Psychiatric patient kills himself at Novant Health Presbyterian Medical Center in Charlotte, North Carolina

From the Charlotte Observer

A patient at Novant Health Presbyterian Medical Center killed himself in the seventh-floor psychiatric unit April 6, according to Charlotte-Mecklenburg police.

The incident involved a 56-year-old Rock Hill man about 4 a.m. on the Monday after Easter. Police investigated and concluded the man committed suicide, according to the April 6 incident report.

The man’s death comes 16 months after another Presbyterian patient attempted suicide by jumping out a window on the same unit. The 25-year-old man suffered broken bones but survived.

The latest incident was reported by Novant Health to the state’s Division of Health Service Regulation, said Alexandra Lefebvre, a spokeswoman for the N.C. Department of Health and Human Services. She said details are not released until an investigation is completed.

Naturally, Novant Health issued a generic statement asserting that they follow the best practices, they are taking things seriously, etc.

Five arrested in East Cove Psychiatric Services investigation

As seen here

Agents with the North Carolina State Bureau of Investigation executed search warrants Tuesday morning at a Kinston psychiatric facility. That afternoon, authorities arrested East Cove Psychiatric Services’ owners and operators Joanna Wolicki-Shannon and Walter Shannon. Shannon, 64, faces 12 felony counts of obtaining a controlled substance by fraud or forgery and received a $180,000 bond. Wolicki-Shannon, 50, received charges of six felony counts of obtaining a controlled substance by fraud or forgery and took a $90,000 bond. According to the SBI, “The doctors wrote bogus prescriptions for phentermine, hydrocodone, Percocet, Adderall, vyvanse and Ritalin using their psychiatric practice employees and members of the office staff’s families to submit them to pharmacies to be filled. The employees picked up the prescribed drugs and delivered them to the doctors.” Agents arrested three others in connection to the case. Lisa Renay Lankford, 53, faces 18 felony counts of obtaining a controlled substance by fraud or forgery and received a $279,000 bond. Candice Raegan Hill, 35, and James Howington, 31, were charged with 10 felony counts each of obtaining a controlled substance by fraud or forgery along with 10 felony counts of trafficking opium. Hill received a $650,000 bond, while Howington received a $659,000 bond. Hill and Lankford are both former office managers at East Cove, and Howington is Hill's boyfriend. East Cove’s main office is located in the 1300 block of North Queen Street, while an additional facility is open Thursdays on Limehouse Road in Kenansville. East Cove serves Eastpointe region clients who require mental health, developmental disability and/or substance abuse services. State agents are being assisted by the FBI in the case. Throughout the day Tuesday the Lenoir County Sheriff’s Office also lent assistance at the scene. The suspects should make their first appearance in Lenoir County District Court on Wednesday.

Life Care Of Greeneville, NC Named In Wrongful Death Lawsuit

As reported in the Greenville Sun

Many more Details are available at the link

A wrongful death civil lawsuit has been filed against a Greeneville nursing home and several other defendants alleging wrongdoing in the care the facility gave an elderly dementia patient.

In the complaint, filed Dec. 2, 2014, in Greene County Circuit Court, the plaintiff, Robin Tweed Keller, of Virginia, alleges that medical battery and negligence by Life Care Center of Greeneville resulted in the suffering and eventual death of her father, Bobby Glenn Tweed, on Nov. 19, 2013, at the age of 79.

The suit identifies Keller as Tweed's only daughter and his next-of-kin -- and the person he had designated his Tennessee Healthcare Durable Power-of-Attorney in September 2009.

She is also identified as the court-appointed representative of his estate.

Defendants named in the lawsuit are:

• Life Care Center of Greeneville, 725 Crum St.;
• Life Care Centers of America Inc., based in Cleveland, Tenn., the parent company of Life Care Center of Greeneville and more than 100 other similar centers in the nation;
• Wayne E. Tasker & Associates Inc., of Morristown, doing business as Green Tasker & Associates Inc., and Tasker Green & Associates Inc., a firm which Keller believes provides services to Life Care Centers in connection with the mental health of patients;
• Dr. William C. Diebold, a medical doctor and board-certified psychiatrist with Takoma Regional Hospital's Center for Outpatient Behavioral Health and Senior Care, who, the lawsuit states, treated Tweed at one point during the last months of his life;
• Stephen L. Haile, an advanced-practice registered nurse who the plaintiff believes to be an officer or employee of the Tasker firm; and
• Dr. Kenneth Nickle, a physician with Summit Medical Group, who, the lawsuit states, served as medical director of Life Care Center of Greeneville during the last three months of Tweed's life and, in that capacity, treated Tweed for two-and-a-half to three months.

