Western State Hospital stands to lose all of its federal funding by Thanksgiving if reforms are not made.
Western State Hospital plans more oversight of how patients are isolated and restrained as the facility tries to avoid losing its federal funding.
The Lakewood psychiatric hospital says checks on patient restraint are among at least 25 permanent or temporary changes to practices flagged during recent federal inspections.
Federal Medicare and Medicaid officials found conditions posing “an immediate and serious threat to patient safety” and gave the hospital until Thanksgiving weekend to fix them or lose about $64 million in federal money.
The hospital has sent the federal government a preliminary “abatement plan” detailing the practice changes along with previously announced plans to cancel an expansion of the hospital that had been intended to comply with court orders.
According to the plan, hospital managers have “established an expectation that seclusion and restraint are only to be used when it is appropriate to mitigate harm to patients and staff and only after all other less restrictive measures have been exhausted.”
Avoiding seclusion and restraint is intended to reduce psychological and physical harm. In August, one patient attacked and injured another patient who was bound to a bed frame and sedated.
Managers are now reviewing a patient’s seclusion and restraint every four hours to see if it can be relaxed, the plan says. It adds stricter requirements for observation by nurses and approval of restraints by doctors.
Reported seclusions and restraints have been on the decline at the hospital in recent years.
In the first three months of 2015, the Department of Social and Health Services reported to the Legislature, hours of restraint per patient stood at just one-quarter of the rate two years earlier.
Seclusion fell to roughly one-third of its previous rate.
A nurse who has complained about hospital practices, Paul Vilja, said federal officials should not accept the abatement proposals because the plan doesn’t address the fact that not all wards are equipped with secure rooms for seclusion and restraint.
The plan also adds a “safety bed” in each of several sections of the hospital to move a patient involved in an assault. And it says the hospital has stepped up attempts to detect risk of violence while placing patients in the hospital.
The hospital’s plan says scrapping the expansion freed up 64 staff members for other duties.
Federal inspectors concluded the hospital didn’t always have enough trained nurses and nursing assistants “to deliver safe and effective care to patients,” according to the plan.
The plan calls for reducing instances of pulling staff off of high-risk wards, while adding staff to wards when an employee there is occupied with one-on-one monitoring of a patient posing a danger.
An employee from another state agency has been assigned to Western State as a contact for workers fearing retaliation from management, according to the plan.
