Another state hospital closes psychiatric care unit in Iowa

OSKALOOSA, Iowa (AP) - Another state hospital is closing its inpatient psychiatric care unit in Iowa.

Mahaska Health Partnership CEO Jay Christensen said Wednesday that the Oskaloosa hospital discharged its last psychiatric inpatient on Monday.

The Oskaloosa geriatric psychiatric unit, which served patients over 60, is the latest of several closed over about the past several years in Iowa, The Des Moines Register (https://dmreg.co/2mwxs5t ) reported. The state closed its Clarinda and Mount Pleasant psychiatric hospitals when Gov. Terry Branstad declared them outdated in 2015. Community hospitals in Creston, Fort Dodge, Iowa Falls, Keokuk and West Union also closed their inpatient psychiatric units.

“I think it’s catching the world by surprise how widespread this is,” Christensen said, noting the national trends pinching mental-health programs.

He said Oskaloosa unit has been losing about $500,000 a year, largely because many psychiatric patients have to stay in a hospital for weeks or months after they’re ready to leave because nursing homes or other residential facilities won’t take them.

Christensen said insurance companies, including Medicare Advantage carriers, weren’t willing to continue paying for hospital care for people who had been stabilized. Many of the patients had histories of being physically aggressive. In those cases, the hospital usually winds up bearing the whole cost.

“Their perspective is, if you’re admitting them, it should be for a certain number of days, and that doesn’t always work with this population,” he said.

The problem has been felt throughout Iowa. In 2016, Broadlawns Medical Center in Des Moines reported holding a psychiatric patient for more than a year because residential programs wouldn’t take him. That single case cost the public hospital nearly $500,000.

The Oskaloosa hospital unit’s closure illustrates the critical need for Iowa to encourage development of residential programs equipped to handle complicated mental health patients, said Peggy Huppert, the Iowa executive director of the National Alliance on Mental Illness.

“It’s not necessarily that we don’t have enough beds, it’s that we don’t have the right kind of beds,” she said.