Osawatomie State Hospital at risk of losing Medicare payments

? The federal government has put Osawatomie State Hospital on notice that if it does not correct problems there in the next three weeks, it will no longer be allowed to bill Medicare for services.

But Kari Bruffett, secretary of the Department for Aging and Disability Services, which oversees the hospital, assured a legislative committee Tuesday that a corrective action would soon be in place and the deficiencies at Osawatomie would be fixed before the hospital is terminated from Medicare.

“We don’t think that’s going to happen,” Bruffet told the Joint Committee on Home and Community Based Services and KanCare Oversight. “We in fact have a plan of corrective action. It includes resolving the outstanding issues this week.”

Bruffett said overcrowding was one of the issues cited in the hospital’s last inspection by the Center for Medicare and Medicaid Services. As of Tuesday, the hospital had 221 patients, which is 15 more than it is licensed to have at one time.

Osawatomie State Hospital is one of only two state hospitals still in operation that houses patients with severe mental illness. The other is in Larned.

“We do have what’s called a census management initiative, and that’s where we contract with community hospitals in Kansas for adult psychiatric beds as an alternative to state hospitals,” Bruffett said. “That has been actively used pretty consistently over the last few months.”

But she said one of the challenges is that many community hospitals, in Kansas as well as surrounding states, have closed their adult psychiatric facilities in recent years, making it harder to find alternative placements for those patients.

Another challenge, she said, is that some communities in Kansas don’t have enough outpatient facilities that can treat patients once they are discharged from a state hospital.

She said for the short term, her agency is looking for ways the state’s 26 licensed community mental health centers can share resources. It is also looking for ways to help those community hospitals that still have adult psychiatric units to expand their capacity.

For the longer term, Bruffett said the state is trying to expand what she called “intermediate options,” facilities that can handle patients for one or two days on an emergency basis, usually in cases dealing with substance abuse.

She said that’s being tried at the former Rainbow Mental Health Facility in Kansas City, Kan., where the state teamed up with area mental health and substance abuse treatment providers in Johnson and Wyandotte counties. She said that program has reduced admissions from those counties into Osawatomie State Hospital, as well as county jails.

Bruffett said the department recently awarded a $1 million grant to launch a similar project in south-central Kansas to serve Sedgwick, Butler and Sumner counties.