Florida Probes Tenet Hospital

Booming Business

Hints about the Florida probe first surfaced late last month.

On Jan. 26, the Miami Herald reported that state officials had begun examining allegations that Florida Medical Center had "routinely violated the rights of psychiatric patients -- some of them frail elderly people -- by holding them against their will." The newspaper went on to say that critics had even accused the psychiatric unit of admitting one elderly patient directly from hospice care.

In its letter this week, the Department of Children and Families expressed particular concern about the unit's elderly patients. It noted that the unit's admissions among that age group were roughly twice the state average. And it cited numbers showing that most admissions throughout the unit were conducted on an involuntary basis.

Moreover, the agency raised questions about the involuntary admission of patients who were simply "confused," "paranoid" or "agitated."

Since then, Skolnick has identified the unit as a clear moneymaker. Based on information from the Ingenix health care database, she calculated that both admissions and prices at the hospital's psychiatric unit were more than double the state's average. Thus, she called the unit a "very busy" place.

"We actually are rather shocked that management would have permitted such high utilization rates, in such a vulnerable high-cost unit, to go 'uninvestigated,'" Skolnick wrote. "Vestiges of the previous management's 'don't ask, don't tell' policy? We certainly hope not."

The Herald also said that business has been "booming" in the hospital's psychiatric ward. After closing the children's unit and adding those beds to the adult program four years ago, the Herald reported, occupancy in the psychiatric ward jumped from 72% to 104% as admissions overflowed during the first half of 2004. The state contends that the unit was still improperly admitting elderly patients as recently as last month, according to Fulcrum's report.