Move of Dix patients now on hold

RALEIGH -- A legal agreement signed this morning will keep patients at Dorothea Dix Hospital indefinitely as the state attempts to address problems at a new mental hospital in Butner.

A Wake Superior Court judge issued a temporary restraining order last week that barred the planned transfer this week of most of the patients from Dix to Central Regional Hospital.

The move was the result of a lawsuit filed by Disability Rights North Carolina that outlined numerous safety concerns and technical glitches that have plagued the new $138 million facility in Butner since it partially opened in July.

Superior Court Judge Allen Baddour had scheduled a hearing for Monday, Oct. 6, to hear further arguments.

Under an agreement approved today, Monday's hearing was canceled as the state voluntarily agreed to keep the restraining order in place until it or the advocacy group goes back to the judge at some future date.

The state's willingness to accept the deal is spurred by the results of a visit last week by regulators from the federal Centers for Medicare & Medicaid Services to the new hospital.

Though the state has not yet released the full details of what the inspectors found, it appears likely the new facility will be found in violation of federal operating rules.

That would make it illegal for the state to proceed with transferring patients from Dix.

A state law that went into effect in July mandates that Dix's patients can't be moved until Health and Human Services Secretary Dempsey Benton can certify that Central Regional meets Medicare and Medicaid standards.

Vicki Smith, the executive director of Disability Rights, said she expected the federal regulators to cite Central Regional with three serious violations and four minor infractions.

One issue was that the new hospital has been billing for government insurance reimbursements under Dix's Medicare and Medicaid provider number, a potential violation of federal rules.

A statement released by DHHS this morning confirmed the regulators had questioned whether or not the two hospitals were really operating as one facility.

"A finding by CMS that the two hospital medical staffs and governance have not fully merged into one could lead CMS to conclude that the integration of the two hospitals into one hospital is not complete," said the statement from Tom Lawrence, spokesman for the state department. "Obviously, having the majority of the two staffs together in one location could have avoided this potential finding."

Lawrence reiterated that the state does not yet know what final decision the regulators will make.

The inspectors arrived unannounced at the new hospital following complaints about a security system that frequently sends out false alarms, emergency pagers that don't work, a roof that leaks in several places and malfunctioning air conditioning that keeps the temperature in the low 60s.

According to court papers filed with the advocacy group's lawsuit, an elderly patient was reported to have suffered from hypothermia this month after his condition went unnoticed too long by those who were supposed to be caring for him.

Disability Rights has a federal mandate to investigate alleged cases of patient neglect and abuse in state hospitals and has been monitoring the situation at Central Regional for months.

It likely will be 60 days before another federal inspection of the hospital would be complete.

Even after the state clears its regulatory hurdles, DHHS will still have to return to court to show Judge Baddour that the issues outlined in the lawsuit have been addressed, potentially quashing any move to merge the hospitals until December.

DHHS officials have said it will cost an additional $350,000 a month to keep Dix open.