Hospital medical units can successfully be converted to an inpatient psychiatric program with careful planning. Below is a quick look from 30,000 feet.
Rationale: Adding inpatient behavioral health beds continues to increase in response to high demand for both mental health and substance use treatment. Long wait times and psychiatric patient boarding in emergency departments are contributing to the need. Reimbursement levels and utilization are generally positive.
Major questions worth answering prior to starting a conversion project include:
- Is there a business case for converting the medical beds to psychiatric inpatient? Projected payer mix, capital and operating costs – complete a proforma and business plan
- What is the current and future demand based on the population and market utilization? Will the new unit be competitive and operate at a good occupancy – is there a business need in that location – conduct a market analysis including the number and frequency referrals out for inpatient behavioral health care, consider surveying stakeholders
- How feasible is the physical plant renovation and conversion costs? State and CMS safety/security requirements define most aspects of the rooms, corridors, therapy spaces, e.g. ligature resistant ceilings, corridor door alarms, foam shower doors, specialized faucets, fixtures, windows, furniture, fixtures, and linens – get an architect experienced with psychiatric units
- Is the hospital prepared to develop extensive and unique psychiatric inpatient operating policies and staffing? State licensing regulations, CMS laws, EMTALA, HIPAA, The Joint Commission or DNV standards are in addition to acute care hospital medical regulations – develop a compliance review
- What is the organizational fit? Does the project fit with existing hospital services and could the new inpatient unit integrate with existing hospital and medical group behavioral health outpatient services and/or community programs? Buy in from within the hospital is crucial – consider forums to solicit participation and input
- Are staff available? Psychiatrists, psychiatric registered nurses, licensed clinical social workers, recreation therapists occupational therapists, addiction treatment professionals, and behavioral health counselors staff inpatient psychiatric units – assess access to these professionals in the market
- There are additional items to consider, for example:
- Will the unit serve adults, adolescents, older adults?
- Will it accept both mental health and substance use patients, voluntary and involuntary admissions?
- How will access be handled?
Working through each of the above is a good start but for more help, get in touch with us at Schafer Consulting Inc.