WMC's planned psych emergency cuts take effect

[N1Medic 69]

Westchester Medical Center's planned psych emergency cuts take effect

Written by Theresa Juva

11:56 PM, Aug. 2, 2011|

VALHALLA — Westchester Medical Center

has officially dismantled its mobile crisis

team and reduced its psychiatric

emergency staff, changes that won't affect

patient care, but are necessary in the

current , the hospital president said.

http://www.lohud.com/article/20110803/NEWS02/108030326/Westchester-Medical-Center-s-planned-psych-emergency-cuts-take-effect

[ny10570 745]

Is anyone in Westchester offering a CPEP now?

[MoFire390 118]

its my understanding the only thing closing is the physic ER. the floors are still open. Phelps does have some of the old staff from WCMC bahivoral health on for evaluations.

[huzzie59 75]

So no more EDP's to the Psych ER?

Bring them the Med Center ER?

[MoFire390 118]

So no more EDP's to the Psych ER?

Bring them the Med Center ER?

rumor has it that Phelps can take them

[ems-buff 81]

Well you still have, Mt Vernon White Plains, and Jacobi, for psych services... In the southern part of the county, and phelps in the northern part of the county

[FFEMT150 214]

rumor has it that Phelps can take them

Not a rumor... Phelps is a psych recieving ER. Have been for years.

[WMCer111 0]

So no more EDP's to the Psych ER?

Bring them the Med Center ER?

they come to the medical er anyway for "medical clearance".....hope they give us staff to sit with these patients.....

[WAS967 97]

So no more EDP's to the Psych ER?

Bring them the Med Center ER?

Agree with what WMC said. The "psych ER" at WMC is not an EMS receiving facility. If the patient is coming from the field they need to be taken to medical ER for clearance first. Only time you should be taking them directly to the psych ER is on a transfer. I always cringe when I hear a BLS call for an EDP and then hear them transporting to the Psych ER. It's a bit of a liability.

The list of abilities from the HVREMSCO protocols lists the following ERs as Psych capable:

Westchester - Mount Vernon, Phelps, Northern Westchester and WMC.

Hudson Valley - Saint Francis, Putnam, Bon Secors, Benedictine (didn't they close/merge into Kingston?), Good Sam, Catskill, Arden Hill (tho I know they are in the process of merging as well - I'd hope the new campus has abilities but this needs to be confirmed).

[NWFDMedic 58]

Agree with what WMC said. The "psych ER" at WMC is not an EMS receiving facility. If the patient is coming from the field they need to be taken to medical ER for clearance first. Only time you should be taking them directly to the psych ER is on a transfer. I always cringe when I hear a BLS call for an EDP and then hear them transporting to the Psych ER. It's a bit of a liability.

The list of abilities from the HVREMSCO protocols lists the following ERs as Psych capable:

Westchester - Mount Vernon, Phelps, Northern Westchester and WMC.

Hudson Valley - Saint Francis, Putnam, Bon Secors, Benedictine (didn't they close/merge into Kingston?), Good Sam, Catskill, Arden Hill (tho I know they are in the process of merging as well - I'd hope the new campus has abilities but this needs to be confirmed).

Orange Regional has both Psychiatric ER and admission services (Arden Hill is no longer a hospital). Kingston offers psychiatric ER services now and the admissions are transferred to Benedictine.

[WAS967 97]

So Benedictine is still open? Interesting. I seem to remember they don't have an ER anymore tho?

I wish the region would update it's hospital capabilities list. It always makes me smile a little to see Phelps on there as a PCI center.

Edited August 12, 2011 by WAS967

[x635 4,066]

Is St. Vincent's In Harrison still in operation, or did they close with all the main hospital's operations.

Makes you wonder when you drive through Dutchess County, actually basically all of NY, and see all those abandoned psych facilities. and wonder where are all those inpatients now? Obviously, there's not a lot of money in psych services, which in turn places the burden on the rest of the medical community, the prison system, and the homeless.

I agree they need to be medically cleared, but what after that? Many of us know we go to the same psych patients routinely.

[201/65 94]

So Benedictine is still open? Interesting. I seem to remember they don't have an ER anymore tho?

After the state recommended the merger of Kingston and Benedictine Hospitals they became "Health Alliance of the Hudson Valley". They did major renovations and added an addition onto the Kingston Hospital Campus ER and closed the Benedictine ER. Anyone being admitted for psychiatric reasons is transferred by ambulance to the Benedictine campus. Benedictine has specialized inpatient units for mental health, detox, cancer care, and orthopedic rehabilitation, while Kingston has the specialized units for emergency medicine, stroke, OB/Birthing, and cardiology.

