DeSoto psych hospital seeks feds' oversight after inspections found underage sex, medication issues
- Written by Julieta Chiquillo Julieta Chiquillo
- Published: 09 January 2019 09 January 2019
DeSoto, TX - A DeSoto psychiatric hospital, which the feds say put patients in “immediate jeopardy” of harm, will continue to receive Medicare funds for at least another month as it seeks a last-ditch special arrangement with the federal government.
The feds used the rare arrangement — known as a systems improvement agreement — in the past to bring Parkland Memorial Hospital and other facilities back into compliance.
At Dallas Behavioral Healthcare in DeSoto, inspectors found myriad problems, which included drug-administration issues, sex among underage patients and long waits for care. In December, the Centers for Medicare and Medicaid Services announced that it intended to cut off Medicare for the hospital in January.
The stakes were high for the region and the hospital. While hospital leaders said the loss of millions in federal funds wouldn’t cause them to shutter the facility, they warned the decision would leave many people without access to mental health care. That could’ve been a blow to the strained North Texas mental-health system, which had already lost more than 300 beds for patients in crisis last year after the closure of Timberlawn and Sundance psychiatric hospitals.
But now the feds have announced in a letter that they have extended the hospital’s Medicare funding through Feb. 8 as they consider an arrangement that would require the hospital to hire outside consultants to help fix deficiencies.
According to the Centers for Medicare and Medicaid Services, it will consider a systems improvement agreement if officials determine that there is a “compelling public interest” and that Medicare patients would have serious problems accessing care if the funding were pulled. The agency also has to make a finding that the hospital is committed to making improvements and that it can sustain them.
The feds had said much improvement was needed. During their first survey, inspectors documented patients left for hours in the hospital’s waiting area and two boys caught trying to have sex.
After the inspection, Dallas Behavioral Healthcare submitted a corrective plan outlining policy changes and other measures.
But when inspectors returned unannounced in October, they said the hospital still had serious problems.
The inspectors discovered that the charts of several patients didn’t indicate why they needed emergency medication. For example, a 12-year-old boy was injected with an anti-psychotic drug for “agitation” — even though a video showed the boy was just watching cartoons, according to an inspection report.
Inspectors also wrote about another sexual encounter between minors and alleged that a female patient had been placed with a roommate despite staff previously identifying her as a “sexual predator.”
While the feds have indicated they are open to giving Dallas Behavioral Healthcare another chance, no agreement has been signed yet. Jesus Quiroga, the hospital's director of business development, said hospital leaders will be able to comment once they confirm details with government regulators.
Systems improvement agreements are rare, according to federal records. Since 2011, regulators have approved them only for seven hospitals in a five-state region that includes Texas — most notably Dallas County’s Parkland Memorial Hospital. All those facilities ultimately came back into compliance with Medicare standards by the end of their oversight agreements, said a spokesman for the Centers for Medicare and Medicaid Services.
Parkland had drawn federal and state scrutiny after the 2011 death of a psychiatric patient who had been forced into isolation and aggressively restrained. The public hospital did not report the death to state and federal regulators as required.
After signing an agreement with the agency that manages Medicare, Parkland overhauled many of its patient-safety practices, revamped the emergency department and hired more nurses to improve patient care. The changes were rolled out over two years and cost more than $75 million.
If Dallas Behavioral Healthcare can get a systems improvement agreement, the hospital might be required to have an independent compliance officer, submit monthly progress reports and face periodic inspections. Medicare funding would continue during the arrangement.
Medicare accounted for nearly 8 percent of Dallas Behavioral Healthcare's $63 million in gross patient revenue in 2017, according to the American Hospital Directory.
Dallas Behavioral Healthcare was also set to lose its Medicaid funding through the state because the requirements for that program are substantially the same as those for Medicare. But the hospital is currently listed as a Medicaid provider by the contractor that manages the program for Texas.
A spokeswoman for the Texas Health and Human Services Commission said no notices of violation had been issued to the hospital in recent months.
Dallas County Commissioner John Wiley Price, who sits in the county’s mental health board, lauded the hospital’s effort to reach an agreement with government regulators. He said Parkland’s success is a good sign that Dallas Behavioral Health can also overcome its problems.
He said government-approved consultants “give you direction; they give you technical assistance. That’s what they need.”
Source: Dallas Morning News