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Retreat gets another site visit

Medicaid, Medicare payments for inpatient services hang in the balance

Anne Galloway of VTDigger.org contributed to this report.

BRATTLEBORO—The Brattleboro Retreat received another visit from the Centers for Medicare and Medicaid (CMS) this week.

CMS is resurveying the private psychiatric hospital following a number of compliance issues on the part of the Retreat earlier this year. Once the survey is completed, it has 10 days to report any findings to the Retreat.

If surveyors find that the hospital is not following the Plan of Correction the Retreat submitted to federal regulators, CMS will terminate its provider agreement on Nov. 15.

CMS announced last spring that it would terminate funding for the Retreat unless officials could show that the psychiatric hospital has improved services.

In July, CMS determined that Retreat staff had improperly restrained and involuntarily medicated patients and asked local police to intervene in cases where staff should have been able to manage crisis situations. One violation led to police officers using a Taser on a patient.

CMS regulations prohibit the use of law enforcement or weapons in a hospital setting.

Regulators also found that medical charts for patients were based on templates and did not include particulars about individual patients.

Without CMS’ blessing, the Retreat will not receive Medicaid and Medicare payment for inpatient services after the termination date. This could mean that the state will have to fork over more money to care for patients at the Retreat who are wards of the state.

In a statement, the Retreat said that CMS previously accepted the hospital’s Plan of Correction.

“We expect that the reviewers will determine that the Retreat is in full compliance with Medicare requirements and will extend their contract with the Retreat,” the statement read.

CMS extended the Retreat’s termination date three times, the most recent extension pushed it back from Oct. 30 to Nov. 15.

“In extending the termination date, we emphasize that actual compliance with all Conditions of Participation applicable to hospitals participating in the Medicare program must be verified during a Medicare revisit survey in order for termination proceedings to be rescinded,” wrote Daniel Kristola, branch manager of CMS’ certification and enforcement branch, in a letter to Retreat President and CEO Dr. Robert Simpson on Sept. 30.

A public notice, which is standard for CMS to post two weeks before a hospital’s termination date, appeared in the Nov. 2 edition of the Brattleboro Reformer.

According to CMS spokesperson Courtney Porter Jenkins, the center’s ultimate goal is to work with the hospital to meet necessary requirements and ensure patients’ well being.

The state of Vermont has 14 to 24 patients in the care of the commissioner at the hospital at any given time. The Retreat is part of the state’s decentralized system of care for patients with severe psychiatric illnesses.

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Originally published in The Commons issue #228 (Wednesday, November 6, 2013). This story appeared on page A4.

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