Also cited as a defendant is an unnamed female who, the complaint states, was employed at Life Care Center of Greeneville. The lawsuit alleges that she was involved in the care and treatment of Tweed and administered certain "atypical anti-psychotic drugs" without obtaining the legally-required informed consent from Keller.

The Greeneville Sun has made attempts to seek comment from each defendant listed in the complaint. Each defendant contacted has declined comment on the pending case at this time.

WHAT LAWSUIT CLAIMS

The suit alleges that, for a few days in August 2013 at Takoma Regional Hospital and then continuing until mid-October 2013 at Life Care Center of Greeneville, Tweed was administered powerful drugs that were inappropriate for his medical condition: dementia and Alzheimer's disease (but not mental illness).

The drugs mentioned in the lawsuit -- Seroquel, Geodon and Depakote -- are described in the suit as "extremely powerful psychotropic medications" classified as "atypical anti-psychotic drugs."

Seroquel and Geodon, the suit alleges, "and other atypical anti-psychotic drugs" have been shown to increase death in elderly patients who are suffering from dementia.

Because of that increased risk of death, the U.S. Food and Drug Administration (FDA) has required the manufacturers of Seroquel and Geodon to include "black box" warnings about the danger of using those drugs with elderly patients who are suffering from dementia, the suit alleges.

The suit describes Depakote as "an anti-epileptic drug, which is used to treat a variety of epilepsy seizure types as well as acute manic symptoms in patients with bipolar disorder."

But, the suit continues, "It has not been approved by the FDA for use with Alzheimer's disease or dementia."

Many more Details are available at the link

A mental patient died after workers at a North Carolina hospital left him in a chair for 22 hours without feeding him or helping him use the bathroom,

From the MSNBC Report

A mental patient died after workers at a North Carolina hospital left him in a chair for 22 hours without feeding him or helping him use the bathroom, said federal officials who have threatened to cut off the facility's funding.

The state sent a team Tuesday to help Cherry Hospital in Goldsboro draft new procedures to ensure patients receive proper care.

An investigator's report released Monday found that 50-year-old Steven Sabock died in April after he at one point choked on medication and had been left sitting in a chair for close to a day at the facility about 50 miles southeast of Raleigh. Surveillance video showed hospital staff watching television and playing cards just a few feet away.

It was not clear from the report exactly how Sabock died. The report states that he was in a hospital bed and later found unresponsive. A phone call placed after business hours to the state Office of the Chief Medical Examiner rang unanswered Tuesday.

Federal officials have threatened to cut off funding because of Sabock's death and a report that a physician punched a patient after the teen bit the doctor.

Department of Health and Human Services spokesman Tom Lawrence said the state team also may investigate what, if any, disciplinary action should be taken following Sabock's death.

Lawrence said the Sabock incident is isolated but that officials are concerned.

"It's not the kind of thing that we in our wildest dreams would expect to happen in our hospitals - in our wildest nightmares, I guess," Lawrence said.

Sabock's father, Nicholas, declined comment when reached by telephone Tuesday evening. A man who answered the phone listed for Susan Sabock, Steven's wife, hung up without commenting.

The investigation released Monday said Sabock died in April after Cherry Hospital nurses left him unattended in a chair and did not feed him or help him to the bathroom.

The report said Sabock sat, unattended, in the room for four work shifts. The report also found that Sabock, formerly of Roanoke Rapids, ate nothing the day he died and had little food in the three days preceding his death. The 47-page report also said workers were supposed to be closely monitoring Sabock's condition and may have forged documents that said they had.

The state has until Aug. 23 to file a report with the Centers for Medicaid & Medicare Services detailing what changes officials are making, Lawrence said.

If the center rejects the report, federal funds will be cut off beginning Sept. 1, Lawrence said.

[...]

Cherry Hospital psychiatrist struck a mentally ill patient

From North Carolina's News & Observer Newspaper

A psychiatrist at a state mental hospital in Goldsboro is still on the job despite an internal investigation that concluded he hit a mentally ill teenager who has developmental disabilities.

Dr. Ralph Berg, 58, struck Ricky Luciano in the back during a tussle over a T-shirt at Cherry Hospital. The incident, which occurred April 28, was recorded on a hospital security camera.

Berg, reached at his home Friday, said he had been instructed not to comment about the case.

