By JOHN HANNA, Associated Press

TOPEKA, Kan. (AP) — The federal government is threatening to cut off funding for patient care at the state mental hospital in western Kansas, saying the facility is not complying with federal rules and demanding safety-related renovations in one of its buildings.

The Kansas Department for Aging and Disability Services said Friday that the federal government is giving the state a month to correct problems at a 104-bed unit of Larned State Hospital, about 115 miles (185 kilometers) northwest of Wichita. The federal government is threatening to cut off the funding in January.

Timothy Keck, the state's aging and disability services secretary, told The Associated Press that his department expects to spend about $1 million making renovations designed to decrease the risks of patients hanging or strangling themselves. The changes include replacing sinks, toilets, door handles and door hinges.

The hospital also was cited for other issues, including for one case each this summer of verbal and minor physical abuse of a patient by staff. The staffer involved in each incident was working during a survey of the hospital in August, and Keck said each was immediately suspended, though he could not say their current status.

Keck said completing the renovations as quickly as the federal Centers for Medicare and Medicaid Services is demanding will be challenging. But he also said he's confident the state will fix all problems and avoid losing federal funds.

"We've already corrected 90 percent of these things," Keck said.

He said hangings or strangulations have not been a problem at the Larned hospital, and the survey report did not mention any specific incidents.

According to the survey report, the physical-abuse case involved an incident in which a hospital worker was trying to keep a patient from destroying a wash cloth. Another worker pulled the patient's pants down, presumably to distract him, Keck said. The verbal abuse incident occurred in August.

Additional issues raised by the survey included instances in which cabinets containing medicines or chemicals were unlocked or not entirely secured and cases in which the hospital didn't follow up enough with new patients to be sure they're aware of their rights.

The federal government decertified the state's other mental hospital in Osawatomie, about 45 miles (72 kilometers) south of Kansas City, in December 2015, over numerous staffing, patient-care and safety issues. The move cost Kansas about $1 million a month in federal funds, and changes there included renovations to reduce hanging risks. An August survey found no deficiencies, but the state is still waiting for the Osawatomie hospital to be recertified.

Kansas House Minority Leader Jim Ward, a Wichita Democrat, was skeptical that the issues at Larned will be resolved as quickly as Keck predicts, given Osawatomie's history.

Some lawmakers have criticized Republican Gov. Sam Brownback's administration over problems at the hospitals, and Sen. Laura Kelly, a Topeka Democrat, said it should have expected to make renovations at Larned.

"We know from Osawatomie what the rules are," she said. "I don't understand why the agency wouldn't pro-actively address this issue."

Keck said the Larned building was constructed in the 1990s and is in good condition. He said it has fewer potential strangulation risks than Osawatomie, which required $1.3 million in renovations.

"We have a very good handle on that and are working very hard to take care of that issue going forward," Keck said.

The Larned building cited for deficiencies houses patients committed for mental health treatment in civil court proceedings. While it has room for 104, it now houses about 60.

The hospital also has a unit for mentally ill criminal defendants and another for violent sexual offenders, together housing about 330 patients.

The federal agency's letter about Larned was dated Thursday and said deficiencies were serious enough to "substantially" hinder the hospital's ability to provide adequate care. The department gave AP a copy, along with a copy of the 24-page report from the August survey.

The federal agency's letter came less than 10 days after a state employees' union said the Larned hospital isn't being adequately staffed. The department said nearly 30 percent of the jobs are vacant but staffing hasn't fallen below safe levels.

The building surveyed in August had 66 patients when the survey began and overall staffing levels were not mentioned as an issue in the report.

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