MHP inpatient geriatric psychiatry unit to close

March 16--OSKALOOSA -- As of March 31, Mahaska Health Partnership's (MHP) Inpatient Geriatric Psychiatry (IGP) department will be closing, according to a recent MHP press release.

The eight bed unit opened in 2003, according to the release.

MHP Chief Executive Officer Jay Christensen expressed sadness at the announcement during a telephone interview with the Herald on March 14.

"It's been a long and difficult decision process. We know it effects patients; and the staff was in a very difficult unit to work in," he said. "We realize it's part of a larger issue; a state and national issue. We feel bad, but it couldn't continue. There comes a point in time where there's always a perfect time to start a service and a right time to end one as well. When it doesn't look like it's going to get better for this service, it's time to start looking at putting those resources somewhere else."

According to the press release, changes in payment, particularly Medicare Advantage plans, have been the single largest financial issue for the unit.

"It really isn't just the reimbursement for the services," Christensen said. "It's as much or more we had patients who could be very difficult sometimes. They could be physical. It wasn't what you'd think of someone that's only got dementia or depression; there were other issues, to the point where insurance or Medicaid said they were no longer qualified for services."

Christensen said with no reimbursement for those services and a unit inappropriate for the patient's needs, it was unfair to everyone.

"Unfortunately, that's an issue we're going to have to deal with at a national level," he said.

The IGP was designed to serve patients over the age of 60. For the most part, Christensen said, patients were older than 65-years-old. Only around 16 percent of the patients over the last year have been from Mahaska County.

"We knew we were going to draw [patients] from quite some distance," he said. "That can be a good thing, but really, it's more about patients taking beds and having nowhere else to go. It's not fair for them when they're not getting the care they need; they're still locked up in a psychiatric unit when clinical indicators suggest they no longer require that level of care."

New admissions to the unit are not being accepted. Christensen said there are still a few patients in the ward and he anticipates they will be discharged before March 31.

"For the most part in that kind of unit, they will be discharged someplace for additional care. Sometimes a nursing home, sometimes assisted living. Depending on their needs, it can be to a longer-term facility; sometimes family providing care. It's not just going back on your own," he said. "We know where they're going they're going to be comfortable; they're going to be safe and healthy. We feel bad we're not going to be able to continue to do that."

Times have changed, Christensen said, as have expectations for that type of care.

"The unit was created with kind of a care model that most of the patients were designed for 10-14 day stays," he said. "Time to get senior citizens in, stabilize [medications], make changes as necessary to stabilize their needs, stabilize behaviors and function in different environments."

Payment models have also changed, with pressure to reduce lengths of stay, Christensen said.

"The pressure to have stays down to a level we didn't really think was good care for those patients, placing them were they no longer meet criteria," he said. "It's a winding road where I don't think we can do this forever."

The IGP was a difficult place to work, Christensen said, and expressed regret regarding the staff.

"We feel bad for the families and patients and really bad for staff. It's a difficult place to work. We have really good people there," he said. "We're hopeful to find positions for them. [There are] some open positions, but likely they won't be perfect matches for everyone [but we're] doing the best we can."

According to the press release, with the closing of IGP, local psychiatrists Dr. Ron Berges, D.O., and Dr. Eric Boyum, M.D., will have more time to spend with outpatients at MHP Behavioral Health Services. In addition to Berges and Boyum, MHP has psychiatric nurse practitioners and more than 10 counselors to help meet the mental health and substance use issues in the region.

"We appreciate the opportunity to have cared for those patients," Christensen said, "and we are very proud of our staff that have been able to do that and we wish them the very best."

Mahaska County Supervisor Mark Doland said he's saddened that the services won't be available any longer, but his thoughts were that it was a good program that served its purpose.

There is a task force, Doland added, that has been formed at the state level to try to address the issue of providing services for people who need them. Doland, who sits on the South Central Behavioral Health Region board, reiterated the board will continue to work with Mahaska Health Partnership.

"They've been an excellent partner in the mental health field and we look forward to working with them in the future to try to provide services in all the areas that we can," he said. "Although this service isn't going to be available in our area any longer, we'll develop new services."

-- Herald staff writer Angie Holland can be reached at aholland@oskyherald.com and followed on Twitter @OskyAngie.

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