State Will Appeal Federal Decision to Terminate Funding To State Psychiatric Hospital
AUGUSTA – The Maine Department of Health and Human Services (DHHS) is appealing the federal government's decision to terminate funding for services at Maine's State hospital. On Wednesday afternoon, the State of Maine received notification from the Centers for Medicare and Medicaid Services (CMS) that it is terminating Riverview Psychiatric Center from its Medicare Provider Agreement. The notification effectively eliminates federal funding for all services the State hospital in Augusta provides. The DHHS and the leadership of Riverview Psychiatric Center were stunned and are disappointed by the recent action of CMS, but DHHS Commissioner Mayhew says she is confident that the State will win its appeal.
"The decision made by the CMS to terminate simply does not pass the straight-face test," Mayhew said. "This inappropriate and unwarranted action jeopardizes access to vital psychiatric services for no reason and I am confident we will win our appeal."
Mayhew noted her appreciation of all of the hard work that Riverview staff and leadership have put forth in addressing federal concerns.
The CMS had initially conducted two surveys at Riverview – one in March 2013 and another in May 2013. They determined that the hospital was not in compliance for several Conditions of Participation, placing $20 million in federal funding in jeopardy. On August 30, CMS accepted Riverview's Plan of Correction, temporarily halting termination until an additional survey could be conducted to evaluate the actions taken by the hospital to address concerns.
Riverview's initial steps to improve safety and to comply with state, federal and local laws were to remove 20 beds from the federal program and to create a geographically separate and distinct unit to serve those patients who are aggressive and create safety concerns. The remaining patients are now cared for in a different unit of the hospital and would be eligible for federal funding.
"We have taken significant steps to address these most critical issues around patient safety, staff safety, quality and well-documented treatment plans," said Mary Louise McEwen, Superintendent of Riverview Psychiatric Center. "The remaining issues do not rise to a level of severity that warrants termination," she said "Most are easily addressed and in one case, we are being held to a standard that we cannot find in the rules that govern participation in the Medicare program."
In addition to addressing safety concerns, Riverview staff created a process improvement team to look at the hospital as a whole. The team made recommendations to address issues such as contraband, staffing, physical characteristics of the unit, client expectations regarding behavior and taking a proactive approach to preventing and dealing with violence. Riverview has implemented all of the recommendations of this group, which received federal approval.
The remaining issues cited by CMS primarily deal with the creation of the two distinct areas of the hospital, the need to develop specific forms, not communicating when a piece of equipment moves from one area to another and sharing staff across the two areas. In addition, CMS noted the failure to allocate staff costs to each area of the hospital, which has already been corrected.
"We cannot find in any of the federal rules a requirement that staffing in these units be separate," said McEwen. "The staffing ratios in the hospital clearly meet federal requirements and can provide for appropriate care for our clients."
"I regret that the State must spend additional financial and staff resources to appeal a decision that is not supported by the facts and I am confident that this decision will be overturned," said Commissioner Mayhew.