KSHB 41 reporter Ryan Gamboa covers Miami County in Kansas and Cass County in Missouri. He also covers agricultural topics. Share your story idea with Ryan.
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In December 2024, the Kansas Legislative Division of Post Audit (KLPA) flagged safety and security at the Osawatomie State Hospital (OSH).
Since 1863, OSH has operated in Miami County, Kansas. The state-run facility provides inpatient psychiatric and mental health services to adults.
"You see more of the really, really sick and the really violent patients here," Eric Blatt, a former contract nurse at OSH, told KSHB 41.
The hospital operates on a $59.6 million base budget for two independently run hospitals operated on the OSH campus, Adair Acute Care (AAC).
In fiscal year 2024, $48.2 million of OSH's funding was allotted from the state general fund. Its other funds, including federal Medicare dollars, were sent to AAC, and the remaining $11.5 million was granted through the fiscal year 2023 budget.
The audit was authorized by four current Kansas legislators and a former state senator.
"A considerable number of my constituents work there at the hospital, and there have been several of those that have approached me about safety issues there at the hospital," explained Rep. Fred Gardner (R-District 9). "Several people from law enforcement have mentioned that. Every year, representatives can request auditing from the Post Audit Division, and then there's a committee that selects the audits that are going to be done... I signed on to that."
KSHB 41 has broken down a number of the audit's findings in the last month.
Auditors found physical security at the state hospital fell short.
RELATED | Safety concerns lead to high staff turnover at Osawatomie State Hospital
"It doesn't surprise me," Blatt said.
Blatt has worked as a psychiatric nurse for 10 years. He's worked at both Osawatomie and Larned State Hospital as a contract employee.
"I was in direct care of patients," Blatt said. "I pretty much managed behaviors, ensuring the patients got the best care possible."
To provide adequate care to psychiatric patients, security measures often fell short, Blatt told KSHB 41.
RELATED | Addressing safety and security at the Osawatomie State Psychiatric Hospital
The audit found OSH does not have adequate processes to ensure physical security.
Auditors looked at five areas of review:
- Whether security staff patrol the campus to ensure buildings are secure in the evenings, overnight, and on weekends.
- Whether each security staff shift has enough staff trained to respond to fires.
- Whether security and other OSH staff ensure that staff who work with patients have personal security alarms they can activate in emergencies.
- Whether facilities staff oversee the keys each staff member has. This includes recording what keys staff members have and ensuring staff return keys when they stop working at OSH. It also includes ensuring staff have management approval for certain high-access keys.
- Whether management monitors for and follows up on safety risks and noncompliance with hospital policies.
Per audit reports, security staff patrols on the OSH campus were incomplete and inadequate.
There are about 25 buildings on the state hospital campus. KSHB 41 submitted a Kansas open records request to review the full audit.
In the audit documents obtained, management does not train or oversee security staff that they're securing the hospital in the evening, weekend or overnight hours.
According to Blatt, direct patient staff relies on security if an altercation arises.
"Most of the time, it's everybody for themselves before security can even get there," Blatt said. "They barely have enough security staff on days or nights."
According to KSHB 41's records request, auditors reported:
"About half of the patrol checks we reviewed were implausibly or questionably brief. About half of the patrol checks we reviewed (though not necessarily the same half as previously mentioned) also appeared incomplete, suggesting security staff aren’t checking all parts of campus as they should."
Auditors state it's likely a result of inadequate training and oversight.
RELATED | Osawatomie State Hospital's economic influence on small-town Kansas
Additionally, the auditors concluded OSH management hasn't promoted a culture of safety.
Blatt and other former employees KSHB 41 interviewed indicated staff in direct contact with patients are required to wear personal safety alarms.
Auditors found management isn't keeping track of personal safety alarm response times, nor is security tracking if the staff is wearing the alarms.
Security staff have not been conducting the checks since late 2021, but a hospital safety coordinator has checked personal alarms since the beginning of fiscal year 2023. OSH's safety coordinator reports found not all staff had their alarms or had functional alarms.
"Nobody uses their personal alarms, and nobody checks to see if you have them, let alone use them," Blatt said.
In a follow-up question to Blatt's response, KSHB 41 asked for clarity on why.
He responded, "Other than alert someone where you are, the alarm is not going to stop the patient beating your head, and a shout is just as effective.”
Another major physical security concern outlined in the audit was the facilities management of its keys.
Auditors report 56 keys as stolen, including keys with access to patient units, and eight master keys as lost.
"With the amount of turnover ... people forget to turn in their keys," Blatt said.
Kansas Department for Aging and Disability Services Secretary Laura Howard already told KSHB 41 the department is working to address employee turnover.
"The Legislative Post Audit was an opportunity to see what are the things that we perhaps need to shore up," Howard said. "There are things like security patrols around the hospital, both the actual patrols and the measurement and documentation around that. Some things around the management of keys, kind of key control, which is always an issue in a big institution, hospital or prison. How do you manage that?"
Howard said her team is actively implementing new practices at OSH.
"... Putting more key card control in place as opposed to maybe having as many keys around there, and one of the things the hospital was already looking at was evaluating going to what are called key boxes, which is a process we have at Larned State Hospital," Howard explained.
Additionally, implementing new key lock boxes and new documentation methods and practices around staff personal security alarms.
"I'm having a safety coordinator conduct random drills to make sure that folks have those and also random drills to see the timeliness of response," Howard added. "I have a lot of confidence that will take place."
According to Howard, the current OSH budget should cover any new security and safety implementations.
"Nobody should have to go to work and be in fear of being harmed, not knowing whether they're gonna wake up," Blatt said. "We need to be alive to care for the patients ... I want a better service for the patients."
The audit was requested by five Kansas legislators: Rep. Samantha Poetter Parshall (R-District 6), Sen. Caryn Tyson (R-District 12), Rep. Carrie Barth (R-District. 5), Rep. Fred Gardner (R-District 9) and former Sen. Molly Baumgardner (R-District 37).
KSHB 41 received a response to an interview from one of the five legislators named on KLPA's audit.
Tyson told KSHB 41 the Osawatomie State Hospital is an important issue but did not have time to discuss it during a phone call. KSHB 41 later reached out in an email seeking an interview and did not receive a response.
If you're a current or former employee at Osawatomie State Hospital, KSHB 41 News reporter Ryan Gamboa would like to hear your voice. To contact Ryan, send him an email at ryan.gamboa@kshb.com.
To review the entire KLPA audit at OSH, click here.
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