Contractor report outlines successes and continuing challenges at Montana State Hospital
Alvarez and Marsal inked a $2.2 million contract with the state in earlier this year
Montana State Hospital. Credit Keith Schubert
The executive director of Disability Rights Montana, a nonprofit advocacy group in the state, said she is pleasantly surprised by the work being done by a private consulting group hired to investigate Montana’s psychiatric hospital.
Alvarez and Marsal, a New York-based consulting firm, inked a $2.2 million contract with the state earlier this year to investigate all health care facilities run by the Department of Public Health and Human Services. On Wednesday, its first status report was made public.
“We were not particular fans of the state spending this $2.2 million on the contract,” said Bernie Franks-Ongoy, executive director of Disability Rights Montana. “That being said, I think we are being happily surprised with the professionalism this group is bringing and the questions they’re asking and the analysis they’re doing.”
Of the seven facilities graded by Alvarez and Marsal in the recent report, three were reported to have “significant deficiencies,” including the Montana State Hospital, and “challenges existed” at the other four, but overall the seven hospitals received a “significant deficiencies” designation.
The report showed the Montana State Hospital was $7,743,087 over budget for the current fiscal year, up from $7.4 million in March. In April, the hospital lost more than $8 million in federal funding after a Centers for Medicare and Medicaid investigation into the facility found it failed to prevent patient falls and did not have an adequate COVID-19 infection plan in place — contributing to the deaths of four patients in five months. The report also highlighted the staffing shortages at the hospital, putting the vacancy rate at 45%.
“Current operational challenges” and “wins” at the state hospital were also outlined in the report.
“Current operational challenges” were listed as limited access to training compliance, working to determine required trainings, limited use of existing data for quality improvement initiatives, the need to collect additional information and improve reporting capabilities, high vacancy rates and over-reliance on contracted staff.
Franks-Ongoy said these challenges are not news, as DPHHS has spent months addressing dangerous working conditions at the hospital, dramatic staffing shortages, and an over-reliance on traveling staff — by December of 2021, contracted nurse assistants were billed for 16,000 hours in that month compared to just 2,000 in January 2021, a 700 percent increase, according to DPHHS data.
“Wins” at the hospital included:
- Improvements in cleanliness and active treatment observed during this monthly period.
- Investment in quality resources and improvement in electronic access to restraint data.
- Increase in staff applications and hires when compared to previous month.
- Work underway to re-open campus, including the Therapeutic Learning Center.
And employees have said morale is significantly up under the reigns of acting administrator Carter Anderson.
While things look like they are improving, Franks-Ongoy still had reservations.
“The real thing is going to be whether all of it gets implemented and whether or not there’s money to do all the things that need to be done to bring all of these facilities into acceptable performance,” she said.
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