SEATTLE (AP) — A patient attacked another patient at Washington state's largest psychiatric hospital this week as federal regulators decide whether to cut millions of dollars to the facility over concerns about safety.
Doctors at Western State Hospital say the number of violent episodes at the 800-bed facility is rising because staffing levels are inadequate, making the facility increasingly dangerous for patients and workers. The state agency in charge of mental health services says it has asked lawmakers for more money to hire the workers needed to operate safely.
Dr. Joseph Wainer, a psychiatrist with the hospital for 10 years, said the facility has never been so dangerous, and it will take a major shift to make it safe again.
"The medical staff had recommended a freezing of admissions until they get it under control, but we were told we should think about finding another job," Wainer told The Associated Press on Thursday.
The federal Centers for Medicare and Medicaid Services sent a 90-day termination notice to the hospital on Sept. 21 after investigators said staff members mishandled a previous patient-on-patient assault. It was the hospital's third warning that nearly $16 million in annual funding could be cut.
Following the latest notice, another attack happened Monday in which a patient suffered a broken jaw, according to Lakewood police Lt. Chris Lawler.
"One patient assaulted another patient for no reason," Lawler said Thursday. "No one was taken into custody."
The injured patient was sent back to the hospital later that evening, said state officials, who are investigating the attack.
The federal agency is aware of the latest assault, and if the hospital doesn't meet its safety standards by December, the facility will lose funding, spokeswoman Stephanie Magill said.
Funding cuts have happened at other hospitals that don't meet agency standards, "but more often than not, the facility comes back into compliance," she said in an email.
"Our number one priority is to ensure the health and safety of our Medicare beneficiaries," Magill said.
The state Department of Social and Health Services has told the federal government that it would implement changes to ensure safety, including requiring nurses to assess patients after a violent outburst to determine if any threat remains. Staffers also must document and report any attacks so workers coming in later can keep watch and create a safety boundary around seclusion-room doors to protect sedated or restrained patients.
The state expects to have the changes in place by Nov. 15. Federal officials are reviewing the plan.
Carla Reyes, acting assistant secretary for the state health services department, said it will work with federal regulators "to ensure that ongoing improvements will reduce future harmful incidents."
The latest federal warning stemmed from an attack in August. In that case, two patients got into a fight, and one was placed in restraints and sedated. Later that night, the other patient walked by staff and assaulted the sedated patient with his fists and a shoe.
A state mental health crisis has worsened conditions at the hospital. In April, a federal judge said the health services department and the hospital failed to provide timely services to mentally ill people charged with crimes, making people wait weeks or months for an evaluation on their competency for trial or for treatment.
The state's push to open new beds to handle criminal competency cases and satisfy the judge's order has left the already short-staffed hospital in a dire situation, said Wainer, the psychiatrist.
"This is a clinical-care, patient safety issue," he said. "The census should be decreased, but the agency is forging ahead."
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