Improper discharges of psychiatric patients result in terminations at state hospital

By Anjeanette Damon

Published Monday, April 29, 2013 | 11:13 a.m.

Updated Monday, April 29, 2013 | 5:02 p.m.

Gov. Brian Sandoval said today the state has taken additional disciplinary action against state mental health employees — including an unspecified number of terminations — after completing a review of nearly 1,500 cases in which mentally ill patients were bused out of state upon being discharged from the psychiatric hospital in Las Vegas.

“Over the weekend, I reviewed the results of the investigation into patients transported out of state," Sandoval said in a written statement. "All individuals who violated release policies have been or will be disciplined. These disciplinary actions include terminations effective today."

After reviewing 1,473 cases in which patients were bused out of state following their discharge from the Rawson Neal Psychiatric Hospital, state officials found 10 cases where policy was not followed to ensure the patients had an adequate support network at their destinations, according to information from the Department of Health and Human Services. The probe was sparked by an investigation spurred by a series of stories by the Sacramento Bee detailing the state practice of sending some patients discharged from Rawson Neal on bus trips out of state.

State officials identified nine hospital staff members involved in the 10 improper discharges. Four no longer work for the state. Of the remaining five, two have been terminated, according to the department.

Of the 10 patients improperly discharged, nine were identified as having a substance abuse problem and never admitted as an inpatient client. One patient improperly bused out of state received inpatient treatment at the hospital.

"While the investigation showed the vast majority of patient releases were done correctly, it also revealed policies were not followed by certain individuals," Sandoval said in the written statement. "I will continue to evaluate the need for further action if necessary."

In addition to disciplinary action against specific employees, the Nevada Department of Health and Human Services has implemented new policies at the hospital, including requiring additional review of patient discharges by two physicians and now requiring that any patients sent out of state be chaperoned. Prior to the policy change, it was up to individual clinicians to decide how to discharge a patient and whether the patient warranted a chaperone when being sent out of state.

“In addition, we have obtained proposals from national experts in the mental health field to provide an objective and comprehensive analysis of our state facilities to ensure that best practices are being implemented and followed," Sandoval said. "As I have stated before, improperly discharging one patient is one patient too many. It is important to me and all Nevadans that we treat our most vulnerable members of society with dignity and care.”