According to the hospital's internal investigative report, released at the behest of Luciano's family, Berg told hospital officials he was defending himself after Luciano, then 18, bit him on the forearm.

Even if Berg was attacked, a state law regarding the use of force in mental hospitals bars staff from retaliating with violence.

The assault was not reported to any law enforcement agency, including Cherry's internal police department.

A review of public files at the N.C. Medical Board gives no indication a complaint was filed against the doctor, who has been on the state payroll since 1999 and receives an annual salary of $187,681.

"He should have been fired," said Deborah Sargis, Luciano's mother. "I've been a nurse more than 20 years. Had I ever seen anything like that when I was working, I would have reported that doctor in a minute."

On the recording

The recording, which the state Department of Health and Human Services did not disclose until pressed by The News & Observer, shows Luciano standing in a hospital day room at 8:37 a.m. with his shirt off, snapping it at two staff members in front of a nurse's station.

Berg enters through a door and attempts to snatch the shirt from Luciano. The two tug at it, spinning around before Luciano appears to dip his head toward the doctor's hand. As the patient is bent over, Berg strikes him in the back, and Luciano collapses to the floor.

The doctor throws the shirt to the floor before grabbing it and leaving through the same door he entered. Luciano, who is schizophrenic and has an IQ of 58, is left sitting on the floor with his head bowed until the tape, as edited, ends.

The written report of the incident included in Luciano's medical file indicates he bit the doctor, who "pushed" the patient to make him release the bite.

A handwritten note that says "no injury to client" was crossed out and replaced with "Error. Reddened area L[eft] shoulder blade." The mark, which later darkened to purple, measured about 4 inches square.

Afterward, records indicate Luciano was given the maximum recommended dose of an anti-psychotic drug, along with anti-anxiety and mood-stabilizing drugs. When administered together, the drugs would have heavily sedated the patient.

An internal investigation was launched that day, after the incident was reported to one of the hospital's patient advocates. In an interview with Berg transcribed in the file, the doctor said he tried to grab the shirt only after Luciano snapped it at him.

"He locked his jaw into my arm," Berg is reported as saying. "As he was locked on me, I went to push him down, and he moved up a bit, and it wound up slapping him on the back. ... I feel badly that it went down like that, but I am going to stand by my guns that I didn't do anything wrong."

Nurses and lower-ranking employees at state hospitals are routinely fired if an abuse complaint is substantiated against them, and their names are placed on a blacklist that makes it difficult for them to find another job.

According to the investigative report, the Cherry officials who reviewed the complaint against Berg recommended that a supervisor "address how the intervention used was not appropriate and discuss how the situation could have been handled differently."

NC Psychiatric Hospital Fails Surprise Inspection, Could Lose Accreditation. Director Replaced

Report from Asheville, North Carolina.

A new director was appointed at Broughton Hospital on Monday after the hospital failed a surprise accreditation inspection last week.

Dr. Art Robarge, who was director of Broughton from 1986-89, has been named interim director, replacing Seth P. Hunt, who had been director since 1995.

Inspectors from the Joint Commission on Accreditation of Healthcare Organizations, an independent nonprofit, have notified Broughton they will recommend a preliminary denial of accreditation. That will give Broughton 45 days to address the problems found by inspectors, or it will lose its ability to receive payment from private insurance companies.

The hospital also did poorly in a recent mock run-through of a Center for Medicare and Medicaid Services inspection by N.C. Department of Health and Human Services staff.

Broughton cares for about 300 patients a month. It is the westernmost of the state’s four psychiatric hospitals and serves people from 37 counties.

The hospital lost certification to receive payment from Medicaid and Medicare in August, and the state has been paying roughly $1.3 million a month to make up for the federal money lost.

[...]

Among the problems the Joint Commission found at Broughton Hospital:

Restrained patients

• There was insufficient proof that staff consistently does a daily physical exam on people who are in restraints to verify a continued need.

• The hospital had insufficient proof that staff had attempted nonphysical techniques before using manual restraint or seclusion.

Cleanliness and safety

• Infection control plans were inadequate, and there was inadequate risk analysis of infection-control data.

• The hospital provided insufficient documentation for fire alarm testing. Fire department connection tests had not been completed, and hospital plans did not show that the local fire department was called when a fire alarm sounded.

Documentation

• The hospital had inadequate proof that a patient had given informed consent for medication with psychotropic drugs.

• Legal guardianship of a patient was not always determined.

• Development of individualized treatment plans was inadequate.

• More than 50 percent of the discharge summaries that documented patient assessment, care, treatment and services were late.

