Busing Analysis

Editorial: Nevada hospital reviews look like a whitewash

Nevada Gov. Brian Sandoval, U.S. Health and Human Services Secretary Kathleen Sebelius and the agencies that should be overseeing mental health care are whitewashing Nevada's practice of busing its mentally ill patients to all corners of the continental United States. It's easier that way.

Sandoval hired experts to conduct what he claimed was an independent investigation of Rawson-Neal Psychiatric Hospital and use of Greyhound buses to transport patients to other states. Not surprisingly, the consultants last month praised the care provided by Rawson-Neal and said busing patients to their home states "is a kindness to them and to their families."

On Sunday, The Bee's Cynthia Hubert and Phillip Reese documented the travails of eight Rawson-Neal patients who had been bused to locations as far away as Maine. Their findings were not kind.

The Bee cannot look at all 1,500 patients who were bused out of Nevada. Federal law shields patients' privacy. But because of their dogged reporting, Hubert and Reese were able to provide a glimpse into the hard reality of Nevada's "Greyhound therapy."

They found the staff failed to adhere to the hospital's stated discharge policies. Seven of the eight had no one waiting for them at the depot when they arrived. None of the patients had treatment plans covering their discharge. Two were bused to cities where they had no ties.

One patient, Nicholas Caroleo, never made it to his destination. His whereabouts are unknown. But upon learning that Nevada bought him a bus ticket in February, his parents got a restraining order barring him from contacting them.

"Nicholas has threatened to kill myself, my husband, himself and my grandchildren," his mother, Pat Caroleo, told the court in Maryland, where she lives. Asked whether he had access to a firearm, she answered, "I have no idea."

Earlier this month, the Joint Commission, an independent accrediting agency, concluded that Rawson-Neal Psychiatric Hospital would retain its accreditation. Last month, the U.S. Centers for Medicare and Medicaid Services approved Nevada's plan to bring the hospital into compliance with federal standards.

Too many of us would prefer that severely mentally ill people simply go away. Treatment is hard for the sickest individuals. So we conclude they have the right to be ill, and avert our eyes rather than see them forage through dumpsters.

Nevada's use of Greyhound therapy was one step on that path of studied indifference. The federal agency that is supposed to oversee the use of federal money for the treatment of mentally ill people took more steps.

Sunday's report ought to make it slightly less comfortable for Sandoval, Sebelius and the others to gloss over Nevada's reckless policy.

The feds and state should review the fate of all 1,500 patients. Based on the reaction so far, we hold out little hope that will take place.