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Shelton hospital frustrated after state leaves client for more than 2 weeks

A guard sits outside of patient's room 24/7 after state drops off client (PHOTO: KOMO News)

On Dec. 12, a man was brought to Mason General Hospital by a group home provider to be medically cleared before being placed in a long-term residential facility.

The hospital staff determined the man suffered from behavioral problems and was medically cleared to be re-released into state custody, according to hospital staff.

As of Dec. 28, that man is still at the hospital.

The man recently aged out of the foster care system and is a client of the Department of Human Services (DSHS) and the Developmental Disabilities Administration (DDA).

Frustrated with the situation, Doctor John Short, an emergency medicine physician at Mason General, took to the internet with a blog, Stuck in the Hospital. He wrote about this man, giving him the pseudonym "Mason."

"The original housing facility wouldn't take him because of these behaviors and they felt like they couldn't handle him, and here we sit, 16 days later with Mason still in our hospital," Short said. "DDA and the DSHS are shirking their responsibilities in regard to Mason — it’s clearly their responsibility and so clearly not our responsibility."

"This is a big deal in small hospitals like ours," said Doctor Dean Gushee, the hospital's chief medical officer.

Mason General is a critical access hospital, meaning they have 25 beds for inpatients and they cannot legally go above the 25 inpatient limit — an inpatient typically meaning someone needing care longer than 24 hours.

With Mason taking up one of the beds, one less bed is available for those who medically need it. Gushee said with flu season, one bed means a lot.

A DSHS representative said they couldn't comment on the situation specifically. But the representative said, "sometimes some of our 35,000-plus clients do go to hospitals."

"The vast majority of clients have successful placements," the DSHS representative said. "Because of a lack of resources in Washington state, some of our hardest-to-serve clients take longer to find suitable placements that can meet their very specific needs. In the governor’s most recent budget proposal, he included a wage increase for our service providers and additional funding for more residential placements, housing and respite care."

With Mason's behavioral problems, the hospital has had to go to extreme measures to care for him. Short said hospital staff has needed to restrain him at some points. Gushee and Short both mentioned 24-hour security outside his door — something the hospital has to arrange and pay for.

Gushee said hospital staff has been injured while caring for Mason.

"We've had several injuries including a nurse who was bitten last night," he said. "We've had guards punched, other people punched it, bitten. He's difficult, we understand that, it's not his fault. Unfortunately, he's in an environment where our staff is not trained for that kind of patient."

Mason has also caused damage to the hospital and equipment. Gushee said he destroyed a sink faucet in his room and damaged two gurneys.

Both Gushee and Short believe the hospital won't be reimbursed for the care Mason has received or the damage he has caused, so Mason County tax payers will end paying for Mason's unnecessary stay. Short guessed the cost somewhere between $50,000-$70,000 on Thursday.

Despite the hard work, Gushee said the hospital staff has been resilient. Nurses and staff have provided Mason with toys; even using their own money to purchase gifts for him for Christmas. The IT department gave Mason a laptop to use.

Gushee said what has put him off the most is DSHS's "callous disregard for the position they have put their client in."

He said as an acute care clinic, the hospital has daily meetings for all patients about patient care and care plans. When Mason was first brought to the hospital, the hospital would have a phone call once a day with representatives for Mason's case. He said those representatives abruptly stopped those phone calls.

"I really expected more," Gushee said. "After they said we are no longer going to have calls and discussion about this, it left us with very few options except to reach out."

Gushee said this isn't the only case like this, and it's a part of a larger issue.

The Office of Developmental Disabilities Ombuds, who monitor and investigate procedures and services provided to those with developmental disabilities, recently put out a report about this situation being common in Washington. The report says the ombuds starting receiving complaints in spring 2018 about adults with developmental disabilities stuck in hospitals without medical need.

"Hospitals could not discharge individuals until another placement became available, leaving individuals in hospitals for weeks or months," the report says.

The report also stated the DDA struggled to find appropriate crisis placement for clients.

"Hospital staff are not trained to provide support to people with developmental disabilities and hospitals are often stressful living environments," the report states.

Short said hospitals aren't equipped for housing people, and "jail isn't the right place either."

Gushee compared Mason's stay similar to being jailed.

"We can't provide the best quality care," Gushee said. "We are providing what amounts to jail."

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