Adobe Acrobat PDF Report from the state on the mock run-through of a Center for Medicare and Medicaid Services. (40 KB)

Another psychiatrist sex scandal

A report from Cleveland County, North Carolina.

A Shelby psychiatrist, accused of having an inappropriate relationship with a patient, signed a consent order indefinitely suspending her medical license.

Dr. Kerry L. Balentine was accused of having a romantic relationship with one of her patients after that patient’s wife died in September 2006. Balentine began grief counseling the patient, the consent order said. She had previously treated him for about a year.

According to documents from the North Carolina Medical Board, Balentine began the relationship after accepting an invitation for coffee.

The order said Balentine stopped seeing the patient in her office in October 2006, “implying that he was discharged from her care but not clearly terminating their physician-patient relationship.”

It also stated that Balentine provided prescriptions for medications, including controlled substances to the patient, after the relationship began and did not chart them.

“Dr. Balentine admits that her relationship with (the patient) violated boundaries as well as the ethics of the psychiatric profession and the medical profession as a whole,” the document said.

According to the consent order, dated Dec. 14, Balentine’s license is indefinitely suspended, she agrees to obey all laws, rules and regulations involving medical practice, she is required to notify the board of any change in residence or practice and that she will meet with the board as requested.

If she fails to comply with the order, the board will have grounds to annul, suspend or revoke her medical license.

She had medical privileges at Cleveland Regional Medical Center and Kings Mountain Hospital.

Quackbuster Psychiatrist Goes down in Flames

This news/press release is important to people who favor natural cures and treatments vs the use of commercially produced pills and medications. It can be found in several places around the Internet, including, but not limited to:

The Foundation for Health Choice

This originally dates from June, but it is still worthy of passing along. Because of the shakedown schemes that this delicensed Shrink has perpetrated, it needs to be repeated as a warning to others whom he might target as potential targets.

Self proclaimed Quackbuster, Stephen Barrett, MD, recently handed crushing defeats by chiropractor Tedd Koren and Ilena Rosenthal, has announced he is leaving his home town and operating base in Allentown, Pennsylvania.

On June 11th, 2007, the Superior Court of Pennsylvania affirmed a lower court dismissal of Barrett’s defamation suite against Dr. Koren. Barrett’s case was so lacking in merit the judge blocked it from going to the jury. Barrett simply had no case against Dr. Koren. This followed another stunning defeat last month in California. There an appeals court ordered Barrett and crony Terry Polevoy, MD to post bonds of more than $400,000.00 after they lost a defamation case against Illena Rosenthal virtually identical to the Koren case.

Perhaps the fact that lawyers and judges in Allentown are catching on to his intimidation schemes explains why Barrett is moving to Chapel Hill, North Carolina. Barrett can run but he can’t hide. Chapel Hill collection attorneys are already being asked to locate his assets to pay his unmet legal obligations. Assets of other Quackwatch, Inc., principals might also be sought.

Who Is Steven Barrett, What Are Quackbusters?

Steven Barrett is an unlicensed Pennsylvania psychiatrist, who, though he failed his psychiatric boards and has been criticized for his lack of expertise by several courts, still claims to often advise the Federal Trade Commission (FTC), the Food and Drug Administration (FDA), the FBI, State Attorneys General, HMOs, Consumer Reports, medical journals and state medical, chiropractic and dental boards.

The insurance industry cites Barrett’s highly opinionated “Quackbuster” attacks to deny paying claims for chiropractic and other natural healthcare.

Barrett and the “Quackbusters,” a vigilante group of self proclaimed skeptics of any medical or health modality that avoids drugs, surgery or radiation, attack almost all non-conventional healthcare practices as quackery. Ignoring all scientific research to the contrary, they dismiss Gulf War Syndrome, Post Traumatic Stress Disorder, Chemical Sensitivity, Chronic Fatigue Syndrome, and dietary supplements as rubbish. Double Nobel Prize winner Linus Pauling is on their “quack” hit list along with many well known and respected doctors and scientists, including Deepak Chopra, Andrew Weil, and dozens of others.

Barrett claims to give over 500 interviews a year to newspapers, magazines, and television shows, including CNN and the Today Show. He claims to have been a peer reviewer for seven medical journals, including the Journal of the American Medical Association, even though he had no license to practice medicine when he did the reviewing.

