UMass Memorial says it can meet psychiatric needs without 13 beds
Grant Welker
UMass Memorial Health Care says it can meet the region's behavioral health needs without the 13 beds it plans to close.
UMass Memorial Health Care says it will be able to meet the region’s behavioral health needs, with the help of area hospitals, if it is allowed to close 13 psychiatric beds at its University Campus.
The hospital made its case to the Massachusetts Department of Public Health April 28 in response to an earlier letter from DPH that said the 13 beds are necessary and ordered UMass Memorial to provide justification.
The health care system in February announced plans to convert 13 of its 27 psychiatric beds in the 8 East Unit into medical/surgical treatment beds, which it has said are also scarce. The proposal was met with opposition from the Massachusetts Nurses Association, the Worcester City Council, and people in the community who attended a March public hearing.
Over the next few months, there will be 275 beds available at behavioral health treatment centers across the region, according to UMass Memorial’s letter to the state. By the nonprofit’s own estimates, closing the beds would displace about 431 patients a year, or 1.2 patients a day. The unit has been at 90-97 percent occupancy since October, but about 70 percent of those patients do not require complex medical care, the letter said.
Four alternative treatment sites were listed.
TaraVista Behavioral Health Center in Devens has 24 beds but is licensed for 108, Harrington Hospital in Southbridge has 16 new beds and 14 existing beds, Saint Vincent Hospital has 13 existing beds and seven planned, and the Westborough Behavioral Healthcare Hospital is scheduled to open in August with 152 beds at full occupancy.
UMass Memorial said it will operate a temporary shuttle to TaraVista, which is its partner in a 14-bed affiliation agreement. It will run two days a week, twice a day, and will be available for a nominal fee until a proposed 120-bed psychiatric hospital opens in 2019.
“The Medical Center is also in discussions with these facilities to develop mechanisms that could further streamline the referral and acceptance process,” Andrew S. Levine, a lawyer with Donoghue, Barrett & Singal in Boston, wrote in the letter. “With the significant new capacity available in the area, the Medical Center does not anticipate that the approximate 1.2 daily transfers that will result from its closure of 13 beds will have any adverse impact on alternative delivery sites.”
Internally, UMass Memorial said, it plans to continue to operate the remaining 14 psychiatric beds on 8 East, and its 26-bed inpatient psychiatric unit at the Psychiatric Treatment and Recovery Center. The health care system also has 24 inpatient beds at UMass Memorial Marlborough Hospital, 20 beds at UMass Memorial Clinton Hospital, and several services available at Community Health Link.
Beds will gradually be phased out, and some patients will be transferred to the Psychiatric Treatment and Recovery Center.
As part of a five- to seven-year master plan of renovations, UMass Memorial plans to reopen two former medical/surgical units this summer on the Memorial Campus, which it said won’t have much of an impact on the number of medical/surgical beds. Other units will have to close temporarily for renovations as those two open, according to the letter.
Also addressed in the letter was the issue of insurance.
“If placement of a patient is impossible because of an insurance issue, that patient will be treated as a free care patient and given priority status for admission to the Medical Center,” Levine wrote.
The Massachusetts Nurses Association said that the hospital is downplaying the impact of the reopening of the two medical/surgical units.
“We are talking about up to 50 new beds, which they say is insignificant, while alternatively claiming that right now, without these beds open, converting just 13 psych beds to [medical surgical] will have a major impact on the problem of boarding medical patients in the ED,” David Schildmeier, director of public communications for the nurses association, said in an email.
Schildmeier said there isn’t enough information on how UMass Memorial will serve its population because many of the alternative facilities it cited aren’t open yet.
“In citing alternative facilities and beds to care for the patients on 8 East, most of these beds are yet to be opened, lack protocols or information on admitting and insurance criteria, and one of the facilities (the Westborough facility), from my reading of the letter seems to indicate that those beds are primarily for patients with substance abuse disorders,” he said. Schildmeier said he is concerned that patients with comorbidities will be moved to a medical/surgical floor, where they will be cared for by staff without the necessary behavioral health expertise.
DPH had 10 days to review the letter and will issue its response by Monday, May 8, according to a spokesperson for the agency.
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