Last week, Cherry Hospital director Jack St. Clair sent federal officials a list of corrective actions, which included training sessions for all nurses and health care technicians held from Aug. 13 to 19 and 15 days of extra monitoring in admissions wards.

The state hopes to convince the federal government that the hospital should keep its money despite a case of negligence that has become a national example. Earlier this month, outside investigators found that a patient, Steven Sabock, 50, was left in a chair more than 22 hours without food or help going to the bathroom. He died April 29.

Video cameras recorded staff members playing cards and watching television in the day room where Sabock sat.

Last week, the head of the agency that oversees state mental hospitals said staff members who neglected Sabock were removed from regular jobs for "re-education." The hospital closed the ward where Sabock died.

Standards chief Mabel Sudderth was reassigned, although St. Clair's letter names her as contact person about the correction plan.

Critics said the hospital did not take quick or forceful action.

"If someone is responsible for a death on videotape, they get fired," said Debra Dihoff, executive director of the National Alliance on Mental Illness in North Carolina. "There's something very wrong with the culture in our state hospitals."

The hospitals have a history of problems. In the past year, the federal government has threatened to take money from all four.

After Sabock's death, Cherry's own investigation identified 16 staff members who were negligent or broke policies. Discipline for 13 ranged from counseling to five-day suspensions. One nurse resigned during the investigation. The fate of the other two is unclear.

The correction plan said that all nurses involved were reported to the N.C. Board of Nursing, and all health care technicians were reported to the health care personnel registry run by the DHHS.

The hospital added the training and monitoring because investigators made clear that Cherry had not done enough, said Jim Osberg, the DHHS administrator in charge of state institutions.

State Rep. Verla Insko, a Chapel Hill Democrat, said Sabock's death was the latest evidence of long-standing problems.

"I think we have to beef up our hospital administration at the state or the institutional level, or maybe both," said Insko. "Maybe bring professional hospital administrators in. We tend to promote from within the system."

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