Feds put Brattleboro Retreat on notice; hospital could lose funding

The Brattleboro Retreat is in hot water with the federal government again.

The state’s psychiatric hospital has lost its “deemed status” with the Centers for Medicare and Medicaid. The retreat must make safety upgrades and improve treatment protocols in order to restore its standing with the federal agency.

Federal funding for the retreat will end on Oct. 6 unless the hospital can show it has met federal standards.

CMS sent the funding termination letter to the hospital on July 8. The retreat has since filed a plan of correction with the state to address the deficiencies. That information was shared with state officials and lawmakers.

Retreat officials neglected to mention the funding termination letter to lawmakers at the Mental Health Oversight Committee on July 22.

Rep. Anne Donahue, R-Northfield, says the omission is significant.

“Once again they were directly in front of a legislative committee and did not volunteer all of what most people would consider the relevant information, specifically about the termination notice,” Donahue said.

Two years ago, retreat officials were mum about an overdose death when they testified before lawmakers. At the time, the Legislature was deciding whether to move ahead with a decentralized mental health system, which included 14 beds at the retreat. Legislators were not informed about the death and subsequent CMS inspections at the hospital until after the legislative session. In May of 2012, the retreat lost its deemed status also and nearly lost its Medicaid funding. The hospital’s standing with CMS was restored in November 2013.

Konstantin Von Krusenstiern, vice president of strategy and development, downplayed the significance of the latest letter of termination.

“It doesn’’t surprise me that the Retreat reps did not report on the deemed status at the MHOC meeting because it is a technical aspect of the process that does not receive a lot of attention,” Von Krusenstiern said.

A teenager attempted suicide at the retreat in June. That “sentinel event” triggered a CMS inspection, or survey, of the hospital. The patient was transferred out of state and later died.

There have been three suicides at the retreat over a two and a half year period, not including the June case. Retreat officials do not claim responsibility in the death of the adolescent who was transferred.

In the past four months there have been two suicide attempts, according to documents from CMS.

The survey found that a patient who was hopeless and expressed intent to self-harm was not reassessed by retreat staff in a timely fashion.

In addition, CMS inspectors cited several safety concerns, including a broken light fixture that could have been used for self-harm and the Retreat’s locked door policy. Two suicide attempts this year occurred during one of the two five-minute times each day patients are allowed to be in their rooms with the door locked while a staff member waits outside with a key. The doors lock from the outside.

The retreat has installed “halligan bars” to pry doors open if there is a problem.

CMS has accepted the retreat’s plan of correction and the state will conduct an inspection in the coming weeks.

Von Krusenstiern says he expects the retreat will meet the federal standards, also known as the conditions of participation, and be found in compliance.

Anne Galloway

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