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Green Says Rawson-Neal Patient Dumping Merely Result Of Lack Of Documentation


Dr. Tracey Green, Chief Medical Officer, State of Nevada 

BY IAN MYLCHREEST -- Rawson-Neal psychiatric hospital in Las Vegas was nearly stripped of its accreditation because it put patients on Greyhound buses and sent them interstate. Federal agencies cited the hospital for discharging and busing patients without an adequate follow-up treatment plan. Two employees were fired and three were disciplined after an internal investigation.

Still, Nevada’s Chief Medical Officer, Dr. Tracey Green, says that the problem was merely a lack of documentation.

In discussing the recent review, Green emphasized the complex process for discharging patients – a process designed to ensure that all professionals have signed off on the discharge planning and that a plan for future treatment is in place. Once stabilized, she said, patients can participate in planning their own future treatment.

All patients are stabilized and were never a danger to themselves or others, Green said. She questioned reports in the Sacramento Bee that Nevada had purchased many more bus tickets for patients than any other state.

Green could not explain how Rawson-Neal had instituted its system of discharging patients and shipping them interstate. “One of the things we really need to keep in mind is that, you know, we did review the 1,500 tickets and found only 10 with documentation errors. And when you look at 1,500 of anything else and found 10, we’d probably say to ourselves, ‘Well, 99 percent quality is pretty darn good,’” said Green.

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New hiring funds are included in the state budget and the hospital will be hiring, says Green. She denies that any patients were being turned away from the hospital: “What’s happening is that we’re backing up in the emergency rooms because we clearly can’t turn over the hospital fast enough to meet all the needs of the community.”

“But we’re not turning anybody away. In fact, we’re taking everybody in,” she adds. Green sees no alternative to the emergency room when so many clients are not going to private facilities.

Green denies that people had been bused out of state against their will. It was done, she said, in consultation with the patient and his or her family and they were always stable when they left. “So, in that sense, I definitely think it’s been exploited.” The mentally ill, once stabilized, she says, could properly be bused out of state.

New funding would help, but we still need new staff and new beds to treat all mental illness adequately, says Green. But even that leaves as many as 70 people in the emergency room waiting to get proper treatment.