The Quackbusters run over 70 websites. Millions of people go to them every year. Look up chiropractic, acupuncture, homeopathy or even vitamin C, as well as almost every other natural health topic, on the Internet and you (and the public) will be led to Quackbuster sites advising you of natural health “dangers.” In all these forums Barrett and the Quackbusters relentlessly attack the consumer right to informed choice. These activities continue the AMA’s anti-quackery committee’s activities that were struck down by federal courts as an illegal restraint of trade in a landmark lawsuit brought by Illinois chiropractor Chester Wilk. They also help insurance companies deny consumer reimbursement claims.

At the same time, Barrett flacks for products like aspartame (NutraSweet), which is the subject of tens of thousands of consumer complaints. Question (asked on Barrett’s web site): “An email message is being circulated with many statements to the effect that aspartame is dangerous. How worried should I be?” Answer (from Barrett): “Not at all. The message is pure rubbish.”

What Did Dr. Koren Do to Provoke Barrett’s Shakedown?

Dr. Tedd Koren is a well-known chiropractor, researcher, writer and lecturer. Barrett sued Dr. Koren in 2003 for calling him a Quackpot, saying he was in big trouble because of a racketeering law suit brought against him and attacking his lack of a medical license in his internet newsletter.

The trial judge and three appeals judges agreed unanimously that these statements were so far from defamation that no jury could be legally allowed to call them defamation. Dr. Koren also said Barrett was “delicensed.” One of the three appeals courts judges thought a jury might be able to find this to be defamation. However two appellate judges disagreed and jurors interviewed after the trial said they too saw through Barrett and felt that he was a litigious, ungrounded and biased denier of the truth.

In part jurors formed this view because Barrett testified with great self-satisfaction in the Koren case that he had sued many doctors-close to forty-in similar cases, demanding up to $100,000 if they wished to avoid a costly lawsuit. Some paid-how many is yet to be discovered. Drs. Koren and Rosenthal and a few others did not. Barrett has failed to win a single lawsuit in this shakedown scheme.

Dr. Koren’s Legal Team

Well known consumer advocate, James S. (Jim) Turner, general counsel to Koren Publications, who several years earlier had persuaded the FTC to drop an investigation against Dr. Koren (brought at a time when Barrett was a consultant to the FTC), organized and coordinated the legal team that represented Dr. Koren. Attorney Christopher Reid of Allentown, Pennsylvania acted as associate trial counsel and appellate counsel and California health freedom attorney Carlos Negrete acted as trial counsel.,

Mr. Negrete said, “Fortunately for all of his colleagues, Dr. Koren decided not to back down and took the case to trial. Barrett is part of a group of intolerant individuals. I am not certain who the supporters of the so-called Quackbusters are, but they seem to me to be just skinheads with stethoscopes.”

During heated and often dramatic courtroom proceedings, Mr. Negrete pointed out many of the questionable statements Barrett includes on his websites attacking chiropractic, as well as facts about Barrett’s own credentials that shocked even his supporters.

Mr. Turner says, “It is very important that a very responsible judge in Barrett’s hometown recognized that he was making false allegations and dismissed the case. Barrett has cost untoward numbers of consumers pain, anguish and probably serious harm by his misrepresentation of the facts about subjects ranging from acupuncture to zinc.”

Mr. Turner, who among other campaigns led the team that got acupuncture needles approved as safe by FDA, worked with a Senate committee to abolish the dysfunctional vaccine regulatory agency, worked with whistleblowers to stop the Swine Flu inoculation campaign, kept aspartame off the market for ten years, and played a key role in lobbying the Organic Food Production Act through Congress (all areas on which the Foundation for Health Choice focuses), says, “Our objective is to end Barrett’s abuse of consumers by eliminating the false and misleading information from his website and his entire network of websites and replacing it with sound, useful information for consumers.”

Says Dr. Koren, “This is just the beginning. Just as the FTC battle was not about Tedd Koren alone but had ramifications for the entire chiropractic and natural health professions so the Barrett v. Koren battle will have major ramifications for all. We’re going to give the Quackbusters a taste of their own medicine. They’ll learn how dangerous medicine can be.”

“Our mission is not just about revealing the Quackbusters to be the unscientific bigots that they are. We are fighting for health care freedom. One of our goals is to permit parents to make sound decisions about vaccination for their children. There are too many sound health reasons for certain children to avoid vaccination and the government has recognized too many vaccine caused deaths and maimings (over $1.5 billion of compensation has been paid to bereaved families by the federal vaccine injury compensation system since 1988) to allow a non-vaccinated child to be refused day care, school, college, or employment,” says Dr. Koren.

Mr. Turner is also lead counsel in a case brought against Barrett by Dr. Don Harrison, the chiropractor who founded and leads Chiropractic Biophysics.

