Inspectors who visited Washington state's largest psychiatric hospital found that safety problems that thrust the facility into the national spotlight after the escape of two dangerous patients a year ago persist, including neglected patients. And a survey of Western State Hospital staff, conducted as part of federal oversight in December and January, found that administrators make decisions that "adversely affect patient safety" and there was a lack of trained or qualified staff, fear of retaliation from managers and too much focus on bureaucracy over staff safety.