Southern Nevada mental health services files plan to prevent patient dumping

Southern Nevada Adult Mental Health Services filed a corrective action plan Thursday to prevent future cases of patient dumping, two months after putting a mentally ill homeless man on a bus to Sacramento, Calif., although he knew no one in the city and had no one designated to help him.

The plan came in response to an investigation by the Nevada Bureau of Health Care Quality and Compliance, which determined after reviewing 30 cases that the state psychiatric hospital in Las Vegas unsafely discharged James F. Brown in February and two other patients.

Nevada officials, including Mike Willden, the director of the Nevada Health and Human Services, have publicly acknowledged that state policies weren’t followed in Brown’s case, saying, “We blew it.”

The state policy requires patients to be discharged with adequate medication and a plan for outpatient care, whether in Nevada or in another state if they request transfer to their home town, family or friends.

In Brown’s case, the 48-year-old was given a three-day supply of medication for schizophrenia, anxiety and depression, some Ensure and a Greyhound bus ticket from Las Vegas to Sacramento with no written plan for help on the other end. The hospital put him in a taxi to the bus station for his 15-hour, solo journey.

California officials complained Brown was dumped on the state after the homeless man turned up at a shelter, asking for help, and then disappeared. The Sacramento Bee wrote about Brown and published a follow-up story last week, after tracking him down at the Home Sweet Home boarding house in Sacramento.

Brown, who had lived in South Carolina, is being reunited with his daughter, who still lives in the South.

“I’ve been bounced around quite a bit along the way,” Brown told the newspaper, saying a Las Vegas hospital worker suggested he might like California. “That’s what happens when you are mentally ill.”

In reaction to Brown’s case, the Rawson Neal Psychiatric Hospital, where he was discharged, implemented new policies, according to the corrective action plan dated March 20 and released Thursday.

A second doctor now must review all out-of-state transfers before such patients can be discharged, and the hospital administrator must approve as well.

The hospital also plans to randomly review 10 percent of all in-state discharges to ensure quality of care.

The medical director and associate medical director of the hospital also must review and update all discharge and medication consent policies and procedures, according to the action plan, which gave an April 17 deadline.

“This review will include processes related to the psychosocial and medical needs of patients to ensure all necessary follow up and after care activities are addressed and documented appropriately,” the plan said.

The plan also calls for all medical staff and social workers at Rawson Neal to be educated on the updated policies by April 25 and to sign a form saying they understand them. The policies also will be posted and included in orientation material for newly hired medical staff, the plan said.

The hospital will put together a new uniform discharge document to be filled out “to provide sufficient information relating to the quality of care for any necessary hand off communication.”

In Brown’s case, his discharge papers from the Southern Nevada Adult Mental Health Services simply said, “Discharge to Greyhound bus station by taxi, with 3 day supply of medication.”

Contact Laura Myers at lmyers@reviewjournal.com or 702-387-2919. Follow @lmyerslvrj on Twitter.