CVH Avoids Medicare Loss

Connecticut Valley Hospital has averted losing Medicare funding after federal authorities inspected the state’s embattled psychiatric hospital in Middletown over the weekend.

CVH had been cited for lapses in patient safety in three straight inspections since February. The federal Centers for Medicare and Medicaid Services said in a public notice that the funding — worth $50 million a year to this budget-strapped state — would end Friday because of safety and security issues.

The termination notice has been rescinded, CMS official Lauren D. Reinertsen said in a new notice Monday. An extended termination date for possible action down the road had not yet been set.

Federal officials had already extended the termination deadline to Saturday night to give the hospital, run by the Department of Mental Health and Addiction Services, a chance to submit a correction plan.

In a statement for the department, state officials said, “(DMHAS) is committed to working to serve our clients in accordance with CMS standards. The Department values CMS’s role in supporting the recovery of clients and appreciates their efforts to improve the service system."

Thirty-seven workers at the hospital’s Whiting Forensic Division have been suspended over allegations of patient abuse, and 10 of those workers have been arrested and charged with cruelty. Also, inspections of other patient buildings on the sprawling campus in February and May, obtained Friday by The Courant, identified safety lapses in the treatment of suicidal, violent or vulnerable patients. The latest inspection report was not publicly available Friday. It had found that the well-being of patients was in “immediate jeopardy,” according to the termination notice.

In addition to a potentially crippling loss of federal money, the hospital faces having to relocate more than 500 patients to other facilities.

In an inspection in February, surveyors found that treatment plans for profoundly ill and compromised patients were largely generic and lacked interventions that were tailored to the behavior of those patients.

For example, inspectors looked at the treatment plan for a nearly blind patient who sees only shadows and shapes, and who lashed out and punched another patient passing in the hall. The aggressive patient reported being “scared.”

Yet the inspectors found nothing in the patient’s treatment plan “related to specific monitoring” or “helping the patient to prevent further violence.”

The inspectors made the same finding for other patients that exhibited aggressive sexualized behavior, anger, delusional beliefs and suicidal ideation.

“For these major safety issues, there are no specific monitoring, intervention, and prevention directions for nursing personnel,” the inspection report states.

In a May follow-up, the surveyors noted that idle time was excessive and asserted that a lack of structured activities “prevents and jeopardizes patients from achieving their optimal level of functioning, potentially delaying a timely discharge.”

It costs the public $567,000 to treat one patient for one year at Connecticut Valley Hospital. With about 565 patients at CVH, the total cost for a year exceeds $320 million.

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