Article Summary –
Montana State Hospital, an adult psychiatric facility, is dealing with severe operational issues and concerns for patient safety. The hospital lost its federal certification two years ago due to patient deaths, safety concerns, and removal of federal oversight, leading to the loss of millions in federal reimbursements. Despite attempts at reform by Gov. Greg Gianforte’s administration, including hiring consultants, establishing a governing board, and investing in facility repair, the staff continues to cite issues such as bad management, burnout, and fear of reprisal.
In late March, advanced practice registered nurses at Montana State Hospital received a glimmer of hope with the filing of a petition to create a union. However, the group’s profound workplace concerns overshadowed the celebrated news. According to emails obtained by Montana Free Press, their fears focus on a crisis of patient safety, shifting practices, disregard for the medical team, and more. These issues stem from the administration of Gov. Greg Gianforte, who is pushing for reforms at Montana’s only adult psychiatric facility, two years after it lost its certification from federal Centers for Medicare and Medicaid Services. (source)
The 260-bed facility in Warm Springs, which treats patients with serious mental illnesses, lost its certification due to patient deaths, falls, and safety concerns. This resulted in the loss of federal reimbursement for patient care, reputational damage, and recruitment difficulties for the hospital. (source)
To regain federal certification by January 2025, Gov. Gianforte and Charlie Brereton, the state health department director, have spearheaded reforms, including hiring consultants, forming a governing board, investing in repairs, and introducing hiring incentives. However, these strategies have caused alarm and frustration among the hospital staff who argue that the changes hinder their work and don’t improve patient safety or position the facility to regain certification.
COMINGS AND GOINGS
Staff turnover and leadership changes have created concerns. Dr. Thomas Gray, the hospital’s forensic psychiatrist and chief medical officer, was placed on administrative leave without any public reason, instilling fear among employees. The state health department has since confirmed that Gray is no longer an employee.
State health department’s Healthcare Facilities Division’s chief administrative officer, Jennifer Savage, took over the hospital’s leadership in January 2024, despite no clinical care background. Her inflexible approach to CMS certification and disregard for staff wellbeing has reportedly led to increased staff turnover.
‘A DECISION THAT WAS MADE IN HELENA’
Staff have raised concerns about new policies implemented by Savage and state consultants, such as discouraging 1:1 staffing and limiting medical staff’s access to security footage following patient incidents. Providers argue these regulations compromise patient care and impede their ability to efficiently perform their duties.
‘BURNED THEIR BRIDGES’
Despite these concerns, the state health department continues to stand by its reforms and changes. According to health department director Charlie Brereton, the administration’s decisions are aimed at stabilizing the hospital. However, recruitment and staff retention remain significant challenges. The stress of the work environment, coupled with the administration’s reportedly dismissive attitude towards staff concerns, has led many to fear that the ultimate goal may be to justify the closure or privatization of the hospital.
Unless the relationship between administrators and staff improves, many believe that achieving recertification from CMS is unlikely. As former staffing supervisor Liz Robinson stated, “They have such a bad reputation for how they treat their employees that no one wants to work for them.”
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