CARSON CITY, Nev. (AP) — Nevada is questioning some findings of deficiencies by federal inspectors at two Nevada psychiatric hospitals.
In letters to the federal Centers for Medicare and Medicaid Services obtained Friday by The Associated Press, state officials said alleged violations cited under the Emergency Medical Treatment and Labor Act should not apply to Dini-Townsend Psychiatric Hospital in Sparks or Rawson-Neal in Las Vegas.
The letters state that the law imposes special responsibilities on a hospital with a dedicated emergency department and is not intended to apply to psychiatric hospitals.
Mary Woods, spokeswoman for the Nevada Department of Health and Human Services, said the intent of the law was to make it illegal for hospital emergency rooms to deny urgent, life-saving treatment to people because of an inability to pay.
Nevada argues the psychiatric hospitals are not designed to treat people in need of emergency medical care but rather to assess and treat mental health problems. Officials note that since their inceptions, neither hospital has been cited before for deficiencies under the law.
The two hospitals have come under increased scrutiny this year following an investigation by The Sacramento (Calif.) Bee into allegations that some patients at Rawson-Neal were given one-way bus tickets out of state to places where they knew no one and had no support network. The newspaper said roughly 1,500 Rawson-Neal patients were provided bus tickets over the past five years, but Nevada officials said they identified only 10 cases were documentation was insufficient to show proper discharge procedures were followed.
The state has since tightened its policies and now requires anyone being discharged to another state to be accompanied by a chaperone.
Both Rawson-Neal and Dini-Townsend are now under investigation by the Centers for Medicare and Medicaid Services, referred to as CMS, and officials in San Francisco and other California cities have threatened to sue Nevada.
Dini-Townsend was cited in last week for deficiencies that include failure to report and keep appropriate medical records, examination delays, and not providing appropriate medical screening and stabilizing treatment. It also was cited for inappropriate patient transfer, a charge also levied against Rawson-Neal in Las Vegas.
In a response, Cody Phinney, administrator of Northern Nevada Mental Health Services that oversees Dini-Townsend, said the hospital is taking steps to improve documentation and coordination of aftercare. The agency's detailed response was not provided, only a cover letter that accompanied it.
Chelsea Szklany, administrator at Southern Nevada Mental Health Services, said in addition to previous actions taken at Rawson-Neal, hospital employees are linking patients with other medical and social services they need, including making appointments, coordinating with family members and caregivers, and verifying follow through.