Lawmakers press agency leaders for answers to state hospital woes

By Jonathan Shorman, Topeka Capital-Journal, January 21, 2015

Pictured is Rep. Scott Schwab questioning KDADS Staff at a joint House-Senate hearing on Osawatomie State Hospital’s Medicare decertification.

Rep. Scott Schwab, R-Olathe, questions Bill Rein, the commissioner of
behavioral health services for KDADS, on how many state funded
positions at Osawatomie State Hospital are currently vacant,
Thursday afternoon, during a hearing on why the hospital lost its
Medicare certification. (Photo by Chris Neal/Topeka Captal-Journal)

The agency in charge of Kansas’ state hospitals on Thursday promised a plan soon to address staffing shortages at the facilities and said records are now regularly reviewed after an instance of falsification was found by federal inspectors.

Leaders from the Kansas Department for Aging and Disability Services faced skeptical and frustrated questioning from lawmakers at a joint House-Senate hearing convened to tackle Osawatomie State Hospital’s Medicare decertification.

Officials also said they hope Osawatomie will be recertified or ready for recertification in three to six months.

KDADS Secretary Tim Keck, who took over the job Jan. 1, at times couldn’t provide firm answers. He wasn’t able to say definitively whether the agency will request additional funds to boost staffing levels.

Bill Rein, the commissioner of behavioral health services, couldn’t tell a lawmaker how many positions the state funds at the hospital that are currently vacant. In response, Rep. Scott Schwab, an Olathe Republican who asked the question, turned to a legislative staffer and asked her to get the answer.

Keck said more information regarding a plan to tackle staffing problems — which he called rudimentary — would be available potentially within a couple of weeks. Lawmakers at the hearing universally acknowledged both Osawatomie and Larned State Hospital face staffing troubles.

“I’ve given (human resources) a directive or request to get the staffing information that we need. And hopefully, within a week after that we will have a better understanding of what our (needs) are, or are not,” Keck said.

The sexual assault of an employee by a patient in October drew federal attention. A patient has been charged with rape, and the hospital took steps to boost security. But a follow-up federal inspection found additional problems, and the federal government withdrew Medicare funding — about $600,000 a month.

The findings included staff placing a male sex offender patient in a section for women and failing to stop him from having sex with a woman who had shown suicidal behavior.

KDADS hasn’t yet sought recertification, but Keck said the agency does plan to do so. He said the hospital is bringing in a consultant to prepare.

Sen. Laura Kelly, D-Topeka, pressed Keck on whether the agency will request additional funds. Keck said the agency hasn’t made a request at this point, and didn’t want to give a yes or no answer at the moment.

“Clearly, we have staffing issues at both Larned and Osawatomie. Now, how many more you might need maybe the consultant can help you with. But the fact that you need more staff and you need more staff right now and yesterday is evident to everyone,” Kelly said. “So it makes no sense to me that you didn’t include a budget request for additional staffing, and you’re standing here now saying you might not.”

Keck then said he was being more hesitant than he otherwise might be because he doesn’t want to promise something that won’t happen. But he indicated that if he had to provide an answer, he probably will make a budget request.

“But I don’t know what that looks like, I don’t know what the numbers look like, so I need more time to assess it,” Keck said.

Lawmakers also delved into record falsification at Osawatomie, an issue found by federal inspectors.

According to inspectors, a mental health technician documented a room check about the same time the October attack is said to have happened. But video footage reviewed by inspectors showed the 8:30 p.m. check wasn’t performed.

Keck said he has told hospital leadership that he has zero tolerance for falsification. And Rein outlined safeguards against record alteration and said employees found to falsify are disciplined.

“We do have individuals in there now that are looking at those records every single day. They’re pulling a sample of those records and making sure that the things are documented the way they should be,” Rein said.

“But I’m not going to stand here and tell you that things don’t slip by that there aren’t sometimes people who say they made checks they didn’t make.”

Some lawmakers have questioned whether the state hospital system should be privatized. Keck didn’t rule out privatization, but said “everything is on the table.”

Sen. Jim Denning, R-Overland Park, has floated the idea of privatizing all or part of the system. He said Thursday that Osawatomie’s top priority has to be building up its staffing level, not just becoming recertified.

“I think we’re spinning our wheels if we don’t make a firm commitment to get that staffing level back up,” Denning said. “Once you get that foundation, everything will start falling in place.”

Although the hearing was focused on Osawatomie, the attention comes amid scrutiny of Larned as well. Internal documents show employees rack up significant overtime hours at that facility, with some logging in excess of 40 hours of overtime a week.

The reports reveal that in recent weeks more than half of all employees in the hospital’s nursing department have worked overtime. Hundreds of workers have accumulated more than eight hours of overtime during a single week.

Jonathan Shorman can be reached at (785) 295-5619 or
Follow Jonathan on Twitter @jshormanCJ.

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