Thursday, April 24, 2014
By BETTY ADAMS Kennebec Journal
AUGUSTA – Federal regulators were horrified that corrections officers had been subduing patients at the Riverview Psychiatric Center with stun guns and handcuffs, according to newly released inspection details that threaten to spike $20 million in federal funding for the state mental hospital.
This aerial photo taken on Tuesday April 30, 2013 shows The Riverview Psychiatric Center on banks of Kennbec River in Augusta.
Staff photo by Joe Phelan
The Riverview Psychiatric Center
Staff photo by Joe Phelan
The Tasers were gone as of May 24, and the contract for Kennebec County to provide corrections officers to the hospital ended Sunday.
"We ran into some difficulties with regard to what responsibilities we were willing to take on," Kennebec County Chief Deputy Ryan Reardon said Tuesday. "Officers were hands-on half a dozen times a day, and sometimes more, to prevent patients from harming themselves, other patients and employees."
The corrections officers from the Kennebec County Sheriff's Office were brought in as a safety measure following attacks by patients on their peers and on hospital workers. Initially, county officers augmented state corrections officers, and now the responsibility for safety at Riverview has been resumed by state corrections personnel.
Security had been stepped up following a particularly vicious attack on a mental health worker March 16 by a patient.
But those security measures were cited top among deficiencies by state and federal regulators who inspected the state forensic hospital in unannounced visits May 8-10.
And if those problems at the 92-bed Riverview Psychiatric Center remain uncorrected, the federal Centers for Medicare & Medicaid Services has warned the hospital it could lose $20 million in federal money -- more than half its operating budget -- beginning Sept. 2.
Riverview Superintendent Mary Louise McEwen said Tuesday that a plan to correct the deficiencies was submitted to federal officials on Friday, and she hopes it will be accepted.
She said corrective measures began almost immediately after the visit and the report, which was sent to the hospital June 4, but there was some initial miscommunication about what federal officials wanted to see in a corrective plan.
"We understand completely what we need to do to satisfy their requirements," McEwen said.
Gov. Paul LePage blames the Democrat-controlled Legislature for failing to fund his proposal to alleviate problems at Riverview by creating a mental health ward at the Maine State Prison in Warren. He is asking lawmakers to return to work on the issue before the next session in January.
The 88-page inspection report after inspectors visited the hospital in March and May shows where the psychiatric hospital failed to meet standards:
• Failure to prevent abuse, putting patients in immediate jeopardy.
"The hospital permitted law enforcement personnel to use Tasers and handcuffs on any patient on the unit, and allowed them to intervene for any patient who they perceived as demonstrating threatening behavior," the report stated.
The hospital addressed that issue during the site visit in May, initiating education for staff and Kennebec County Sheriff's Office corrections officers, protocol clarification and hospital review of all incidents, according to the report.
• Failure to comply with laws that ensure patients are treated in a safe setting and free from physical and psychological abuse and harassment.
• Failure to ensure patient rights "as evidenced by the use of a Taser on a patient who was in a non-threatening position on the floor and use of hard handcuffs by sheriff's officers to escort patients to seclusion and restraint," placing patients "in danger of physical harm, pain and mental anguish."
While hospital personnel are trained in Non Abusive Psychological and Physical Intervention, known as NAPPI, the county corrections officers were trained in use of restraint and control, the report says.
In one incident, on May 1, a Taser was used on a patient after other interventions were tried. A report showed that "the patient had pulled a soap dispenser off the wall and thrown it at staff."
Another patient, identified as Patient B, was handcuffed following an incident May 7 during which the patient allegedly kicked a hole in the bathroom wall. The patient was twice able to get out of five-point restraints "and attempted to assault staff." The nurse who documented the incident told the team "she supported the use of handcuffs in this highly assaultive patient."
The report also faults Riverview with failing to meet standards for patient rights involving restraint or seclusion.
Former Chief Justice Daniel Wathen oversees a long-standing consent decree that settled a lawsuit by mental health advocates that holds the state mental health system to agreed-upon standards of care. Wathen had referenced "two serious security situations on the Lower Saco Unit" in his most recent report issued last month.
"One incident involved a client assaulting a member of the staff and the second involved jeopardy to the health and safety of patients arising from the actions of correctional officers providing unit security," Wathen wrote in a report.
In his report, Wathen foreshadowed the funding threat Riverview now faces. He noted that the Centers for Medicare & Medicaid Services "has an effective remedy for correcting deficiencies, it has both the authority and the intention to suspend payment for Medicare services unless the deficiencies are addressed to its satisfaction."
Betty Adams can be contacted at 621-5631 or at: