AUGUSTA — Riverview Psychiatric Center is in “substantial compliance” with all conditions for participation in Medicare and on track to regain federal certification and the roughly $20 million in annual funding it lost after having its certification revoked in 2013.

The state Department of Health and Human Services received notice the center has been found to be in substantial compliance with conditions that must be met to receive Medicare funding reimbursement. The notice followed a review of the state’s mental health facility by the federal Centers for Medicare and Medicaid Services.

Bethany Hamm, the department’s acting commissioner, said auditors found no serious conditions in need of correction at Riverview and cited only minor deficiencies. She said there is “no question in my mind” those cited minor deficiencies will be addressed and Riverview will regain complete certification, probably after a follow-up review by federal officials in December.

She and Gov. Paul LePage praised Riverview Superintendent Rodney Bouffard and other staff members at the hospital for working to improve treatment and address problems cited by the Centers for Medicare and Medicaid Services when it revoked Riverview’s certification in 2013. The problems included staffing shortages, excessive patient restraints, including the use of handcuffs, and a lack of continuity of patient care.

“Rod’s experience and leadership style was critical in turning the hospital around,” Hamm said.

She said notable improvements at Riverview included seclusion and restraint rates that fall below the national average, maintenance of consistent staffing and the addition of long-term medical staff to help ensure continuity of care.

Bouffard said he was proud of hospital staff members whose efforts, he said, made recertification possible by providing the best possible care to patients.

He said when he arrived in 2016, he was presented with the results of four surveys conducted at Riverview, including one that cited 93 pages of deficiencies there. He said administrators reviewed them all and formed a plan to correct them. They did so, he said, by seeking out programs that have had proven success elsewhere and worked with the staff to put them in place at Riverview.

Changes included a dramatic reduction in the use of restraints on patients at the hospital, and a new treatment process he said has resulted in better outcomes, quicker patient discharges, and more successful treatment.

“We totally revised the treatment process, and the result of that is we’re seeing far more effective treatment,” Bouffard said. “Bottom line is treatment is improved markedly.”

In 2013 federal authorities found the hospital to be out of compliance with federal Medicare guidelines, citing problems found during an audit, including the use of stun guns, pepper spray and handcuffs on patients, improper record-keeping, medication errors and failure to report progress made by patients. Reviews since then, when the state has sought to re-certify the hospital, have expressed concern about staffing levels there.

Bouffard said staffing has improved significantly at the hospital, and of that staff, far fewer workers are traveling employees and more are long-term employees, which he said is better for continuity of treatment. He said that’s important for patients, especially at Riverview, which, he said, takes the most difficult patients in the state.

In August, Daniel Wathen, who as court master oversees a consent decree governing how the state must treat people with mental illness, issued a report that said conditions at the state psychiatric hospital have improved over the last year for both patients and workers.

Wathen said Wednesday that Riverview has made significant improvements to treatment, staff turnover is down and morale is up, and Bouffard has focused on what needed to be addressed at Riverview. He said funding to add and keep staff members at the hospital was key.

“The stability that was achieved on staffing, which came about after Rod Bouffard showed up and funding was made available for improvements, that was pretty critical, both in terms of having a full complement of staff and having continuity of care,” Wathen said. “It’s hard to establish that when your psychiatric staff is changing every month. They have some very good people in all those positions now. They always had good people there, but they didn’t have enough.”

Hamm said Riverview being on track for recertification is a result of years of hard work there, helped significantly by increased support she said was provided by LePage and his administration.

“I can’t impress upon folks enough the support the governor has given in this effort,” Hamm said. “Anything Rod has needed and I had to get the governor to resolve, he’s been quick to do that.”

Rep. Patty Hymanson, D-York, House chairwoman of the Legislature’s Health and Human Services Committee, however, said legislators passed legislation to increase pay and add positions at Riverview over LePage’s veto.

“I want to applaud the dedicated and talented staff at Riverview for their management, care for patients and hard work to regain this certification,” Hymanson said in an emailed statement. “While it is deeply unfortunate that the administration allowed conditions at Riverview to deteriorate to the point where certification was revoked for five years, it is gratifying to know that hospital management and Superintendent Rodney Bouffard always remained committed to providing the excellent care patients deserve.”

Hamm said the state will submit a plan of correction to address the few minor deficiencies cited by the Centers for Medicare and Medicaid Service and, probably in December, federal officials will return to Riverview to see how the state has done taking action on that correction plan. She fully expects all deficiencies, some of which Bouffard said already have been addressed, to have been fixed by then and that Riverview then will regain certification.

Certification is significant because it returns about $20 million in annual federal funding reimbursement to Riverview, where the annual budget is about $38 million.

The state filed an application in October 2017 seeking reinstatement.

“Given the intense scrutiny the hospital has been subject to, this accomplishment serves as a testament to the hard work and dedication of the Riverview staff over the past years,” LePage said in a news release. “Moving forward, we must all ensure we take politics out of the provision of essential mental health services.”

Riverview Psychiatric Center in Augusta on Aug. 25, 2015. (Joe Phelan/Kennebec Journal 2015 file photo)