Colorado investigation of Mind Springs’ Grand Junction hospital wraps up, but some Medicaid payments still on hold

A state inspection of West Springs Hospital in Grand Junction this week found it had fixed concerns raised earlier this fall, but some Medicaid payments are still on hold.

A copy of the December report didn’t specify what problems inspectors had identified in October, but Mind Springs Health CEO John Sheehan said the biggest issues were that the psychiatric hospital had never opened its emergency room and that a building on the campus needed more security.

Mind Springs provides outpatient mental health and addiction treatment for most of western Colorado, in addition to operating West Springs Hospital.

The finding that all of the problems identified in October were fixed ends federal and state investigations, but it doesn’t automatically restart all Medicaid payments, Sheehan said.

Rocky Mountain Health Plan, a subsidiary of United Healthcare that administers Medicaid in western Colorado, gets to decide if it wants to resume paying for enrollees to receive care at West Springs. It halted payments for newly admitted patients in October, following a complaint by two former employees.

Mind Springs spent much of 2022 under various investigations. In January, three state agencies announced they were auditing it. The audit, released in May, didn’t find any evidence of fraud, but did note a lack of transparency and that the services provided didn’t always match communities’ needs.

A group of former employees also alleged fraud this year, saying they’d been asked to fill out documentation as if they’d seen patients they hadn’t. The state agencies that oversee mental health centers haven’t said if they believe those allegations are true.

The October inspectors noted that West Springs was supposed to open a psychiatric emergency room when it opened four years ago, but for whatever reason, it didn’t, said Sheehan, who joined Mind Springs in August. Now, it has eight beds available to securely assess if people in crisis need to be admitted to a psychiatric hospital, though it won’t start taking transfers from police until January or February. They’re still making sure the processes are ready to safely transition people out of police custody, he said.

Unlike other mental health settings, a psychiatric emergency room can confirm that a patient is medically stable and whether their condition needs hospital-level care, Sheehan said. It also should get patients the right care faster than if they had to wait in a general emergency room, he said.

“I think this is going to transform care in the community,” he said.

The other major concern revolved around an auxiliary building, which apparently somehow wasn’t properly licensed four years ago, Sheehan said. There was an incident where a patient ran away while being transferred between buildings, so they’ve enclosed the walkway to prevent that and are making some other changes before asking the state to inspect and approve that building, he said.

Sixteen of West Springs’ 64 beds are in the auxiliary building that’s temporarily closed, but that hasn’t been a problem, since the hospital typically treats about 30 people a day, Sheehan said. Right now, it only makes 35 beds available, with a plan to gradually bring more online as leadership becomes confident that they can take more patients while maintaining quality improvements, he said.

Now that the investigations are over, Mind Springs can pivot to other priorities, like speeding up access to outpatient therapy and continuing the process of analyzing where hospital care could improve, Sheehan said.

“We’re still a work in progress,” he said.

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