Federal officials ordered an end to Medicare funding at beleaguered Osawatomie State Hospital in Kansas this month after inspectors found that two violent patients, one a registered sex offender, preyed on other patients.
Newly released documents show that nursing staff assigned an aggressive woman, known to attack other patients and staff, to share a room with a vulnerable woman in a wheelchair. Staff placed the sex offender, a man with a history of criminal sodomy, on a women’s hallway of the psychiatric hospital.
The sex offender “displayed inappropriate sexual behaviors, including kissing other patients, attempting to kiss other patients, hugging and inappropriately touching other patients, and having another female patient place her hands down his pants,” according to a summary of findings of an inspection visit to the hospital late last week.
The document, released Wednesday, also said that the female patient “on almost a daily basis … participated in some sort of assaultive/aggressive act against another patient or staff, including choking, pulling handfuls of hair out, kicking and throwing coffee.”
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Staff caught those two male and female patients kissing, and the patients told staff they also had sex together.
Kansas officials were not ready Wednesday to comment on what the inspectors found.
“We’re still reviewing these findings,” said Angela de Rocha, a spokeswoman for the Kansas Department for Aging and Disability Services. The department operates Osawatomie and a second psychiatric hospital, Larned State Hospital.
De Rocha said Osawatomie will remain open as the state applies for recertification of the hospital to receive Medicare reimbursements for eligible patients: “We’ll continue to admit new patients. We will continue to take new Medicare patients.”
Osawatomie State Hospital, about 50 miles southwest of Kansas City, has been under fire for more than a year for a growing list of violations of federal patient safety and welfare regulations.
Last December, the hospital restricted new admissions to end chronic overcrowding. Early this year, the hospital began a thorough rehab, replacing patient beds and mattresses, installing new bathroom fixtures, replacing suspended ceilings and making other changes to eliminate things that could be pose a suicide risk, or that could be turned into weapons. The improvements are still underway.
The inspection visit last week by the Kansas Department of Health and Environment and the federal Centers for Medicare and Medicaid Services stemmed from the rape in October of a hospital employee by a patient.
Police said a 21-year-old staff member went to a room to help a patient and was attacked as soon as she entered. Another patient heard sounds of a struggle, went into the room and stopped the attack until other staff members could arrive to help. Aaron C. Goodman, 42, of Hartford, Kan., was arrested and charged with the crime.
Inspectors who came to the hospital after the incident found deficiencies in how the hospital handled the safety of patients and employees. The hospital initiated a number of corrective actions, such as issuing staff personal alarm buttons to alert security personnel.
The inspection visit last week was to determine whether the hospital’s measures were sufficient. Inspectors said the hospital failed to adequately supervise the two violent patients. That continued to put patients’ health and safety at serious risk, the inspectors said.
The female patient was diagnosed with several psychiatric conditions, including post-traumatic stress disorder, bipolar disorder and borderline personality disorder, according to the inspectors’ findings.
The hospital’s treatment team had advised nursing staff that it wasn’t appropriate to have the woman room with a patient limited to a wheelchair and unable to defend herself from attacks, inspectors said. However, nursing staff indicated that even if they had moved the woman out of that room, she would still have targeted the vulnerable patient.
The woman also posed a danger to herself, the inspectors found. She had attempted suicide by tying her pants around her neck. And she frequently tried to place objects such as coins, pens, spoons, knives and safety pins in her eyes, ears and vagina.
The male patient had been diagnosed with antisocial personality disorder and major depressive disorder with psychotic features. The inspectors said the man fashioned a weapon out of a plastic knife and tried to stab someone in the neck. After that incident, nursing staff assigned him to a female hallway, where he continued to flirt with female patients and make “inappropriate sexual gestures,” such as placing a blanket over his lap and that of a female patient sitting next to him, inspectors said.
Medicare payment for new patients at Osawatomie ended Monday. Medicare will continue for existing patients through Jan. 21, de Rocha said.
De Rocha said Osawatomie receives Medicare reimbursement for just 14 of its approximately 146 patients. During the first five months of this fiscal year, the reimbursements totaled about $1.8 million. The hospital’s annual budget is about $30 million, de Rocha said.
More significant, de Rocha said, are payments Medicare makes to hospitals such as Osawatomie that care for large numbers of uninsured patients. Osawatomie received about $600,000 per month from that program, she said.