By Person272367 (Own work) [CC BY-SA 4.0], via Wikimedia Commons
May 12, 2016; Boston Globe

Morton Hospital in Taunton, Massachusetts, found itself under fire last week after a man who was released from the facility subsequently injured five and killed two people the same afternoon. Arthur DaRosa, who was eventually killed by police, was brought by ambulance to Morton Hospital in the evening on Monday, May 9th, and was discharged around 4:00 am the following day after being treated for “anxiety.” Relatives reported that he said that the devil was playing tricks on him and trying to poison his children. He had also, they said, threatened suicide.

A day later, the hospital announced it had cut its contract with Taunton/Attleboro Emergency Services (TAES) which, by requirement of the state, performed evaluations on Medicaid patients who came to the emergency room with mental health complaints. When publicly cutting that tie, the hospital did not directly reference DaRosa; instead, they blamed TAES for not promptly attending to patients who had been waiting for hours in the emergency room even a day after the incident.

The hospital is, of course, not allowed to discuss confidential patient information and so can say nothing about DaRosa’s case, but it has said about the incident in a statement, “If the state-contracted agency responsible for conducting evaluations in the Emergency Department had requested an admission to a psychiatric bed, there were beds available within the hospital’s network.”

In Massachusetts, the state controls the protocols for low-income Medicaid patients and requires that an independent body okay any admissions. In contrast, privately insured patients who go to emergency rooms with mental health concerns receive evaluations from the hospital’s staff doctors and nurses.

Morton says it will use in-house staff to evaluate Medicaid patients with mental health issues, although it is unclear what that means about state reimbursement for services. “As we have said in the past, the current policy mandating that the evaluation process must be carried out by a third-party state contractor is misguided,” reads a Morton Hospital statement released on Wednesday, May 11th:

For several years, we have asked that our hospital and others be allowed to direct these assessments independently through qualified psychiatrists, clinicians, and other medical personnel who have been subject to the hospital credentialing process, peer review process, and the policies that guide the care of every other patient—and not through an outside state contracted vendor who we do not choose.

Massachusetts Governor Charlie Baker gave a response at a press conference:

No one can be released from a hospital without a certification that’s jointly signed by the provider organization and by the emergency services program, which means somebody at Morton Hospital also signed the same document that the emergency services people signed. But, obviously, looking into that is part of the investigation.

—Ruth McCambridge

Correction: This article has been altered from its original form. Morton Hospital is owned and operated by Steward Health Care System, which is a for-profit organization. NPQ regrets the error.