Outdated patient records blamed for Eleanor Slater Hospital confusion
Providence JournalJun 03, 2021
PROVIDENCE — This is the explanation given state lawmakers for the sudden and seemingly inexplicable surge in the percentage of "psychiatric patients" that has placed the state hospital at risk of losing millions of Medicaid dollars:
Patient records had not been updated for years and, in many cases, since before the turn of the century.
But members of the
They were told that, for example, a patient admitted with a serious brain injury from a car accident may have arrived as a "medical" patient a decade ago and, over time, developed dementia or some other behavioral problem requiring drugs that place them in the "psychiatric" category.
The state's Medicaid director,
Clinical staff at
"Quite frankly from a regulatory perspective the only opinion that matters is the opinion of the Medicaid agency,'' Shaffer said.
This back-and-forth took place amid allegations that doctors at the state's
Nurse says medicine was manipulated so hospital could meet targets
In written testimony, certified nursing assistant
"Unfortunately, we have recently lost a patient who died after being removed from the medication who then ceased all eating,'' Bolduc wrote. (State officials have not yet responded to questions about her allegations.)
*The
Though federal health-care privacy law "allows for patient information to be shared in some circumstances to assist in discharge or transfer to another health facility, [the hospital] has now agreed to ... [obtain] patient or family consent before sharing such information'' in the future, said
The stakes: the state has not billed Medicaid for upwards of
The state won a federal agency's approval to resume billing in March, but has not yet done so amid fresh questions about whether the state hospital is impacted by federal rules ban Medicaid payments to facilities where more than 50% of the patients have mental disease.
"Let's take a step back,'' said Rep.
"Their diagnosis affects everything,'' said
"The issue [that] had come up was whether our charts were as robust as they should be. We were looking at discharging [patients] ... so we asked our [doctors and administrators] to look into: is our documentation what it needs to be? Are our patients in the right categories based on their diagnosis codes?"
."What was being kept in the system was their original diagnoses upon admission."
"The folks over at Zambarano shouldn't have had such an uptick, if there [are] no psychiatrists, right, at Zambarano?" said Marszalkowski.
Elaborating, Dr.
In his turn, Dr.
But if they have a problem that involves the need for psycho-tropic medications, specifically anti-psychotic medications, he said, that pushes people over to the mental disease category. "That's true of many of the folks at Zambarano."
"States all across the country have
The state has asked the federal
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