Patients continue to linger in state psychiatric hospital without treatment plans, inspection shows

In June, state health inspectors visited William R. Sharpe, Jr. Hospital in Weston, a 200-bed psychiatric facility that has dealt with years of scrutiny for its overcrowding, alleged patient abuse and failure to help patients who don’t need to be there move on from the facility.

Their inspection showed the facility, which is operated by the state health department, continued to house patients without adequate treatment plans.

Sharpe patients are regularly in the hospital without active treatment and sufficient plans for discharge, according to a patient advocate, who referred to it as “warehousing patients.”

“The most egregious issue is the failure to provide the treatment they’re required by Centers for Medicare & Medicaid Services to provide,” said Mike Folio, legal director for Disability Rights West Virginia. “Some patient lengths of stay are well over 1,000 days.”

“They end up being housed there with no or little prospect of being discharged. Patients are developing behaviors because of their stay,” he added.

Sharpe, which serves both voluntary patients with disabilities and those who have been found unfit for a trial, was never meant to house people long term.

“… It was determined the facility failed to ensure that patients’ treatment plans are comprehensive treatment documents … This deficient practice affected 22 of 22 active patient records reviewed and has the potential to affect all patients within the facility,” state Office of Health Facility Licensure and Certification inspectors wrote. 

Leaders with the West Virginia Department of Health and Human Resources have said they don’t have enough community placements for people in need.

DHHR did not provide an interview for this story but responded in an email. Agency spokesperson Jessica Holstein said they continue to focus on providing quality care to patients through a number of initiatives, including a psychologist who is trying to improve discharge planning and community placements for patients with disabilities housed in state-run facilities.

A few months after the inspection, a Sharpe employee underwent surgery after being assaulted by a patient.

The employee was conducting a hall check, when a patient caused several fractures to the employee’s head, according to the criminal complaint on Aug 13.

These issues and others at Sharpe are nothing new for lawmakers. They’ve heard about the problems there for years and said they’d improve the facility for patients. Folio said there’s been little movement to address the problems, which has resulted in patients stuck in the troubled facility. But now, lawmakers are taking a closer look at Sharpe and hope that changes at DHHR and future legislation could improve the hospital’s long-standing problems.

A group of lawmakers along with DHHR leadership toured Sharpe in August to see the facility first-hand.

For Folio, the action is too little, too late.

In October 2022, Senate leaders asked Gov. Jim Justice for an independent investigation into DHHR’s treatment of people with disabilities and efforts to cover up problems. Nothing came of it. Then, in December, Folio brought concerns to lawmakers about patient treatment at Sharpe along with more allegations of DHHR concealing information.

“Legislators promised accountability, they promised reform, they promised better services and protection, and none of that has come to fruition,” he said.

Lawmakers tour Sharpe hospital

Delegates Amy Summers and Heather Tully, two nurses who together lead the House Committee on Health and Human Resources, were among lawmakers who toured Sharpe on Aug. 25 alongside DHHR leadership.

“As health vice-chairs, we knew we needed to put our eyes there,” said Summers, R-Taylor. “It was really good and very beneficial.”

The day included a presentation by Sharpe CEO Pat Ryan and a tour of the hospital.

Summers said, “Going in, I thought, ‘This is going to be really bad.’ There’s been just a lot of complaints from staff, from vendors not getting paid and from DRWV. Even though the complaints are all valid … I was pleasantly surprised at the energy I felt there.”

DRWV is federally-mandated to monitor the treatment of individuals with disabilities in state care. Folio said the tour was not a reality of everyday operations at the hospital.

“My hope is that legislators weren’t duped by what was an illusion of active treatment when we know there’s no active treatment,” he said.

As a result of the June inspection deficiencies, Holstein said, Sharpe conducted audits of 100% of the treatment plans, made corrections and revised applicable policies in order to be compliant.  “Sharpe had never been cited for this before,” she said.

Summers said she felt like Sharpe was trying to do better and that it had improved its rate of getting forensic patients competent enough to stand trial.

