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April 24, 2012
TOPEKA Larned State Hospital officials say they need an additional $2.1 million to offset staffing shortfalls cited during a recent accreditation survey.
The money, according to a recent report, would be used to raise nurses’ wages, fill vacant positions and increase the medical director’s salary from $210,000 to $240,000.
The House and Senate budget committees are expected to consider the hospital’s request later this week.
Larned State Hospital is one of three state-run hospitals for the mentally ill.
The request for additional funding comes on the heels of The Joint Commission, a national organization that accredits hospitals, last month citing the hospital for 30 deficiencies, most of which were tied to understaffing issues.
The hospital was given 45 days - until May 5 - to come up with a plan for correcting 14 of the more serious deficiencies. It was given 60 days for correcting the remaining 16.
After the 60 days, inspectors will return to the facility for an unannounced review of the state’s remedies.
Angela de Rocha, a spokeswoman for the Department of Social and Rehabilitation Services, declined to discuss the hospital’s efforts to recruit and retain staff. Instead, she referred KHI News Service to the Department on Aging, which will assume responsibility for the state hospitals on July 1.
Calls and emails to KDoA were not returned today.
The Kansas Legislative Research Department last week released a 57-page summary of the spending issues to be discussed during the Legislature’s veto session, which begins Wednesday.
Among the issues involving Larned State Hospital:
• “Failure to adequately correct medical staffing vacancies to The Joint Commission standards will trigger a site survey by the Centers for Medicaid and Medicare Services. A loss of CMS certification would result in an annual loss of $14.5 million in reimbursements to the state.”
• The hospital’s direct care workers, called mental health technicians, “continue to be mandated to work an extra 12 to 24 hours per week.”
• Understaffing issues at the hospital have “resulted in a significantly high turnover rate, increased training costs, increased Kansas Organization of State Employees grievances, increased Family Medical Leave Act claims, low morale and a poor community reputation.”
• Between July 1, 2011, and March 31, 2012, the hospital paid almost $1.4 million in overtime.
• Almost a third of the hospital’s 103 nursing positions are vacant; about 45 percent of the physician and psychiatrist positions are vacant.
Since January, the hospital has been without an on-campus medical director. It currently contracts with Dr. Vishal Adma, medical director at Wheatland Psychiatric Hospital in Hays.
The hospital’s 467 mentally ill patients are at the facility because they have been deemed a danger to themselves or others. The hospital complex includes three 30-bed psychiatric units, a 190-bed forensic unit and a 177-bed sexual predator treatment program.
Of the 467 patients, 217 are in the sexual predator program.
The hospital’s staffing troubles are not new. “For the last 10 years, the facility has been underfunded by the Legislature and by the governor(s),” said Pawnee County Attorney John Settle. “They’ve cut and cut and cut.”
Settle has been a vocal supporter of adding 60 beds to the hospital’s 190-bed forensic evaluation unit.
“What people don’t seem to understand is that this is a hospital that’s set up to provide very specialized care. At the same time, it has no control over volume,” Settle said. “So the state can set an arbitrary budget number, but the hospital can’t hold itself to that number. It can’t control mental illness.”
Larned, located between Great Bend and Kinsley, is in Pawnee County.
“A lot of people say the hospital hasn’t been able to get enough people to work there because this is a rural community,” Settle said. “That’s a bunch of baloney. The problem isn’t that there aren’t enough people out here. The problem is that good people in health care can find jobs almost anywhere and, right now, the hospital isn’t a fun place to work.”
Sen. Allen Schmidt, a Hays Democrat, said he expects the Legislature to heed Larned State Hospital’s call for an additional $2.1 million.
“I’m sensing a heightened level of concern,” said Schmidt, whose nine-county district includes Larned and hundreds of state hospital employees. “I’ve received some strong indications that both SRS and the Legislature recognize the problems and are ready to rectify them.”
But Sen. Laura Kelly, a Topeka Democrat and ranking minority member on the Senate Ways and Means Committee, said the initiative should not be limited to Larned State Hosptial.
“We can’t raise salaries for nurses at one hospital and not raise them for nurses at the other state hospitals,” she said. “I’m not sure it’s legal. I know it isn’t fair.”
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.