CMS monitors Baylor's efforts to curb high rate of 'eloped' psychiatric patients

(Story updated at 1:p.m. ET, Friday, Oct. 17, 2014.)

Baylor University Medical Center in Dallas has until the end of October to demonstrate to the CMS that it has addressed lapses that have allowed significant numbers of untreated psychiatric patients to walk out of its emergency department without staff realizing they had left. The CMS accepted the hospital's corrective plan last week, and the federal agency will determine whether its “immediate jeopardy” judgment will be removed following an unplanned follow-up inspection by Oct. 30.

The medical center's CEO, John McWhorter, received a letter from federal health officials on Oct. 7, saying the facility no longer met Medicare participation requirements because of deficiencies representing “immediate jeopardy to patient health and safety.” A representative from the 876-bed, not-for-profit facility declined to comment, but McWhorter admitted to local media that the hospital “didn't do a very good job of keeping [patients] from leaving.”

The Dallas hospital was given until Oct. 13 to outline a plan of corrective actions, which federal investigators accepted Tuesday.

A representative from the 876-bed not-for-profit facility declined to comment. The plan submitted to the CMS includes a “comprehensive evaluation” of policies, and reeducation and training of staff. The hospital is revising its “safe environment checklist,” which includes requirements for continued and direct observation of moderate and high-risk patients until they are released or transferred to another facility. It also included limiting the number of visitors allowed in the room with the patient. In one case, a patient followed visitors out of the room.

According to the hospital inspection report, of 361 patients admitted to the hospital's emergency department on Sep. 8, 31 patients were classified as “eloped,” meaning they had left the hospital without the knowledge of staff and before their treatment was completed. The report details how a few psychiatric patients had arrived at the hospital—some with suicidal or homicidal thoughts and one who ingested a combination of Windex and over-the-counter pain medications. Each walked out of the hospital without staff noticing.

The rate of patients leaving the hospital's emergency department with incomplete evaluation or treatment was more than twice the rate set by national benchmarks and three times higher than the hospital's own goal, inspectors noted.

The surveyors will pay another unplanned visit to the facility before the end of the month to ensure the immediate jeopardy has been removed, the agency said. According to a CMS spokesman in Dallas, the agency has issued 13 immediate-jeopardy determinations to hospitals in the state in fiscal 2014.

Follow Sabriya Rice on Twitter: @Sabriyarice