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HomeMy WebLinkAboutAttachment 5 EL BHH Operational Profile1 EASTLAKE BEHAVIORAL HEALTH HOSPITAL Operational Profile Overview Scripps Health has entered into a joint venture with Acadia Healthcare to significantly expand its ability to provide quality behavioral health services to patients. The two health care organizations are proposing to develop and jointly operate a new, state-of-the-art 120-bed inpatient behavioral health hospital in the Eastlake community of Chula Vista, CA. Consistent with behavioral health best practices, the hospital will be constructed as a one-story facility to promote patient safety, a therapeutic, nurturing and structured treatment environment and operational efficiency. The hospital will provide safe, quality care and critically needed inpatient bed capacity and intensive outpatient services. Hours of Operation The hospital will operate 24 hours per day with three employee shifts. The shifts are anticipated to be 7:00 am–3:00 pm, 3:00 pm-11:00 pm, and 11:00 pm-7:00 am. Employees A total of 150 employees are anticipated to be on site, led by a Chief Executive Officer, Chief Medical Officer, and Chief Nursing Officer. Employees will include physicians, nurses, mental health technicians, intake directors, administrators, maintenance staff, and more. Ratio of Patients to Employees All Acadia facilities meet or exceed all state laws and statutes related to patient care, including the ratio of patients to clinical care staff. Other Acadia behavioral health hospitals in the state staff at a minimum 1:6 ratio of clinical staff to patients (please note that the ratio is clinical staff to patients, not all staff). This number can vary, and staff can be added based on the acuity of the patient’s condition, but it will never be lower than one clinical staff member per six patients. Number of Patients There will be a maximum of 120 inpatients. The number of outpatients is projected to range from 20 to 50 patients per day. Types of Patients The proposed Eastlake Behavioral Health Hospital will be an inpatient treatment facility providing care for a variety of patients in our area. It will serve adolescent, adult, and geriatric populations and will include specialized programs for distinct patient segments, such as members of the military and veterans. Patients coming to the facility may be referred by their medical providers, emergency departments, community partners (e.g., schools, senior homes, churches, military installations, public and government service providers), or self/family referral. Intensive outpatient treatment services will also be offered at the hospital. 2 Current plans include six separate units with 20 beds each. Consistent with behavioral health best practices, patient populations are housed by age group (geriatric, adolescent, adult) and acuity but with individualized treatment based on the patient’s condition and current functioning. Length of Stay The average stay for patients admitted to the hospital will be 7-10 days. Visiting Hours Visiting hours are typically from 6 pm to 7 pm to accommodate work schedules of visitors. On some occasions, the clinical staff may meet with the patient and their family to describe the treatment, medication, and discharge plan. This also gives the opportunity for family members to ask questions of the doctor and clinical staff. Visiting hours are distinct from other family interactions that may occur as part of specific inpatient and outpatient treatment programs. Patient Drop Off and Transportation Plan Transportation to the hospital will vary depending on the type of referral. If a patient is referred by a primary care physician, community, public health or safety partner, or is a self/family referral they would likely arrive by private automobile. If a patient is referred from an acute hospital emergency department, they would arrive by ambulance or other professional medical transport service. Sirens would typically not be needed since the transport to the facility would not be deemed an acute medical emergency. All decisions to admit or discharge a patient will be made by the attending psychiatrist and other members of the clinical treatment team based on the patient’s current condition and treatment progress. Upon discharge, all patients must have a detailed safe discharge plan guiding their ongoing care and overall well-being including continuity of care (ongoing medication and treatment) and housing. This plan will include pre-arranged private transportation from the hospital to the patient’s next destination. Are patients held involuntarily? Each state proscribes specific legal protocols for involuntarily committing an individual into inpatient care if he or she is determined (based on the opinion of one or more designated clinical or public safety experts) to constitute a legitimate risk to themselves or others. In the state of California, Welfare and Institutions Code (WIC) 5150 and 5250 govern involuntary holds. WIC 5150 is a 72-hour mandatory evaluation, and WIC 5250 is a 14-day involuntary hold. Holds are only valid in Emergency Departments and LPS-designated units (a Lanterman Petris Short (LPS) Conservatorship is the legal term used in California which gives one adult (conservator) the responsibility for overseeing the comprehensive medical treatment for an adult (conservatee) who has a serious mental illness). It is the current expectation that Eastlake will provide specialized, compassionate behavioral health service to both voluntary and involuntary status patients in full accordance with all legal, ethical, and regulatory requirements. 3 Are any patients allowed to leave on their own? In the overwhelmingly majority of cases, behavioral health inpatients (whether involuntary or voluntary) continue to receive care until the attending psychiatrist in consultation with the other members of the clinical team determines that safe discharge is clinically indicated based on the patient’s treatment progression and individual circumstances. Prior to discharge, patients must have a detailed discharge plan that outlines the specifics of the transition to and location of their next stage of care (e.g. nursing home, residential treatment center, long term rehabilitation, transitional or temporary housing, personal residence). It is Acadia’s policy to include arranged transportation to the specific post treatment care location for all patients upon discharge, either by hospital personnel or in some cases by the patient’s family, legal guardians, or other authorized individuals such as military base commanding officers or their designees. The lack of such a post discharge plan (including the arranged transportation component) in many cases comprises an important determining factor on whether discharge is clinically appropriate. Security Plan Protecting the safety and security of patients, staff, and the surrounding community is of paramount importance to Scripps and Acadia and a responsibility we take very seriously. The hospital’s design and operations will integrate countless seen and unseen patient safety and security measures. These include but will not be limited to: • Fencing and landscaping barriers • 24-hour security patrols • Controlled access in and out of the facility • Single entrance/exit on Showroom Place • Closed circuit security camera monitoring of the exterior and common areas (e.g. lobby, cafeteria, visiting area, outside areas) • 15-minute patient safety checks (maximum, as some patients may require more frequent checks) Contrary to sensationalized, often outdated and largely debunked stereotypes and misconceptions, most patients experiencing serious behavioral health conditions are neither dangerous nor inherently prone to violence, particularly when receiving professional, compassionate treatment in structured and therapeutic inpatient or outpatient settings. We can provide links to a number of studies and reports that address this issue, upon request. Oversight and Accountability The Scripps/Acadia behavioral health hospital will be fully licensed by the state of California and accredited by The Joint Commission, an independent non-profit organization with a 60-year track record conducting robust inspections, accreditation and quality care clinical assessment surveys on behalf of the federal government. It will also be fully certified and in good standing with all major government (e.g. Medicare/Medi-Cal, Tricare) and commercial payers prior to and at all times after its opening. In the entire 12-year history of Acadia Healthcare and the more than 100 year history of Scripps Health, none of its inpatient or outpatient facilities have ever failed to be 4 accredited, re-accredited, lost its state hospital license or been de-certified by the Centers for Medicare & Medicaid Services (CMS) or any other government program. Acadia facilities strictly adhere to all reporting requirements and maintain strong track records on multiple independently administered, evidence-based clinical quality performance tracking and measurement programs. These include The Joint Commission’s HBIPS (Hospital Based Inpatient Psychiatric Services) Core Measures and CMS’ Inpatient Psychiatric Facility Quality Reporting Program (IPFQR) used by over 1,600 psychiatric hospitals to measure clinical accountability metrics linked to improved patient outcomes and are published on CMS Hospital Compare website. In aggregate, Acadia’s behavioral health facilities meet or surpass (in some cases by large margins) the national and state average in multiple categories, including those related to patient safety. Acadia consistently endeavors to improve its aggregate scores as part of its overall quality assurance initiatives and clinician training programs.