North Carolina Medical Board forced to give up secret proceedings due to psychiatric drug death.

A group of men protecting their own through secret proceedings is forced to tell the truth. But for one widow, it is far too late.

My own reaction to this story is to describe the North Carolina Medical Board in the most vile and disturbing terms. This is probably not appropriate for civilized society. And is probably would be too much of an understatement anyhow.

As seen in the News Observer.

A week ago Monday, a state law was changed thanks to Maggy Lewis of Durham.

She has been choking back tears, however, not sipping champagne.

The law she helped rewrite opens up the complaint process at the N.C. Medical Board. But the handling of her own husband's death will remain under wraps.

It was about four years ago that Lewis' husband, Mark, grew depressed after being laid off from a job he truly loved.

He had survived other job losses over the years, the deaths of both his parents and the dissolution of his previous marriage.

But this layoff threw him for a loop.

He went to a psychiatrist for help.

The doctor prescribed an antidepressant. And then, another, and another, and another.

After about a year and a half, Lewis' husband was on seven drugs simultaneously, five of which increase the amount of serotonin in the brain.

He shook, sweated, grew confused and slept poorly. His mood became erratic.

Finally, Mark took his own life.

Maggy Lewis was crushed. She blamed her husband's psychiatrist for prescribing so many drugs and changing the doses abruptly.

Lewis briefly looked into suing but decided against it.

During the research, however, she had four medical experts review her husband's files. Each independently found that his prescribed medications had induced serotonin syndrome, a well-documented syndrome caused by an overload of drugs that increase serotonin.

Lewis filed a complaint with the state medical board.

She was curious to see what the doctor's response was. Turns out she will never know.

Lewis came up against the hard fact that North Carolina law allows the doctor's response to a complaint to remain secret. Ditto the board's response -- unless direct action such as suspension of a doctor's license is involved.

Incredulous, Lewis contacted her state representative, Paul Luebke, to see about getting the law changed.

The medical board's openness was already under review, and to the board's credit, it supported opening up the complaint process.

When the bill passed in August, it seemed like a true victory. Under the rewritten law, patients have the right to know how the board handled their complaints and how it reached its decisions. The complaining patient or loved one also can request and receive a copy of the doctor's official response.

It was a few weeks later in August that Lewis received a letter from the medical board noting that her complaint had been "handled appropriately." Had the doctor been chastised? Had the doctor told the whole truth to the board?

Lewis appealed to the board for more information.

"I appealed to their basic decency," she said.

The week before the rewritten law went into effect, however, she got a final answer from the board: "No."

"I have no way of knowing what the doctor said in response, what she said about my husband," Lewis said. "The board members sat in a room and discussed my husband for hours, and I have no way of knowing what was said."

So, no, Lewis isn't celebrating -- though, for her legislative "victory," all of us owe her a debt of thanks.

Pulling the Plug on Federal Funding for Psychiatric Hospitals

The Federal Government has decided to stop funding a psychiatric hospital after the facility failed to make safety improvements following an incident in August where a patient fell and ended up in intensive care. The development is the latest glitch for North Carolina’s battered mental health system. It sounds like a case of not throwing good money after bad, but, as seen in this report, there is concern about the lack of funding, which they say is needed for proper care of patients. Even though this was not happening before.

North Carolina taxpayers will fork over an extra $1 million next month to treat mental health patients because the federal government cut funding for one of the state’s four psychiatric hospitals.

And the price tag could soar higher if the state can’t convince the Centers for Medicare and Medicaid services to reverse its decision.

The government cut funding for Broughton Hospital because the facility failed to make safety improvements after a patient fell in August and ended up in intensive care, according to a federal report made public Friday. Another patient died at the hospital in February while in restraints, kicking off the recent federal inspection, according to state officials.

The development is the latest glitch in North Carolina’s battered mental health system. A reform plan started in 2003 to get people out of state-run hospitals and back into the community has resulted in a series of rate cuts that have meant less money for local providers.

This is first time one of North Carolina’s public psychiatric hospitals has lost federal funding.

“There is no question we were surprised,” said Jim Osberg, chief of state operating services for mental health.

[...]

Debatable decision

About 22 percent of the hospital’s 295 monthly patients are covered by federal dollars. Broughton, located in Morganton, is the only public psychiatric hospital for Western North Carolina.

Osberg said Broughton reviewed its procedures after the February fatality and made changes that were accepted by federal inspectors.

