Feds drop funding of second mental hospital

Cherry Hospital will lose $800,000 a month after decertification, based on unsafe patient conditions

The state's troubled mental hospital in Goldsboro has lost its federal funding because regulators determined that conditions are not safe for patients, the state announced Thursday.

The decision means that Cherry Hospital will lose an average of $800,000 in federal insurance payments each month and may have its budget cut, said Leza Wainwright, director of the state mental health division. The hospital's budget this year is about $73.8 million.

The decertification marks a setback for the state Department of Health and Human Services, which has been trying to increase public confidence in state hospitals after a run of problems.

The federal government warned the state six times over the past 13 months that it had unsafe conditions in its mental hospitals, and Cherry is the second state mental hospital to lose its federal certification.

Broughton Hospital in Morganton lost its federal funding for nearly a year, but the state was able to compensate for its loss of about $1 million a month.

The state cannot guarantee it can do the same for Cherry, Wainwright said, but no decisions have been made on what may be cut.

In their report on Cherry, inspectors described incidents in which staff members beat patients and intimidated witnesses. Inspectors also cited an incident in which a dangerous patient was left unsupervised and attacked another man. The hospital failed to follow its own policies on tracking patient abuse and neglect, according to their report.

"The state has a lot of work to do on making its state psychiatric hospitals safe," said Vicki Smith, executive director of the patient advocacy group Disability Rights North Carolina.

The state legislature should consider establishing patient advocates at the hospitals who are independent of hospital directors, she said.

"Their internal advocacy system is flawed," she said. "They're hired and fired by the management they're supposed to be watching."

A death, a beating

State officials were warned that Cherry was in trouble after an inspection early last month found that a patient, Steven Sabock, was left sitting in a chair for more than 22 hours without food while staff members in the room played cards and watched television.

Doctors were not immediately notified that Sabock had fallen and smacked his head on the floor while choking on his medicine. Nursing staff members did not follow a doctor's orders to regularly check his vital signs and give him fluids. At least two hospital workers were caught falsifying Sabock's medical records.

Sabock, 50, died of a heart condition April 29.

After being warned that it was in danger of losing its money, Cherry started a staff re-education program on proper patient care to show investigators that it was trying to solve its problems. While those classes were under way, on Aug. 18 two healthcare technicians were accused of beating a 30-year-old patient in a hospital breezeway.

Inspectors went back to the hospital in the last week of August and found more problems with patient abuse and witnesses afraid to report it for fear of retaliation.

Two healthcare technicians witnessed the Aug. 18 beating, according to the inspectors' report, but they did not immediately report it because they were afraid for their own safety. One of the healthcare technicians, who worked for an outside agency, told her employer about the beating, and the agency called Cherry.

When the technician returned to work, she could hear other workers calling her a snitch, according to the inspectors' report. She told investigators she felt intimidated by the accused workers because they called her on her cell phone and threatened her.

Six staff members, including three nurses, knew about the alleged abuse and did not immediately report it. The two health care technicians accused in the beating were fired. A nurse was fired for not reporting the beating, and a part-time nurse was told not to return to work.

A review of records found that one of the technicians accused in the assault was the subject of six other allegations of patient abuse from August 2005 to January 2008. None of the allegations was substantiated.

Investigators found that a patient with paranoid schizophrenia who was known to be dangerous broke another patient's cheekbone while a group was left unsupervised Aug. 10.

Cherry did not ensure that patients' food was served hot, the report said. Some patients reported being hungry after meals, and staff did not properly monitor how much patients ate.

An Ohio hospital management company, the Compass Group Inc., started an evaluation of Cherry on Wednesday. It will give the state an assessment of the hospital's problems within 10 working days, Wainwright said, along with an assessment of how long fixes will take.

Cherry has longstanding "staff issues and staff morale issues," Wainwright said, and there are no obvious ways to fix them.

The company has until Oct. 15 to finish the first phase of its work, for which the state will pay $90,000. In a second phase, the company will manage the hospital and training. The length and price on the second phase of work will be determined after the correction plan is delivered and approved.