The federal agency that oversees Medicaid and Medicare compliance has put Nevada on notice of "serious deficiencies" at a Las Vegas psychiatric hospital following reports of patients being improperly discharged.
A letter Thursday from the Centers for Medicare and Medicaid Services, first reported by The Sacramento Bee and obtained Friday by The Associated Press, gave Nevada 10 days to correct problems in its mental health discharge policies at Rawson-Neal Psychiatric Hospital or risk the loss of federal funding, potentially tens of millions of dollars.
The move follows an investigation launched by the Bee after James F. Brown, a patient at Rawson-Neal, was put on a bus alone in February and sent on a 15-hour trip to Sacramento, Calif., where he knew no one. Brown suffers from schizophrenia and depression.
The newspaper then reviewed bus ticket receipts dating to 2008 and found the hospital, part of the Southern Nevada Ault Mental Health Services, had transported about 1,500 patients to other states. Roughly 500 went to California.
Last year alone, Rawson-Neal bused out patients at a pace of more than one per day, shipping nearly 400 patients to a total of 176 cities and 45 states across the country, the Bee reported.
City attorneys in Los Angeles and San Francisco this month launched their own criminal investigations into whether Nevada engaged in "patient dumping."
California state Sen. Darrell Steinberg, who also called for an investigation, said Nevada has put people at "grave risk" and he welcomed the intervention by the federal agency.
"People with mental health disorders can recover with access to prevention, early intervention and treatment," Steinberg, a Democrat, said in a statement Friday. He called Brown's treatment "tantamount to abuse," adding that the hospital and Nevada "must be held accountable by federal regulators."
Earlier this week, Nevada Gov. Brian Sandoval said his administration launched three separate investigations after he learned of the Brown case. He said disciplinary actions were taken and a new policy was implemented to strengthen oversight. The state now requires two physicians instead of one to sign a discharge order for patients, and the decision must be approved by a hospital administrator.
The governor's office said Nevada will also require chaperones for all state psychiatric patients who are bused out of state.
"Let me be clear, improperly discharging one patient is one patient too many," Sandoval said this week.
Late Friday, Sandoval's office said measures Nevada has implemented will be filed with the federal agency as part of its response to remediate problems.
"Corrective action was taken immediately and the corrective action plan will be submitted to CMS next week," Mary-Sarah Kinner, Sandoval's communications director, said in an email.
The federal agency noted that if Nevada's efforts are sufficient, the hospital's status as being "deemed" to meet Medicare conditions of participation will be restored after a re-survey of practices.
In the meantime, the hospital can continue billing Medicare.