But when inspectors went back in August to check out the plan, they found another patient had been injured, according to the Friday statement from the Department of Health and Human Services.

That led them to recommend the funding cut, Osberg said.

[...]

What’s next?

The federal funding cut comes at a bad time for North Carolina as it works to fix its failed reform system.

In April the state threatened to slash the hourly amount it pays local providers by 40 percent but later backed off. The rate was cut from $61 an hour to $51. In July, the state made its third rate cut with a drop between 5 and 9 percent.

The cuts have the potential for sending more people to the state’s hospitals as providers scale back their services or get out of the business all together. WNC has already lost one provider – ARC N.C.

A special team will arrive on Tuesday at Broughton, which is the only public facility serving Western North Carolina.

It will include experts from other state institutions, including a psychiatrist and a nurse specialist with Medicare and Medicaid inspection experience. They will work with Broughton staff to fix problems.

After the state’s review and changes, federal government inspectors will be asked to re-inspect the hospital. If that inspection clears Broughton, the state could get its funding back.

The process will take at least 30 days and maybe longer, Osberg said.

State mental health Director Mike Moseley, in a written statement Friday morning, said his staff will work to make sure Brought doesn’t permanently lose its federal dollars. In the meantime, he said the public needs to know care will continue.

[...]

Deaths in professional wrestling can be traced to ‘wrestling cocktail'

Steroids, alcohol, and the psychiatric drug Xanax can be a very deadly combination. As reported in the Charleston Post and Courier Part of a series, more at the link

The news Monday that yet another professional wrestler had died at a relatively young age made headlines across the country.

But to Marc Mero, who has led an effort to clean up the business, it was just another name on a morbid list of wrestlers who have failed to reach the age of 50.

That's not to say Mero wasn't saddened to hear about the passing of Brian 'Crush' Adams, who was found dead at his home in Tampa, not that far from Orlando where Mero runs a high-end gym. Mero had talked to Adams a couple of weeks earlier, and the 6-6, 300-pounder sounded in good spirits, asking to come down and see Mero's facility.

The cause of the 44-year-old wrestler's death remains a mystery, and further tests have been ordered following an autopsy.

Mero hastened that it would be too early to speculate, but he couldn't help but wonder if his friend had fallen victim to a disturbing trend in the wrestling profession.

'Who knows how he died, but it seems to be the typical MO of ‘a wrestler found dead.' And he was one of the guys I was closer to, and it's just like, here we go again,' says Mero.

Adams had a history of steroids, having been arrested in 1995 on charges of illegal possession of steroids and weapons while living in Hawaii, which led to his WWE release.

Mero, like many, believe a number of elements — not just steroids — were involved in the Chris Benoit double murder-suicide in June. Steroids, painkillers, depression all likely played a part. But, he says, they're all by-products of a business that has a high mortality rate.

'Welcome to the world of professional wrestling,' says Mero. 'It's not one particular thing. It's the wrestling cocktail.'

Mero, who retired from the business several years ago, spoke with a forensic psychologist and his wife, a toxicologist, who told him alcohol, which was found near Benoit's body, and Xanax, which was found in his system, can be a very unpredictable combination.

'Some people can go sleep, and some people can absolutely freak out. They don't even remember what they did. And obviously mixing this with steroids and pain medication ... your body is only wired a certain way, and it can short-circuit.'

Mero still struggles trying to comprehend how Benoit, who he wrestled many times in WCW, could have killed his wife and 7-year-old son.

'It is one of the most baffling things. We all know he loved his son. What caused him to go over the edge and snap like that? One thing we don't talk a lot about is depression. There are many wrestlers who are depressed. I remember once thinking, ‘Oh, my gosh, I've got all this money in the bank, everywhere I go people are going to recognize me,' and you try to find happiness through other means. It's a very, very strange life. There are guys who can do it, and those who can't.'

The media, he says, put an emphasis on steroids because it seemed to be the most sensational hook to the story.

'They jumped on the steroid bandwagon since it was a double murder-suicide,' says Mero, who adds that WWE's explanation of what constitutes steroids makes little sense. 'The testosterone they're talking about ... we would have loved to have gotten our hands on that. Now when you get it from your doctor, it's not called steroids, it's called ‘hormone replacement.' I only wish there had been doctors back then, although there were doctors doing it illegally.'

'I don't see these problems that much in baseball or football with doctors prescribing because they don't get to pass go and collect $200 like they do in WWE,' he adds. 'So if we really tighten up the drug program and change the testosterone level from 10/1 to 4/1 like in the other sports and you get to retake it, and if you produce a prescription from your doctor, you pass it. That's something I think will take care of itself.'

