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West Hartford hospital hopes to serve growing number of senior psychiatric patients

Hartford Courant - 12/17/2018

Dec. 14--Hebrew Senior Care plans to expand the short-term psychiatric unit of its West Hartford hospital in a $1 million project tied to the growing demand for behavioral and mental health care among Connecticut's older residents.

The nonprofit organization hopes to increase capacity from 22 behavioral health beds to 38 to address the "serious gap" in psychiatric services for seniors, stemming from Connecticut's aging population, rising rates of Alzheimer's disease and more older adults living alone or with their families rather than nursing homes, Hebrew SeniorCare told the state early this month in a certificate of need application.

With approval from the state Office of Health Strategy, the hospital hopes to unveil the expansion in August or September 2019.

The hospital plans to create the larger psychiatric department by eliminating its specialty, acute-care medical unit, which has struggled to attract patients even as behavioral health referrals flooded in from dozens of facilities across the state, as far as Putnam, New London, Danbury and Torrington, according to the proposal.

This past year, a shortage of beds alone caused 468 behavioral and mental health patients to be turned away from the hospital at Hebrew Senior Care and the Masonicare Health Center in Wallingford, which formed a senior health care alliance last January.

"That was the catalyst for us rethinking our strategy and our business plan," said Denise Peterson, Hebrew Senior Care's president and CEO.

Adding beds will help keep seniors who require psychiatric care out of emergency rooms and hospital hallways, waiting to be transferred to an appropriate facility with an open bed, Peterson says.

Private hospitals in Connecticut charged Medicare and Medicaid more than $747 million for inpatient mental disorder stays in 2015, up 38 percent from 2011, according to a 2016 report from the Department of Mental Health and Addiction Services.

Connecticut hospitals have been stretching in recent years to meet that demand.

Last December, Waterbury Hospital told the state it wanted to be able to use all 30 of its inpatient behavioral health beds for adults rather than reserving five of them for adolescents. And in early March, a $5 million renovation at Bristol Hospital transformedanold IT center into a 15-bed center for older patients with psychiatric and behavioral disorders.

The need is only expected to grow. Between 2010 and 2040, the number of Connecticut residents 65 and up is expected to grow by 57 percent, even as the total population remains stagnant, according to the state's projections.

Nationally, the number of Americans living with Alzheimer's disease is expected to nearly triple between 2014 and 2060, from 4 million people to 14 million, the Centers for Disease Control and Prevention said in September.

"There's no doubt in my mind the whole health care system will be stressed," said Dr. Genevieve Henry, the geriatric psychiatrist in charge of Bristol's new unit. "And we're already seeing the beginning of that."

But, Henry adds, Connecticut's private hospital sector is on the right track to offering enough short-term care beds for mental and behavioral health patients.

"Not every state is remotely close to that," Henry said.

Some areas of Connecticut are moving faster than others. Bristol Hospital also sees referrals from across the state, particularly the shoreline, Henry said. And it remains difficult for families to find outpatient and follow-up services with psychiatrists who specialize in dementia and other geriatric needs.

In the past year, 60 percent of the Hospital at Hebrew Senior Care's behavioral health patients had a form of cognitive impairment, as opposed to severe mental illness, the hospital told the state.

Hebrew Senior Care also plans to open an outpatient clinic to offer transitional services to patients when they are discharged.

The $1 million expansion comes about two years after Hebrew Senior Care entered into bankruptcy in August 2016 and sold its building to a New York-based skilled nursing company, National Health Care Associates. The organization has remained a tenant of the building, 1 Abrahms Blvd., off Route 189.

Hebrew Senior Care was discharged from bankruptcy last August with a plan to reorganize around specialty care, like a medical-model senior day center and Hoffman SummerWood, the organization's 104-unit assisted living facility.

Fundraising is ongoing for the proposed renovations to the hospital's behavioral health unit.

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