Raleigh, N.C. — The state's new psychiatric hospital in Butner is in immediate jeopardy of losing its certification to bill the federal government for Medicare and Medicaid services, according to a federal report released Tuesday.

Central Regional Hospital came under fire for questionable practices earlier this year, partly because of its delayed merger with Dorothea Dix Hospital in Raleigh.

The federal reports cited a number of reasons why the Centers for Medicare and Medicaid Services placed Central Regional in immediate jeopardy, including the staff's failure to provide care in a safe environment, failure to prevent patient abuse and failure to prevent patient neglect.

CMS conducted an investigation from Nov. 17-21 at the Central Regional and Dorothea Dix campuses. Some of the physical issues cited were burned-out light bulbs and fire-protection system defects at Dorothea Dix, and a locked exterior door in an unoccupied portion of Central Regional.

In addition, an inappropriate restraint of a patient was noted during the investigation. The hospital took immediate action to address the patient-care issues, including disciplinary action against the employees involved in that incident, said Dr. Michael Lancaster, co-director of the state Division of Mental Health, Developmental Disabilities and Substance Abuse Services.

Lancaster said the physical problems at Central Regional were fixed the day they were noted. However, he said physical problems at Dorothea Dix are still being addressed.

Central Regional had also been using a Medicare and Medicaid provider number for Dorothea Dix, which is a violation of conditions for participating in the programs.

Central Regional was intended to combine the operations from John Umstead Hospital in Butner and Dorothea Dix, but Dix patients are still waiting to move, partly because of ongoing safety issues. Umstead patients moved into the $130 million facility in July, Lancaster said.

The hospital has been notified that it must correct the problems by Dec. 14 or face the loss of its ability to receive Medicare and Medicaid funding. CMS officials will later return to the facilities for an unannounced visit to determine if the problems were truly corrected.

The loss of  federal certification could be a huge blow to the Department of Health and Human Services. In September, Cherry Hospital in Goldsboro lost its federal funding after a patient died after choking on medication and being left sitting in a chair unsupervised for nearly 24 hours. That is costing the state roughly $800,000 a month.