She is optimistic about the new leadership of Secretary of the West Virginia Department of Health Facilities Michael Caruso, who is holding a position created earlier this year by the lawmaker-mandated reorganization of DHHR.

“I think Mr. Folio has concerns that are true, and Sharpe will acknowledge where they’re failing and try to do better. I honestly think the new secretary is going to be a fresh set of eyes,” Summers said.

Lawmakers passed legislation to split the behemoth health department into three departments in an effort to improve outcomes after DHHR faced scrutiny for its $7.5 billion budget alongside poor outcomes in health and for vulnerable populations in its care.

Folio, who previously worked for DHHR, brought ongoing issues at Sharpe to former DHHR Secretary Bill Crouch, who retired at the end of 2022 after coming under fire for issues with the intellectually and developmentally disabled (IDD) community, alleged abuse and neglect issues at the state’s psychiatric hospitals and pervasive child welfare problems.

Folio said he now meets weekly with DHHR employees to discuss the treatment of patients with disabilities. Multiple offers to meet with Caruso have been ignored, though, he said.

Patient overcrowding outlined in inspection

Summers and Del. Adam Burkhammer, R-Lewis, who attended the tour, noted that the Sharpe visit, while overwhelmingly positive, was a reminder of issues that need to be addressed through legislation.

“At the conclusion of the discussion, legislators pledged to work cooperatively with [the Office of Health Facilities] to address its needs in the upcoming legislative session,” Holstein said in an email.

Legislation could include allocating funding to replace an outdated electronic health system and address overcrowding through a new hospital wing with one-person rooms, Summers explained.

The June inspection report showed that while the hospital was supposed to have two patients in each room, the facility’s “bed crisis” led investigators to find a dozen rooms holding three patients. In another part of the facility, a windowless visitation room was being used as a bedroom for a patient.

“We are paying attention, and we are concerned,” Summers said.

She added that the Legislature must address the “high number of injuries” occuring on-site.

“70% of those [injuries] are patient on patient,” she said. “It’s concerning.”

Burkhammer represents the area where Sharpe is located. He said he has received numerous calls in the last few years about safety and injuries at the psychiatric hospital.

“I want to make sure we’re doing everything in our power possible as the state Legislature [to make sure] that our state employees are safe on the job,” he said.

Sharpe has implemented an electronic incident reporting and employee complaint system resulting in “more efficient and thorough accounting and response to incidents and complaints,” according to Holstein with DHHR.

Long-standing staffing shortages continue, as well — now amid a national health care worker shortage. Nearly a decade ago, a Kanawha County judge intervened to force DHHR to deal with employee shortage at Sharpe.

“DHHR’s Office of Health Facilities has been working diligently to improve the salaries of employees at Sharpe, specifically direct patient care staff,” Holstein said, adding that they’ve implanted hiring rates, sign-on niceties and more.

Burkhammer said contract health care employees, who are filling in the gaps, are currently being paid more than hospital personnel — some who have worked there for years. It’s causing division among staff and budgeting issues, he said.

“I think we really have to focus on salaries,” he said. “I think we have dropped the ball on that for years. And, with the current cost of living and inflation, the fact that employees at Sharpe are eligible for state assistance … I think that’s unacceptable.”

DHHR announced Sept. 6 it was looking to hire a financial advisory firm to review its long-term care facilities and psychiatric facilities, including Sharpe, to identify needed improvements.

“We are very proud of the quality of services we provide, and this [request for proposal] supports our efforts to continue to improve outcomes, enhance services and evaluate opportunities for the patients and residents at these facilities,” Caruso said in a news release.

DHHR is currently under a federal investigation for its treatment of people with disabilities.

Folio said he continues to make reports to OHFLAC, the state group that inspects the facilities, about deficiencies at Sharpe, some of which he said violated state code.

“We are giving the Legislature and DHHR this next session, then we’re filing suit,” Folio said. “We’re willing to work with them and help them, but all they want to do is talk and camouflage the reality of what’s occurring.”