[NWFDMedic 58]

Is St. Vincent's In Harrison still in operation, or did they close with all the main hospital's operations.

Makes you wonder when you drive through Dutchess County, actually basically all of NY, and see all those abandoned psych facilities. and wonder where are all those inpatients now? Obviously, there's not a lot of money in psych services, which in turn places the burden on the rest of the medical community, the prison system, and the homeless.

I agree they need to be medically cleared, but what after that? Many of us know we go to the same psych patients routinely.

St. Vinny's in Harrison is still a behavioral inpatient facility (and I hate that run from SFH).

[mfc2257 464]

Replying to the earlier comment about Psych services not making much money... It is actually the way the hospital allocates cost to the unit. Here is an over simplified example:

A hospital has a 20,000sf psych unit. It's cost is relatively low because it requires very little specialty equipment, the staffing costs are low, and the overall amount of resources that are dedicated to the unit are low as well. Lets say the average daily census translates to a 90% occupancy which generates $10mil a year in gross revenue.

The same hospital has dual MRI machines that take up 5,000sf. The cost is excessive due to the cost of the machines, specialty staffing, maintenance etc but they generate $10mil a year in gross revenue.

Now the crux of it all... The hospital has determined that its overhead allocation per SF is going to be $400/SF which is applied pro rata to each unit in the hospital. So they allocate $8mil in costs to the Psych unit (20,000 X $400) and $2,000,000 in cost to the MRI (5,000 X $400). The hospital CEO says to the CFO why do we keep operating Psych beds when they only made us $2mil last year compared to MRI which made us four times that.....

If the hospital had allocated cost in a more equitable manor the true story of cost vs revenue would show that psych made more money than originally depicted. Many NFP hospitals do it this way because its easier and they're not playing with their own money. In the FP world cost accounting is a much more thorough process and that is why companies like Psychiatric Solutions (recently purchased by Universal Health) have no problem making money in the free standing psychiatric hospital business. You don't see many in NYS because its an over-regulated service area.

[ny10570 745]

Is St. Vincent's In Harrison still in operation, or did they close with all the main hospital's operations.

Makes you wonder when you drive through Dutchess County, actually basically all of NY, and see all those abandoned psych facilities. and wonder where are all those inpatients now? Obviously, there's not a lot of money in psych services, which in turn places the burden on the rest of the medical community, the prison system, and the homeless.

I agree they need to be medically cleared, but what after that? Many of us know we go to the same psych patients routinely.

All of those state hospitals are from an extremely different era of mental health services. Everything from autism to major personality disorders were treated with little differentiation in care. Today's services are much more diverse and intensive allowing the majority of those patients to enter society. While some in group homes with direct supervision and little day to day social function others are now living normal lives.

[NWFDMedic 58]

Replying to the earlier comment about Psych services not making much money... It is actually the way the hospital allocates cost to the unit. Here is an over simplified example:

A hospital has a 20,000sf psych unit. It's cost is relatively low because it requires very little specialty equipment, the staffing costs are low, and the overall amount of resources that are dedicated to the unit are low as well. Lets say the average daily census translates to a 90% occupancy which generates $10mil a year in gross revenue.

The same hospital has dual MRI machines that take up 5,000sf. The cost is excessive due to the cost of the machines, specialty staffing, maintenance etc but they generate $10mil a year in gross revenue.

Now the crux of it all... The hospital has determined that its overhead allocation per SF is going to be $400/SF which is applied pro rata to each unit in the hospital. So they allocate $8mil in costs to the Psych unit (20,000 X $400) and $2,000,000 in cost to the MRI (5,000 X $400). The hospital CEO says to the CFO why do we keep operating Psych beds when they only made us $2mil last year compared to MRI which made us four times that.....

If the hospital had allocated cost in a more equitable manor the true story of cost vs revenue would show that psych made more money than originally depicted. Many NFP hospitals do it this way because its easier and they're not playing with their own money. In the FP world cost accounting is a much more thorough process and that is why companies like Psychiatric Solutions (recently purchased by Universal Health) have no problem making money in the free standing psychiatric hospital business. You don't see many in NYS because its an over-regulated service area.

That's a great explanation. I'm working on my Master's degree in healthcare administration and in one finance class, we were taught to prorate the overhead in the same manner. When I mentioned the words 'cost accounting', I was more or less ridiculed about how cost accounting doesn't take into account the "true" costs of a service.