As manhunt continues for violent murderer, scrutiny on mental hospital

SEATTLE -- A violent ex-felon who escaped from a Washington state psychiatric hospital that's under federal scrutiny over safety violations remained elusive Friday morning, a Spokane County Sheriff's deputy said.

Anthony Garver was charged in 2013 with tying a 20-year-old woman to her bed with electrical cords, stabbing her 24 times in the chest and slashing her throat. He was found too mentally ill for trial and was being held at Western State Hospital after a judge found that he was a danger to himself or others.

Garver, 28, escaped Wednesday night with Mark Alexander Adams, 58, a patient who had been accused of domestic assault in 2014. The two crawled out a window in a locked, lower-security unit of the hospital. Adams was captured the next morning.

Spokane County Sheriff's Deputy Mark Gregory said early Friday that there's been no additional sightings of Garver since reports on Thursday and they're not sure whether he left the area or is hiding in the woods.

"He's comfortable being out in the wilderness and adapts pretty easily," Gregory told The Associated Press. "He has hidden in the woods before."

Garver's father, who lives in the Spokane Valley area, called authorities Thursday to report that Garver had stopped by, Gregory said. Local media report that his mother called 911 when she saw him, reports CBS Seattle.

"The father said he was there for a very short time, got spooked and left," Gregory said.

The deputy said he hopes the next time Garver is taken into custody, that he'll be held in a more-secure facility. Garver was moved to a less-secure unit at the psychiatric hospital after the murder charge was dismissed and he was placed under a civil commitment. Garver has been convicted of multiple charges and twice fled from authorities by stealing a car or leading a high-speed chase.

"He has a history of running from law enforcement and of not doing what he's supposed to do, so I hope when he is caught, he'll be placed in a facility that has better security," Gregory said.

Western State Hospital says the men were discovered missing 45 minutes after they were last seen, but police said it took an hour and a half. There was no immediate way to reconcile the different timelines.

The escape is the latest in a litany of problems at the 800-bed hospital south of Tacoma, where assaults on both staff and patients have occurred.

U.S. regulators have repeatedly cited the facility over safety concerns and threatened to cut millions in federal funding. The Centers for Medicare and Medicaid Services recently extended the hospital's deadline for fixing the problems from April 1 to May 3.

But the escapes and two recent violent attacks at the had brought new scrutiny, said Steven Chickering, the Associate Regional Administrator of the Western Division of Survey and Certification for the Centers for Medicare and Medicaid Services.

"CMS was aware of all three of these situations, and cannot comment on how they will affect Western State Hospital's Federal funding," he said in an email. "CMS is currently following its procedures and processes for these situations."

A federal judge also has said the hospital has failed to provide timely competency services to mentally ill people charged with crimes.

Garver's lawyer, Jon Scott, said he hopes Garver "is found quickly and safely."

Adams also got on a bus and asked the driver how to get to the airport. Someone recognized Adams, and officers picked him up without incident in a town just south of Seattle-Tacoma International Airport, Lakewood police Lt. Chris Lawler said.

The men were last seen at 6 p.m. Wednesday during dinner and found missing 45 minutes later during a routine patient check, said Carla Reyes, assistant director of the Department of Social and Health Services' Behavioral Health Administration, which oversees mental health services in the state.

Police said the absence was discovered at 7:30 p.m. and officers were alerted just after 7:45 p.m.

Patients in the hospital's lower-security unit are checked every hour, Reyes said. Garver and Adams were not placed in the high-security unit because a judge granted a state request to hold them as a danger to themselves or others after treatment failed to restore their ability to understand the criminal charges against them.

Officials are conducting a safety review of the hospital and will bring in outside experts to help, Reyes said.

"We can never have too many fresh eyes reviewing a situation as serious as this," Reyes said in a statement.

Nursing supervisor Paul Vilja said he was amazed to hear the men who escaped were assigned to a unit with hourly checks, because some of the more-dangerous patients are in units with checks every 15 minutes.

Vilja and other hospital workers objected when the hospital first required the 15-minute checks two years ago because they said staffing levels were not adequate to handle the extra duties. Workers were required to fill out forms for each check but often fell behind, so not all of them were done, Vilja said.

The state has tried to fix some of the problems by increasing funding to hire more workers. But the hospital has struggled with recruiting and retaining staffers.

The state has a history of underfunding its mental health programs, including its facilities, said Lauren Simonds, executive director for the National Alliance on Mental Illness Washington. She said she hopes funding added during the recent legislative session will help move the state from being ranked lowest in the nation.

Despite increased federal scrutiny, assaults have persisted at the hospital, according to records obtained by The Associated Press.

A patient with a history of violent behavior choked and punched a mental health technician on March 26, according to an internal report. A March 23 report said a male patient slipped out of his monitors and was found in a bathroom with another male patient, who said he was sexually assaulted.

Injured employees missed 41,301 days of work between 2010 and 2014, and on-the-job injuries forced staff to move to other jobs, like desk work, for 7,760 days during that period, according to state Occupational Safety and Health Administration records.

