bureau reporter Sean Whaley at swhaley@reviewjournal.com or 775-687-3900.