There was swift reaction online and around the Finger Lakes to the news that Finger Lakes Health would be shuttering its Acute Rehabilitation Unit at Geneva General Hospital and Behavioral Health Services program at Soldiers & Sailors Hospital in Penn Yan.
Lara Turbide, a spokesperson for Finger Lakes Health told the Finger Lakes Times in December that Finger Lakes Health made the decision to close the units in November, notifying affected employees within a day of the decision.
She told the Times that the first step in the process was notifying state regulators that it would discontinue services. Turbide added that sustainability of the programs became an issue. “There has been a declining volume for both services,” she said, adding that for the mental health unit, there are minimum staffing levels needed to run the program, regardless of patient numbers. “We’ve been sustaining losses for many years.”
There was speculation initially that the closure of the Behavioral Health Services program at Soldiers and Sailors was connected to the case involving Paul Khouzam, who had been released in August from the unit after being taken there by Yates County sheriff’s deputies because he was considered a possible a danger to himself or others.
He was released, and later attacked his mother with a hammer at the home they shared. She later died from her injuries.
Turbide cited low patient volumes and “reimbursement challenges” at both the rehab and mental health units as major factors in the decision to close the facilities when speaking with the Times. She denied the possibility that the closure was due to the Khouzam case.
She also told the newspaper that other options exist in the region for care. As for behavior health services – inpatient programs at Clifton Springs, Newark and other area hospitals will have to shoulder the burden of Finger Lakes Health’s closure.
In a letter to FingerLakes1.com – Brittney Christensen, B.S.N., R.N., hammered back at the decision to close the facility. “Apparently, the unit is being closed due to ‘low volumes and reimbursement’,” she explained. “Essentially, reporting to our community that our mental health is not financially beneficial to those making the decisions.”
She said there are serious concerns connected to ‘not caring enough’ about mental health locally. “It tells the community that the mentally ill are less-deserving of a decent life and adequate treatment,” she continued. “By forcing the mentally ill to attempt life without the treatment they need – ultimately portrays the detested stigma that if you suffer from mental illness you are less-likely to be a contributing member of society.”
Christensen says the discussion around low patient volumes and poor reimbursement are ‘relatively common’ subject matter in the healthcare industry. “We cannot predict how many of our citizens will become ill or how much their insurance will pay for these services, and we shouldn’t have to,” she added. “These services were designed to be available in the time of need, not for someone to make a buck.”
She contends that Finger Lakes Health didn’t consider alternatives to shutting down the operations before making that decision. Speaking to the considerations of local employees – Christensen said, “Our voices and input were not considered.”
Opponents of the closure say it will ultimately hurt the community if the services are ceased. “We need to take care of one-another,” Christensen continued. “This is a monumental decision to be made without the input of those who are actually impacted – the community.”
The Geneva Believer, who spoke with current- and former-employees painted a grim picture about the practices that ultimately led to that closure decision. Seven employees they spoke with noted that declining volumes on the unit were due to doctors intentionally finding questionable, and potentially illegal, reasons to refuse admission to patients in need. Employees even spoke of a “Don’t admit list,” which provided reasons to decline admission to some patients.
Turbide told the Penn Yan Chronicle-Express that the unit is “certified to provide care to people with mental health diagnosis only and is not allowed to provide care to people who may have an additional diagnosis, such as substance abuse.” However, that reasoning was taken further, according to some past and current employees – and included facilitators looking for reasons to not treat patients.
On Friday, Turbide spoke with FingerLakes1.com providing an update and additional context via email. “As with any service changes, significant consideration is given to community need, volumes, and financial viability,” she explained. “At this time, we have made notification and submitted a request to New York State Department of Health and the New York State Office of Mental Health for Soldiers & Sailors Memorial Hospital to discontinue Inpatient Psychiatric Services related to lack of reimbursement and declining volumes.”
She noted that there will be no closure of the unit until the OMH and DOH provide such approval.
For now, she explained, the request has simply been made to the appropriate regulatory entities. “For inpatient adult psychiatric services as provided at Soldiers & Sailors, there are other inpatient behavioral health units regionally who have capacity,” Turbide added. “If given permission by DOH and OMH to discontinue services, Finger Lakes Health will continue to deliver outpatient behavioral health services at the John D. Kelly Center operated by Soldiers and Sailors Memorial Hospital. There are appropriate processes to follow and we are just beginning to work through this process with the appropriate regulatory agencies.”
Turbide said that volumes are in the single-digits with some days having no patients at all. She also noted that approximately 40 percent of patients served were from other counties. “There are several other inpatient psychiatric units operated by other area health systems also operating below capacity in the region who can and are willing to accept referrals,” Turbide added. “If we do close the inpatient psychiatric unit at Soldiers & Sailors, we, Finger Lakes Health, will continue to make referrals as clinically appropriate to other area facilities and will continue to offer out-patient care at the John D. Kelly Center in Penn Yan.”
As far as employee impact, Turbide said that all employees had been, or would be offered opportunities to explore other job opportunities within the health system if the closure is approved.
– By Josh Durso
He serves as News Director for FingerLakes1.com. Hosts a recurring podcast called “Inside the FLX,” which is available on iTunes, YouTube, and the Tune-In App. Send tips, story ideas, or comments to his inbox at firstname.lastname@example.org.