Benoit's personal physician, Dr. Phil Astin, was charged with providing more than a million doses of prescription drugs and steroids — in just two years — to patients other than Benoit. A federal agent's affidavit said Astin prescribed a 10-month supply of anabolic steroids to Benoit every three to four weeks between May 2006 and May 2007.

'We really have to get down to these doctors because that's bad,' says Mero. 'Some of them are writing scripts over the Internet. They need to give them some strict penalties. I think because of Dr. Astin coming to light, a lot of doctors are getting real worried, and I guarantee you that a lot of pictures of professional wrestlers on the walls of doctors' offices throughout the country have been taken down.'

Officials to look into mental-health fraud

From the Winston Salem Journal of North Carolina

The state said yesterday that it will try to recoup payments from providers and examine possible fraud after a preliminary audit found misuse of a new service for mental-health and substance-abuse treatment paid for with Medicaid dollars.

The Department of Health and Human Services announced last month that it would audit private companies and nonprofit agencies that provide what's called "community support." The providers determine patients' needs and then give some basic aid such as helping clients work on social skills.

A review of the program led regulators to start visiting the 167 providers billing the highest amount of community-support services per person they served, the department said yesterday.

While the audits continue, "we now know that some providers aren't using the services as they were intended, or they aren't properly documenting their use," department secretary Carmen Hooker Odom said. "We need to act now to make sure that children and adults with mental illness and substance-abuse disorders get the services they need."

The department plans a three-tiered response to these providers that will include paying back claims that weren't documented fully or have 5 percent of Medicaid payments withheld until they demonstrate compliance.

Providers with a compliance score below 50 percent will have 25 percent of payments withheld and their actions referred to authorities for investigations into fraud and abuse.

The department is already working to recalculate the proper payment rate for the service, which federal Medicaid officials agreed to pay for last year.

Documents show violations Cape Fear Valley Medical Center

As seen in this report from the Fayetteville Observer

A 13-year-old girl with a history of depression and suicidal thoughts went to Cape Fear Valley Medical Center in January 2005 for treatment.

Within five minutes the emergency room psychiatrist — who had seen her before — called her a criminal and told her to leave and not return. But she did.

On the way back to her Fayetteville group home, and upset about the hospital visit, she suffered a skull fracture and internal injuries when she jumped from a car traveling 40 mph. This time she was treated in intensive care.

The incident was categorized by state investigators as one of the most severe violations that can occur in a hospital, and it became part of a series of violations that have made Cape Fear Valley perhaps the most heavily cited hospital in the state in the past three years.

The state conducts the investigations for compliance with federal Medicare and Medicaid standards.

Joyce Korzen, Cape Fear Valley’s chief operating officer, said violations found by the state always have been corrected, and the hospital has never lost eligibility to receive federal funding or been penalized with fines.

Cape Fear Valley, a private, nonprofit corporation, has previously disclosed that space and staff limitations in its emergency department have caused patients to wait several hours for treatment. But documents obtained from the N.C. Health and Human Services Division of Facility Services provide details on other major violations that have been previously unreported.

From January 2005 to June 2006, the state determined three instances when Cape Fear Valley was out of compliance with requirements to receive Medicare and Medicaid funding because of six major violations. Each time, the federal Centers for Medicare and Medicaid Services, known as CMS, issued Cape Fear Valley a termination date for losing funding.

Losing such funding would cost the hospital about two-thirds of its $1.2 billion annual operating budget. The 394-bed acute care facility is Fayetteville’s largest.

The psychiatrist who denied treatment to the 13-year-old girl resigned five weeks later, but state inspectors have found similar violations since then. Mistreatment of another suicidal adolescent was among more federal violations that were resolved just two months ago.

Many of the violations were found in the treatment of psychiatric patients whose emergency room visits have increased due to cuts in state mental health services that have affected many hospitals. But the number of violations at Cape Fear Valley, along with other violations that did not involve behavioral care, is believed to be among the highest in the state.

“I’m not aware of a system or hospital in the last three years that’s had that number,” said Cecilia Boone, a Facility Services hospital surveyor.

Boone leads the state’s investigations on complaints about federal emergency treatment standards. She was involved in all three of the recent inspections at Cape Fear Valley and said the hospital was cited with another major violation in 2004.

The state is not required to keep track of how often hospitals are cited, and CMS did not have immediate information to compare the number of Cape Fear Red Lake Indian Reservation Valley’s violations with other North Carolina hospitals.

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