Federal scrutiny intensified on Washington’s largest psychiatric hospital, whose history of attacks on patients and staff and a failure to improve safety was brought into sharp relief when a patient accused of killing a woman escaped from a lower-security ward and was still on the loose two days later.
U.S. regulators are investigating a recent violent attack on a hospital worker and a patient-on-patient sexual assault at Western State Hospital. A workplace inspection released Thursday also found a series of missteps that posed safety risks, including unlocked rooms, unattended items that could be used as weapons and workers who abandoned their posts instead of watching patients.
The Centers for Medicare and Medicaid Services has repeatedly cited the facility over safety concerns and threatened to cut millions in federal money. An agency spokesman says the hospital is under additional scrutiny over the escape and recent assaults.
One of the escapees from Western State, Anthony Garver, 28, remained at large Friday night. Garver, who was charged with torturing a woman to death but found too mentally ill for trial, was last seen in the Spokane area where his parents live. He and patient Mark Alexander Adams, 58, crawled out a window of their ground-floor room Wednesday night. Adams was recaptured Thursday.
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Officials said Friday that a third patient left the facility Wednesday with an escorted group but didn’t return. The patient, who wasn’t identified, was committed to Western State after being deemed unfit to face trial on residential burglary charges and violation of a no-contact order.
The patient’s whereabouts aren’t known, and police have been notified. The patient was under less restrictive conditions than the two men who escaped later Wednesday.
Garver had been charged in 2013 with tying a 20-year-old woman to her bed with electrical cords, stabbing her 24 times in the chest and slashing her throat. The murder charge was dismissed after a judge said mental health treatment to prepare him for trial was not working.
State officials did not explain why Garver, a felon with a history of running from authorities, was kept in a lower-security area. Some high-security units require patient checks every 15 minutes, but Garver was not placed in one, staffers say.
“He was in a locked area with locked windows and hourly checks,” said Kathy Spears, a spokeswoman for the Department of Social and Health Services, which oversees the state’s mental health care.
The hospital says the men were discovered missing 45 minutes after they were last seen, but police said it took an hour and a half. Security staff was inspecting the windows Friday to determine how the men loosened the bolts.
The history of violence at the facility stretches back years. Hundreds of employees have suffered concussions, fractures and cuts in assaults by patients, resulting in $6 million in workers’ compensation claims between 2013 and 2015. Patients also have attacked other patients, causing serious injuries.
Federal regulators sent notices to the hospital four times last year after inspectors found it failed to ensure the safety. The facility has until May 3 to address the violations or lose millions in funding.
Most recently, a patient with a history of violent behavior choked and punched a mental health technician on March 26, according to an internal report. A March 23 report said a male patient slipped out of his monitors and was found in a bathroom with another male patient, who said he was sexually assaulted.
The hospital faces new scrutiny after the two attacks and escape, said Steven Chickering, associate regional administrator of a division of the Centers for Medicare and Medicaid Services.
“CMS was aware of all three of these situations, and cannot comment on how they will affect Western State Hospital’s federal funding,” Chickering said in an email. “CMS is currently following its procedures and processes for these situations.”
In addition, the hospital’s safety and emergency management manager sent a memo to staff Thursday citing numerous violations observed during a recent review.
Some of the problems involved how the hospital is laid out, “but they also observed actions by staff that could pose a safety and/or security risk,” Pamela Rieta’s memo said.
Her team saw a patient wearing a long necklace, telephones with long cords, an unattended chair and other items that could be used as weapons left at the nurse’s station, the memo said.
Cabinets and lockers in activity rooms and kitchen areas were unlocked and unattended. Patients returning from ground privileges were not scanned for contraband. Several kitchen doors were propped open without staffers present, allowing patients to enter, the memo said.
The team also saw staff leave their posts “to hang out and talk … not observing the patients.”
The state’s Behavioral Health Administration, which oversees the facility south of Seattle, is conducting a safety review and will bring in outside experts to help, assistant director Carla Reyes said.
As for Garver, he was last seen Thursday in Spokane after he got on a bus from Seattle. Investigators were not sure whether he left the area or is hiding in the woods, Spokane County sheriff’s Deputy Mark Gregory said.
Garver’s father, who lives in the area, called authorities Thursday to report his son had stopped by.
“The father said he was there for a very short time, got spooked and left,” Gregory said.
The deputy said he hopes Garver will be held in a more-secure facility after he is apprehended.
“He has a history of running from law enforcement and of not doing what he’s supposed to do, so I hope when he is caught, he’ll be placed in a facility that has better security,” Gregory said.