Politics & Government

$65 million on the line with latest Western State review

In this photo taken April 11, 2017, a security officer stands on steps at the entrance to Western State Hospital, in Lakewood. Inspectors who visited Washington state’s largest psychiatric hospital found that safety problems that thrust the facility into the national spotlight after the escape of two dangerous patients a year ago persist.
In this photo taken April 11, 2017, a security officer stands on steps at the entrance to Western State Hospital, in Lakewood. Inspectors who visited Washington state’s largest psychiatric hospital found that safety problems that thrust the facility into the national spotlight after the escape of two dangerous patients a year ago persist. AP

Federal regulators are walking the halls at Western State Hospital this week to decide whether the psychiatric facility fixed enough of its safety and staffing problems to stay eligible for nearly $65 million a year in federal dollars.

The inspection is a crucial step of an agreement the state made with the Centers for Medicare and Medicaid Services in June to upgrade the roughly 800-bed hospital after it failed past examinations, putting the funding and the hospital’s federal certification at risk.

The Lakewood hospital has struggled for years to get past employee shortages, patient assaults, escapes and low staff morale, problems exacerbated by budget cuts during the Great Recession.

Regulators found patients and staff were being assaulted more than four times a day during a four-month period.

The problems bubbled over in April 2016 when two patients — one previously accused of killing a woman by stabbing her 24 times and cutting her throat — escaped through a key-locked window they had tampered with for months.

Both patients were found within days, but Gov. Jay Inslee fired hospital CEO Ron Adler and put Cheryl Strange in charge.

Since those turbulent times, the state has touted improvements at Western State.

Aggressive hiring strategies and temporary pay raises for some have increased staffing levels. Inslee told The Olympian’s editorial board last week the hospital has filled 388 vacant positions.

Hospital officials said in April they have implemented strategies to reduce violence and made patient safety improvements, such as rekeying locks.

In addition, state lawmakers are debating the best way to transform the hospital’s population by moving most of its noncriminal patients to other facilities in Washington.

The approach would shift staff focus to the hospital’s growing population of criminal, or forensic, patients who are committed to Western State because they’ve been charged with or convicted of crimes.

“Staff has worked hard to improve the quality of care and safety for patients, staff and the community,” Carla Reyes, an assistant secretary with the Department of Social and Health Services, said in a statement Monday.

Not all is perfect, however.

Strange told reporters in April the hospital’s improvements are a work in progress. And a more recent survey found some of the psychiatric facility’s issues persist.

Kathy Spears, a spokeswoman for Western State, said in an email “the number of reported assualts remains similar to that of the past five years,” but the “severity of injuries continues to decrease.”

“We expect that trend to continue as our new staff become more experienced working in a large acute-care setting,” she said.

Whether the improvements are enough to put the federal government at ease remains to be seen.

Spears said 23 government inspectors arrived at the hospital Monday and are expected to be there through Friday interviewing staff and patients, reviewing medical records, checking patient rooms and more.

A news release from the state Department of Health and Social Services says the regulators will release their results “at a later date.”

Walker Orenstein: 360-786-1826, @walkerorenstein

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