After patient suicides, hospital loses Medicare certification

Topics: Medicare, Reimbursement, Finance, Safety, Quality, Performance Improvement

April 13, 2011

A Kansas City hospital has been federally sanctioned after a second patient within two years committed suicide last month, the Kansas City Star reports.

Federal records allege that the 105-bed Two Rivers Psychiatric Hospital failed to properly monitor a 59-year-old woman with a history of depression, hallucinations and suicidal thoughts. Surveillance videos show that hospital staff did not properly implement suicide precautions and that the woman strangled herself with a strap after only three days at the facility. The staff then fumbled through resuscitation attempts, the Star reports.

Federal officials this week notified the hospital that it has been removed from the Medicaid and Medicare programs for failing to implement adequate suicide precautions. CMS will continue to pay for current beneficiaries' inpatient care for another 30 days but will not pay for new admissions or outpatient care. Two Rivers' CEO in a statement said the hospital is preparing to appeal the decision.

This is not the first time the hospital has been subject to Medicare decertification, the Star reports. CMS began investigating chronic problems at the facility in May 2008, after an inspection uncovered several patient abuse cases, including one in which a nurse used to towel to silence a patient's screams. In addition, an Army soldier who had been experiencing post-traumatic stress disorder committed suicide in September 2008. Following the incident, CMS threatened to revoke Medicare funding unless the facility improved patient care and allowed an outside expert to monitor its progress. Less than one year later, inspectors were unable to find evidence that the hospital's patients received any psychotherapy or treatment other than medication. Furthermore, the hospital in 2010 refused to admit an emergency patient who had threatened to kill someone, despite federal law requiring the facility to accept emergency admissions (Bavley, Star, 4/8; Cronkleton, Star, 4/12).

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