OSAWATOMIE, Kan. – A rolling landscape and tree-dotted vistas belie a flurry of activity at the state mental hospital in eastern Kansas, as administrators and employees work to bring it back into line with federal standards this summer and officials ponder its longer-term future.
Citing a “systemic failure” to protect suicidal patients, adequately supervise care and perform required safety checks, the federal government decertified Osawatomie State Hospital in December. The state is losing up to $1 million a month in federal funds.
Republican Gov. Sam Brownback’s administration hopes to see the hospital recertified by July. But legislators in both parties worry that the short-term focus on meeting federal standards means the state isn’t dealing enough with the longer-term question of whether it has enough hospital beds for the mentally ill.
“That’s part of a much bigger conversation,” said Tim Keck, the interim secretary of the state Department for Aging and Disability Services, which oversees the hospital.
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Keck said his department first wants to have federal officials see a decision to recertify the hospital as a “no-brainer” based on a “wholesale change” on its 391-acre campus about 45 miles southwest of Kansas City. The federal government’s action came after a critical November survey and an employee reported being raped by a patient in October.
A July 2015 survey forced the state to make renovations designed to eliminate patient suicide risks. The hospital capped its population at 146 patients – 60 fewer beds – in June 2015 to accommodate the work.
The state last month increased the pay for nurses, and it has filled nearly 60 positions since mid-January. It plans to restart a program in June to train mental health technicians at the hospital’s campus. The department has brought in consultants to improve operations and the planning of patient care.
But Kansas House Majority Leader Jene Vickrey, a Republican from the nearby Louisburg, said the state also needs to put the additional 60 beds back online as soon as possible because, “We’re putting a lot of stress on the entire system.”
The department also has floated the possibility of turning the hospital over to a private company. Legislators reacted to the idea by adding a provision in the state budget that requires their approval first.
“There does not appear to be a look long-range, a master plan, a plan to build out capacity,” Sen. Laura Kelly, a Topeka Democrat, said after touring the hospital recently.
The discussion about the hospital comes as it approaches the 150th anniversary of receiving its first patient in November 1866.
Reminders of the past mark the campus in older buildings, some largely abandoned as states moved in past decades away from using large hospitals to treat the mentally ill. Fifty years ago, Osawatomie had more than 750 patients.
A largely deserted medical building contains old equipment, including machines used in shock therapy. It also contains cots used in 2014, when the population hit 258 and some rooms housed three patients, according to a critical October 2014 survey.
The Associated Press obtained a copy of the survey report and other federal and state documents about the hospital through an open records request. The Centers for Medicare and Medicaid Services first threatened to cut off federal funds in November 2014, when the hospital was 25 percent over its 206-bed capacity.
Other critical reports followed, raising questions about care and nursing shortages.
Last July’s survey spent more than 90 pages listing issues with fixtures in various buildings that it said could allow patients to hang or strangle themselves. The hospital is finishing up renovations that will leave 60 patients surrounded by modernistic plastic furniture, handles that give way and doors with alarms on top.
But state officials stressed that the reported rape and the November survey prompted the federal government to decertify the hospital. In a February letter to a Democratic legislator later provided to AP, the county prosecutor said the criminal case against the alleged rapist was one of five she filed last year in which patients were charged with battering employees.
Keck and hospital officials said the recent pay raise for nurses is making it easier to fill positions and address staffing issues. Kathy Bolmer, a Nashville-area consultant hired by the state, said she’s encountered “almost no pushback” from employees in working on operations changes.
“I feel pretty good about the pathway that hospital’s on now,” Bolmer said.
Follow John Hanna on Twitter at https://twitter.com/apjdhanna