Editor’s note: This article is by Howard Weiss-Tisman of the Brattleboro Reformer, in which it was fist published Oct. 26, 2014.
BRATTLEBORO — The federal government has accepted a plan of correction from the Brattleboro Retreat putting the psychiatric hospital on a path toward full compliance with the agency that oversees Medicare and Medicaid reimbursements.
The Retreat found out late Friday that the Centers for Medicare and Medicaid Services had accepted the Retreat’s latest plan which was required after the facility failed a survey conducted by the agency this month.
“We are pleased that the Plan of Correction has been accepted and that the measures we are implementing as a result of the latest survey will put us on a path to be in full compliance with the conditions of participation under the CMS provider agreement,” Brattleboro Retreat Vice President for Strategy and Development Konstantin von Krusenstiern said. “The specific incidents have been investigated and now that a plan of correction is in place, CMS will return at some point to verify that we are complying with all CMS conditions.”
The Retreat has until Nov. 1 to finalize a Systems Improvement Agreement with CMS, which will incorporate the plan of correction.
The agreement will be an up-to-two-year plan under which an outside consultant will perform a full evaluation of the Retreat’s systems, training policies and employee oversight.
The Retreat said it will work closely with the Vermont Division of Licensing and Protection and CMS while the Systems Improvement Agreement is being conducted.
The 33-page plan of correction includes a number of changes to the Retreat administration, which have been approved by the hospital’s board of directors.
The Retreat has created a position of vice president of quality and clinical services who will review all current practices and determine a course of improvement. The vice president of quality and clinical services will report directly to Retreat CEO Robert Simpson and a member of the executive team.
The Retreat and CMS committed to work on the Systems Improvement Agreement after members of the Shumlin administration called the federal agency to encourage it to take a broader look at the challenges the Retreat was facing.
Since opening its 14-bed adult intensive unit as part of efforts to replace the Vermont State Hospital last year, the Retreat has fallen short of federal safety rules on a number of occasions.
The hospital has been able to address the deficiencies but von Krusenstiern said the Retreat wants to develop a facility-wide plan to prevent future problems and ensure the safety of its patients.
According to von Krusenstiern, CMS has conducted similar systems improvement agreements with other hospitals.
He said details of the agreement are still being hammered out and he was not sure how future surveys will be conducted while the Retreat was in the middle of the agreement and working on its safety systems.
Gov. Peter Shumlin said he hoped the Systems Improvement Agreement would make the Retreat a safer hospital.
“My belief is that this partnership, we should see as a blessing to help make sure that we’re delivering the best quality care that we can for our most acutely ill patients,” Shumlin said Friday. “I’m behind the partnership between CMS and the Retreat to make sure that we are doing everything right in the delivery of services.”
The Vermont Division of Licensing and Protection did a survey at the Retreat from Sept. 29 through Oct. 1 and found the hospital was not in compliance with the requirements necessary to retain federal funding.
The visit by CMS inspectors was a follow-up to their surveys in June and August, when the Retreat was found to be out of compliance with the conditions of participation under the provider agreement.
Inspectors found that the Retreat was routinely using an elastic bandage on patients which could be dangerous and that a patient’s rights were violated after the patient had left the grounds and was returned by the Brattleboro Police Department in handcuffs.
CMS inspectors also cited the Retreat for allowing a patient to bathe alone. The patient was discovered face down in the water, and while the patient was not seriously injured the hospital was cited for failing to follow appropriate safety measures.
“We have to take the role of CMS seriously,” Shumlin said. “Their role is to come in and say, ‘You’re doing these things well, but you’ve got to do better in this area,'” Shumlin said. “That’s how you get high standards. So I think it is a learning experience for both the Retreat, for the state and for CMS. Our job is to make sure they’re doing everything that they should be to get patients healthy and keep patients safe.”
Howard Weiss-Tisman can be reached at 802-254-2311, ext. 279, or hwtisman@reformer.com. Follow Howard on Twitter @HowardReformer.
