Federal officials have a clear message for Nevada’s Rawson-Neal mental health facility: Stop mistreating patients, or see your federal Medicare dollars disappear. In a curt letter distributed by the Center for Medicare and Medicaid Services (CMS), the federal agency that oversees major entitlement spending warned the hospital — which has been accused of unceremoniously dumping its homeless patients onto buses — that “If we do not receive an acceptable, timely submission, or if a resurvey finds that the hospital is not complying with any [conditions of participation], we will notify you that we are initiating action to terminate the facility’s Medicare provider agreement.”
The beleaguered hospital gained national attention after reports surfaced that it had systematically been dumping homeless patients with serious mental illnesses onto buses to other states. Doctors allegedly told the patients this was necessary due to a dearth of funding for housing and mental health services in the state, suggesting that they would be better off elsewhere. Rawson-Neal allegedly bused at least 100 patients to California in just one year, despite the fact that Golden State is only marginally better at funding mental health care than Nevada is.
Primary reports focused on a schizophrenic patient named James Flavy Coy Brown, who was discharged and placed onto a Greyhound to California with nothing but light snacks and three days’ medication. A follow-up investigation by the San Francisco Bee found that the behavior was nothing new, leading state and federal officials to slam the alleged patient mistreatment:
The Bee followed with an investigative report that said Rawson-Neal had purchased one-way bus tickets for 1,500 discharged patients over five years, some of whom had been sent to locations where they had no contacts.
The revelations prompted the city attorneys of Los Angeles and San Francisco to announce probes into the matter earlier this week. Rawson-Neal patients were bused to both cities, according to the Bee’s findings.
Nevada Gov. Brian Sandoval said in a statement that his office had launched three separate investigations and that disciplinary actions had been taken. The governor’s office determined that policies were not followed in at least one instance. The new policy, he said, provides “additional oversight” to ensure the hospital follows proper discharge procedures.
“I take the concerns regarding Rawson-Neal Psychiatric Hospital very seriously and it is not the policy of the state of Nevada to engage in ‘patient dumping,’” he said in a statement.
State officials have also claimed that the problem is limited to Rawson-Neal, and not reflected through other state-operated facilities.
Now that Rawson-Neal’s Medicare dollars are in jeopardy, doctors and hospital administrators might be more eager to take action. But if the facility buckles under the weight of losing its federal funding — in addition to Nevada’s steep cuts to mental health services through its Medicaid program — then other public facilities in the state would be forced to absorb its patient load. Considering the multiple barriers to providing the homeless with mental health treatment, that could end up being a tall order.