Smithfield police reported that Jacob Douglas Ansley, 32, of Clayton hanged himself with a bed sheet Aug. 13. Employees checked on him at 9:15 that morning but found him dead in his room when they returned an hour later, said Lt. Keith Powell. Afterward, the hospital offered counseling to its employees.

Jim Perpich, the hospital’s marketing director, said the state Division of Health Service Regulation wrapped up its investigation last week. “The surveyor right away said our nursing staff was outstanding, and he described the overall care as being outstanding,” he said. “But the fact is a patient took his own life, and [the surveyor] concluded that others could do so as well.”

If another patient suicide occurs at the hospital, it would face heavy consequences, Perpich said. “All hospital services would be put in immediate jeopardy,” Perpich said. “It means if you don’t take the immediate steps to improve the facility to make it what [the state] deems as being safe, they can withhold your Medicare and Medicaid reimbursement.”

To ensure patient safety, the hospital has made changes to all patient rooms in the Behavioral Health Unit.

The doors on the cabinets, closets and bathrooms have been removed, and a toilet pipe has been enclosed to prevent patients from tying anything on it.

“With the doors, people can go behind them, and if they are harming themselves, we can’t see it,” Perpich said.

Most days, the unit averages 18 patients, but as of last Friday, it held only 11 patients. As the patients are discharged, only six to 10 rooms will remain open. The rest will undergo extensive renovations to implement even more safety precautions.