Brattleboro Retreat could lose its Medicare provider agreement
by Anne Galloway vtdigger.org A federal agency has found more deficiencies at the Brattleboro Retreat and has given the hospital 45 days to make more improvements.
If the psychiatric hospital is not in compliance by the next visit from Centers for Medicare and Medicaid (CMS) it could lose its Medicare provider agreement and federal funding, according to a statement from the Vermont Department of Mental Health. The Retreat is not in immediate jeopardy of losing funding.
The last CMS survey was conducted on June 7; the Retreat and the state were notified on June 14.
Roughly 30 percent of the Retreat’s patients are Medicare recipients, according to Peter Albert, senior vice president for government relations at the Retreat. Of those recipients, he said, many are state patients.
The latest development comes on the heels of two previous surveys, one in January and another in March after the death of a 29-year-old man who died of a drug overdose from methadone he snatched from a nurse’s cart. The Retreat was investigated by state and federal agencies and deficiencies were found in nursing and pharmacy services. The facility wrote a corrective action plan and succeeded in improving both areas of concern. The problems at the Retreat occurred at the same time lawmakers drafted legislation to make the facility a key component of the state’s community mental health system. Legislators weren’t aware of the problems at the hospital when they approved the plan.The state now has a contract to renovate the facility to accommodate 14 beds for psychiatric patients who would have formerly gone to the Vermont State Hospital.
At a Statehouse hearing on Wednesday Rob Simpson, CEO of the Brattleboro Retreat, apologized to lawmakers for not being more forthcoming.
This time federal surveyors found the Retreat was out of compliance with two conditions of participation– the “governing body” and “quality assessment and performance improvement plan.” Both compliance deficiencies are related to internal communication between staff and management, according to Albert.
“The findings contained in the report deal with communication issues among our staff, our analysis of an adverse event, and with a deficiency in how we communicate treatment plans to patients,” Albert said in a statement. “The findings, although serious, do not indicate that any of our patients are in any immediate jeopardy. We had already begun making internal changes to address these issues.”
In an interview, Albert said CMS can “look at anything else they want” in a survey. “It is serious, we need to be in compliance,” he said.
There were two incidents at the Retreat last weekend, Albert said.
In one instance, too much of a methadone maintenance medication was given to a patient. Albert said the patient was “fine.”
In another, a patient who was a ward of the state and was being evaluated for a forensic psychiatric diagnosis “eloped” or escaped the grounds when he went for a walk with a member of the staff. Albert said the patient had been cleared of the forensic diagnosis before he was given permission to go on the walk. Several hours later, the patient went to the Brattleboro Memorial Hospital for treatment after he was bitten by a dog, Albert said. Retreat officials were contacted.
Patrick Flood, commissioner of the Department of Mental Health issued a statement that he continues “to have faith in the Brattleboro Retreat’s commitment to provide quality services and is optimistic the Retreat will correct the deficiencies and remain certified for Medicare and Medicaid.”
The CMS survey documents were not released on Friday.
Brattleboro Memorial Hospital, which treated Jared Fitzpatrick the patient who overdosed in January, was investigated by CMS in March. According to documents obtained from the Division of Licensing and Protection, the hospital was not out of compliance in any area.
June 16, 2012 vtdigger.org Vermont Department of Mental Health 6.15.2012