More than half of the 700 injuries reported by nurses, psychiatric technicians, counselors, psychiatrists and other workers during that period were caused by violent patient assaults, the records said. - A violent ex-felon who escaped from a Washington state psychiatric hospital that's under federal scrutiny over safety violations remained elusive Friday morning, a Spokane County Sheriff's deputy said.

Anthony Garver was charged in 2013 with tying a 20-year-old woman to her bed with electrical cords, stabbing her 24 times in the chest and slashing her throat. He was found too mentally ill for trial and was being held at Western State Hospital after a judge found that he was a danger to himself or others.

Garver, 28, escaped Wednesday night with Mark Alexander Adams, 58, a patient who had been accused of domestic assault in 2014. The two crawled out a window in a locked, lower-security unit of the hospital. Adams was captured the next morning.

Spokane County Sheriff's Deputy Mark Gregory said early Friday that there's been no additional sightings of Garver since reports on Thursday and they're not sure whether he left the area or is hiding in the woods.

"He's comfortable being out in the wilderness and adapts pretty easily," Gregory told The Associated Press. "He has hidden in the woods before."

Garver's father, who lives in the Spokane Valley area, called authorities Thursday to report that Garver had stopped by, Gregory said.

"The father said he was there for a very short time, got spooked and left," Gregory said.

The deputy said he hopes the next time Garver is taken into custody, that he'll be held in a more-secure facility. Garver was moved to a less-secure unit at the psychiatric hospital after the murder charge was dismissed and he was placed under a civil commitment. Garver has been convicted of multiple charges and twice fled from authorities by stealing a car or leading a high-speed chase.

"He has a history of running from law enforcement and of not doing what he's supposed to do, so I hope when he is caught, he'll be placed in a facility that has better security," Gregory said.

Western State Hospital says the men were discovered missing 45 minutes after they were last seen, but police said it took an hour and a half. There was no immediate way to reconcile the different timelines.

The escape is the latest in a litany of problems at the 800-bed hospital south of Tacoma, where assaults on both staff and patients have occurred.

U.S. regulators have repeatedly cited the facility over safety concerns and threatened to cut millions in federal funding. The Centers for Medicare and Medicaid Services recently extended the hospital's deadline for fixing the problems from April 1 to May 3.

But the escapes and two recent violent attacks at the had brought new scrutiny, said Steven Chickering, the Associate Regional Administrator of the Western Division of Survey and Certification for the Centers for Medicare and Medicaid Services.

"CMS was aware of all three of these situations, and cannot comment on how they will affect Western State Hospital's Federal funding," he said in an email. "CMS is currently following its procedures and processes for these situations."

A federal judge also has said the hospital has failed to provide timely competency services to mentally ill people charged with crimes.

Garver's lawyer, Jon Scott, said he hopes Garver "is found quickly and safely."

Adams also got on a bus and asked the driver how to get to the airport. Someone recognized Adams, and officers picked him up without incident in a town just south of Seattle-Tacoma International Airport, Lakewood police Lt. Chris Lawler said.

The men were last seen at 6 p.m. Wednesday during dinner and found missing 45 minutes later during a routine patient check, said Carla Reyes, assistant director of the Department of Social and Health Services' Behavioral Health Administration, which oversees mental health services in the state.

Police said the absence was discovered at 7:30 p.m. and officers were alerted just after 7:45 p.m.

Patients in the hospital's lower-security unit are checked every hour, Reyes said. Garver and Adams were not placed in the high-security unit because a judge granted a state request to hold them as a danger to themselves or others after treatment failed to restore their ability to understand the criminal charges against them.

Officials are conducting a safety review of the hospital and will bring in outside experts to help, Reyes said.

"We can never have too many fresh eyes reviewing a situation as serious as this," Reyes said in a statement.

Nursing supervisor Paul Vilja said he was amazed to hear the men who escaped were assigned to a unit with hourly checks, because some of the more-dangerous patients are in units with checks every 15 minutes.

Vilja and other hospital workers objected when the hospital first required the 15-minute checks two years ago because they said staffing levels were not adequate to handle the extra duties. Workers were required to fill out forms for each check but often fell behind, so not all of them were done, Vilja said.

The state has tried to fix some of the problems by increasing funding to hire more workers. But the hospital has struggled with recruiting and retaining staffers.

The state has a history of underfunding its mental health programs, including its facilities, said Lauren Simonds, executive director for the National Alliance on Mental Illness Washington. She said she hopes funding added during the recent legislative session will help move the state from being ranked lowest in the nation.

Despite increased federal scrutiny, assaults have persisted at the hospital, according to records obtained by The Associated Press.

A patient with a history of violent behavior choked and punched a mental health technician on March 26, according to an internal report. A March 23 report said a male patient slipped out of his monitors and was found in a bathroom with another male patient, who said he was sexually assaulted.

Injured employees missed 41,301 days of work between 2010 and 2014, and on-the-job injuries forced staff to move to other jobs, like desk work, for 7,760 days during that period, according to state Occupational Safety and Health Administration records.

More than half of the 700 injuries reported by nurses, psychiatric technicians, counselors, psychiatrists and other workers during that period were caused by violent patient assaults, the records said.