Officials at Kansas’ two state psychiatric hospitals have taken steps to reduce staffing shortages and improve care but haven’t been able to free space for more patients.
Representatives from the Kansas Department for Aging and Disability Services, Osawatomie State Hospital and Larned State Hospital spoke this week to a special committee overseeing the hospitals. Staffing issues are improving, officials said, though they cautioned that both hospitals still need more workers.
Federal officials ended Medicare payments to Osawatomie State Hospital about a year ago due to safety issues, and several inspections had found problems with treatment. KDADS Secretary Tim Keck said the department will allow contractors until January to submit bids to run Osawatomie State Hospital, but that he was impressed by current staff’s efforts to improve care.
Larned State Hospital hasn’t been dogged by the same quality issues, but staff shortages led to high turnover and burnout among employees forced to work double shifts.
While Larned State Hospital has enough space available to take voluntary patients, patients sometimes wait a day or more to get into Osawatomie State Hospital, often spending that time in emergency rooms.
Osawatomie State Hospital still doesn’t have enough staff to reopen 60 beds that have been offline for more than a year, KDADS Interim Secretary Tim Keck said. State officials didn’t give a specific number of employees it would need to hire to reopen the beds.
“We want to be very confident that we have enough staff to protect our patients,” he said.
Signs of positive morale
While more than one-quarter of all staff positions are vacant in both hospitals, officials could point to some positive signs. Ven Rao, human resources manager for Osawatomie State Hospital, said more employees are referring friends and acquaintances, which he called a positive sign for morale. About 14 percent of applicants said someone had suggested they look for a job at the hospital, he said.
The hospitals also are looking within for more front-line workers. State officials said employees at both hospitals who don’t work in direct-care positions volunteered to train as mental health technicians so they could fill in if necessary.
“We want to be very confident that we have enough staff to protect our patients.”- Tim Keck, interim secretary of the Kansas Department for Aging and Disability Services
KDADS also is attempting to get longer-term patients out of the hospitals. Valeo Behavioral Healthcare in Topeka has taken six patients into a transitional living facility over two months. One went back to the hospital and another is ready to move into an apartment and live independently, Valeo CEO Bill Persinger said.
Another three people who have mental illnesses and developmental disabilities left the state hospital and are getting services through Equi-Venture Farms, said Ben Swinnen, the facility’s executive director.
Osawatomie State Hospital officials also are looking into whether up to 25 longer-term patients could be transferred to nursing facilities for mental health, Keck said. The department may have to make changes to how nursing facilities are reimbursed to give them an incentive to take hospital patients, he said.
Angela de Rocha, spokeswoman for KDADS, said it was too early to comment on what specific changes might be necessary, because the department is only exploring the idea of partnering with nursing facilities.
Changes to care
Despite staffing issues, the hospitals have made some changes to improve mental health care, officials said.
David Barnam, clinical director at Larned State Hospital, said the hospital is putting more focus on teaching cognitive skills to cope with symptoms, particularly for the 31 percent of patients who have schizophrenia. Medications and other forms of theory are of some help to people with schizophrenia, he said, but they aren’t very effective on their own.
Mental health care also is changing in the Osawatomie State Hospital unit that is seeking Medicare certification. Dwain Shaw is CEO of the unit, which now must operate separately from the rest of the hospital under Medicare requirements.
He said the unit works with patients when they arrive to begin planning their transition and has changed how treatment plans are written to better address a patient’s needs.
The unit has a doctor available during business hours, with medical residents covering other hours, Shaw said. It also has improved screenings to ensure patients are physically healthy enough to stay at Osawatomie State Hospital, he said.
“This place was a center of excellence in the past. It can be a center of excellence in the future,” he said.