Before Parkland placed a patient named Todd Arko in what the feds described as "immediate jeopardy," nearly costing the hospital its Medicaid funding, there was another, lesser-known hospital that the feds say also placed a patient in immediate jeopardy.
Green Oaks is a private psychiatric hospital that in February 2013 was contracted out by Parkland to "revamp" the county hospital's psychiatric services after federal regulators and The Dallas Morning News uncovered a bunch of horrendous things in Parkland's psych ward. The two hospitals ended the deal in July 2014, but Green Oaks, though private, still receives some Medicaid funding of its own.
Like Parkland, Green Oaks recently received a letter from the Centers for Medicare and Medicaid Services stating that it could lose its public money after providing poor care to a patient.
We just got a copy of the CMS report detailing how Green Oaks failed the patient. Though the report doesn't identify the patient's name, the story matches Arko's experience at Green Oaks that I reported on two weeks ago.
The patient was brought to an emergency room on June 27 with an extension cord wrapped around his neck, according to doctors' notes described in the CMS report. The cord had broken in a suicide attempt. Bones in the patient's feet, spine and wrist were fractured, and he tested positive for Tylenol and cocaine. The emergency room discharged the patient to Green Oaks for psychiatric evaluation on July 3, with instructions that he keep weight off his extremities and then eventually go to a rehab facility.
On July 17, the patient was still in a wheelchair when Green Oaks discharged him to a boarding home. (Arko said he was renting a room in Plano but lost it after the suicide attempt). A driver for the patient found a boarding house that would accept him on an emergency basis for the night. But the boarding house was not wheelchair accessible, the CMS report says. The patient's driver, who Arko and his sister said was an employee of the Metrocare mental health program, told the CMS inspectors that Green Oaks "did not communicate patient #1's medical status and/or needs."
Th CMS concludes in its report that Green Oaks had sent the patient to a boarding home "where his medical needs and NWB [non-weight bearing] status could not be ensured, supported or maintained."
Like Parkland, Green Oaks already seems to be in the clear. Included in the CMS report is Green Oak's corrective plan-of-action, which the hospital promises involves a massive retraining of its nursing staff. The CMS says it has already approved the plan.
Arko's fate is still uncertain. As he was getting kicked out of Green Oaks, his family tried to get him admitted to physical rehab facility at Baylor instead of the boarding home, but Baylor refused to take him. So the Metrocare driver later took Arko to Parkland, where his family tried to arrange for Arko to have surgery. Parkland opted to discharge Arko to a homeless shelter the next day instead, sparking the CMS investigation. Arko is now in jail for violating his probation on a drug possession conviction.
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Here's the CMS report on Green Oaks:
Send your story tips to the author, Amy Silverstein.