Politics & Government

Dix closure delayed

A state judge has stalled the plan to start shutting down Dorothea Dix Hospital next week and transferring its patients to a new state mental facility in Butner dogged by safety and staffing concerns.

Superior Court Judge Allen Baddour issued a temporary restaining order Thursday that bars the state Department of Health and Human Services from moving the bulk of Dix's patients to Central Regional Hospital, a process that had been scheduled to begin Oct. 1.

It is not clear how long Baddour's order might forestall the demise of the 152-year-old Raleigh institution, but some Dix employees and advocates for the mentally ill were hopeful Thursday that the decision might buy enough time for a new governor to take office.

Both gubernatorial candidates, Republican Pat McCrory and Democrat Bev Perdue, have urged the administration of Gov. Mike Easley to hold off on closing Dix.

The judge acted in response to a class-action lawsuit filed Tuesday on behalf of Dix patients by the advocacy group Disability Rights North Carolina, which has been monitoring conditions at Central Regional since the new $138 million hospital partially opened in July.

"We are pleased with the decision, obviously," said Vicki Smith, the executive director of Disability Rights. "What the danger is when courts get involved is that the lawyers start arguing small points and we forget why we're there, which is to document that patients are safe."

The lawsuit details 15 concerns at the new hospital, including a faulty security system and insufficient staff that the advocacy group said would endanger patients. The legal maneuvering is not intended to keep Dix open permanently, Smith said, but to postpone its closure until the new hospital is demonstrated to meet the standards of outside accrediting agencies.

Thursday's court ruling could pose serious problems for the state in light of a review this week of complaints about Central Regional by inspectors from the federal Centers for Medicare & Medicaid Services.

According to an internal memorandum issued Thursday by Dr. Michael Lancaster, co-director of the state's mental health division, regulators are threatening to withhold federal funding from both Dix and Central Regional because of the failure of the two institutions to merge.

Lancaster, who was in court Thursday, looked stunned as Baddour made his ruling. Afterward, he expressed his disappointment. The staff at Central Regional had already fixed some of the safety problems and would continue to make positive changes, he said.

The judge scheduled a hearing for Oct. 6 to hear further arguments from lawyers representing Disability Rights and the state Attorney General's Office. The state lawyers claimed in court that the nonprofit group, which has a federal mandate to investigate claims of patient neglect and abuse, has no legal standing to challenge the move.

A state law that went into effect in July mandates that Dix's patients can't be transferred until DHHS Secretary Dempsey Benton can certify that Central Regional meets the standards of two organizations that accredit hospitals -- The Joint Commission and the Centers for Medicare & Medicaid.

Though neither group has signed off on the new hospital, Benton said that he has independently made the determination that Central Regional meets those standards.

In Baddour's courtroom, Mark Lodge, a special deputy attorney general, said the legal requirement had been met.

"The secretary is the one to make the determination," Lodge said. "It's not Disability Rights. It's not the patients."

The judge disagreed, finding from the bench that the group has the right to fight the state and that the group's lawsuit has merit.

Disability Rights' case was bolstered Thursday by an affidavit disclosing recent incidents that raise questions about the quality of care inside the new hospital.

According to court documents, within the last month a patient at Central Regional who was supposed to be under increased supervision managed to tear out her stitches after abdominal surgery without anyone on staff noticing.

In another incident, a malfunctioning air conditioning system at the new hospital kept the internal temperature so low that an elderly patient was found to be suffering from hypothermia. No one on the staff noticed he was in danger until a physician assistant passing by saw the unresponsive patient.

Still, the affidavit says, it took an hour for the staff to locate a rectal thermometer, further delaying medical treatment.

"What we have [at Central Regional] is a system that is operating in the margins at present that would be pushed over the edge with the addition of another 170 patients" from Dix, John Rittelmeyer, the director of legal services for Disability Rights, told the judge.

Related stories from Raleigh News & Observer