AILSA CHANG, HOST:
The state psychiatric hospital in Montana is in crisis. Since last fall, four patients have died for reasons that could have been prevented. And this week, the federal government said conditions at the state hospital are so bad, it will no longer pay for care there. That has advocates worried that things will only get worse. Montana Public Radio's Aaron Bolton reports.
AARON BOLTON, BYLINE: Federal inspectors visited the Montana State Hospital in the small town of Warm Springs in February, following complaints. They found that since October, four patients had died from preventable COVID infections and serious falls. Marla Lemons worked as a clinical psychologist at the state hospital for 20 years. She says she and other staff tried to tell hospital administrators and state health officials that chronic staffing shortages were making the hospital unsafe for staff and patients. But she says no one listened.
MARLA LEMONS: That's why I left. And that's why many, many people are now leaving again. There's another mass exodus right now.
BOLTON: The inspectors warned the state that the hospital could lose federal funding if it didn't fix patient safety problems. But during three follow-up inspections, they only found more problems. This week, the Federal Centers for Medicare and Medicaid Services, or CMS, said it would no longer pay for care at the hospital because of the unsafe conditions. That's a big deal because CMS funding is often a significant portion of hospital budgets. Ben Miller is the president of Well Being Trust, a foundation that focuses on mental health care.
BEN MILLER: From what I can see, CMS doesn't do what they did in Montana that often.
BOLTON: Miller says CMS sometimes will work with hospitals for years before pulling funding. He says the fact that the agency did that in just two months here shows how bad things are. Republican Governor Greg Gianforte's administration says the unsafe conditions are due to staffing shortages that have been a problem for years and that it will take time to resolve. Ben Miller says losing the federal funding will make solving longstanding problems more difficult.
MILLER: This is the harsh reality of what happens when we don't do a good job addressing issues of mental health and addiction, that people do find themselves back into jails or prisons and/or they find themselves on the street.
BOLTON: The Centers for Medicare and Medicaid Services says it considered offering Montana a plan to continue receiving federal funding. But that's now off the table. State health officials say they never saw a proposed agreement and that losing federal funding won't disrupt day-to-day care at the state hospital. They've now hired a consulting firm to help improve safety issues.
BERNADETTE FRANKS-ONGOY: I'm not sure how that's practical under the present conditions.
BOLTON: Bernadette Franks-Ongoy is the head of Disability Rights Montana, the state's federally designated patient advocacy group. Both patients and families tell her they're worried the hospital could shut down. She says state health officials aren't answering many questions about how they'll maintain care for patients.
FRANKS-ONGOY: They are representing that this is going to be business as usual and that day-to-day care is going to be fine.
BOLTON: The state says it's evaluating whether some state hospital patients can be moved to other facilities. But Franks-Ongoy says people wind up at the state hospital because there is no other place to go. For NPR News, I'm Aaron Bolton in Columbia Falls, Mont. Transcript provided by NPR, Copyright NPR.