Since 2003, Vermont State Hospital (VSH) has lost, regained and once again lost its certification. In March, the Centers for Medicare and Medicaid Services (CMS) denied VSH’s bid for recertification yet again because of patient care issues and safety concerns about the aging facility’s physical environment.
State Rep. Anne Donahue (R-Washington-2) says, “First, an interesting aspect is that CMS has become more clear in the past year that they are not considering recertification; they are treating [the hospital] as though it is a new entity seeking certification. This is important because it creates a different standard than simply remedying the past problems or ‘coming into compliance.’ I think that with each round of the roller-coaster that VSH has been on, it becomes clearer that CMS does not intend to certify an old, out-of-date facility that does not have the proper space to run a quality, modern psychiatric hospital.”
Donahue, however, remains hopeful that the hospital can regain its certification. “The state has apparently been told that it can seek certification yet again, if it gets a consultant recommended by CMS to work with it,” she says. “I hope that this will add new impetus to the stagnant efforts to develop a viable plan by the state – and the money to do it – to replace the services currently provided at VSH.”
Michael Hartman, Department of Mental Health (DMH) commissioner, explains that CMS’s decision does not affect the state’s plan to replace the hospital, some sections of which are 100 years old. His department has issued a proposal that emphasizes the need for new construction and the importance of establishing funding source for the project.
However, building a new facility will take time, Hartman adds. “The soonest is likely to be a minimum of two to three years of having to go through the planning, construction and design documents and the legislative process,” he says. “It’s hard to move forward without funding being clearly defined.”
In the meantime, the state will reapply for certification after consultants help develop a consistent quality assurance program that demonstrates the hospital’s ability to operate “one hundred percent without any flaws,” Hartman says. “In the end we’re clear it’s an uphill battle. No one goes from being decertified for such a long time to being certified. CMS is holding us to a higher standard than for a normal hospital.”
By Phyllis Hanlon