The CEO of a new state psychiatric hospital being built in Berlin said Thursday he’s hopeful the facility will earn federal certification when it opens in July.
Jeff Rothenberg, currently the director of the eight-bed Green Mountain Psychiatric Care Center in Morrisville, said for that to happen Vermont will ask the Centers for Medicaid and Medicare Services (CMS) to transfer a certification from that facility to the state hospital.
But CMS hasn’t certified Green Mountain Psychiatric Care Center, and the time frame for approving that request and whether CMS would allow such a transfer are unclear.
CMS certification is important because it allows a psychiatric hospital to bill for the services they provide. The Morrisville Center is financed through so-called “global commitment” dollars – Medicaid money that can be spent on any initiative that improves care.
Gov. Peter Shumlin’s FY 2015 budget, which sets aside $19.3 million for the new state hospital, anticipates it will have CMS certification.
Rothenberg said if the hospital isn’t certified, it would drive up its operating costs – though he could not say by how much, except that he did not believe it would be a large amount.
“Besides the money, it’s a validation for staff of the services we’re providing,” Rothenberg said.
During a visit to the Morrisville facility last month, CMS inspectors found a deficiency in how physicians were documenting patient memory in their assessments.
Rothenberg said the inspectors described it to him verbally as a “minor finding,” and his staff has changed their practices.
“Once we correct that, there doesn’t appear to be any further step (in obtaining certification),” Rothenberg said.
Rothenberg is hopeful CMS will allow Vermont to transfer the certification from the eight-bed Morrisville center to the 25-bed state hospital in Berlin.
That expectation is bolstered by the Joint Commission’s suggestion that its stamp of approval will follow the center from Morrisville to Berlin for the first six months the facility is open. The Joint Commission is an influential nonprofit that accredits hospitals and health centers.
“When they were here in August … they indicated the site change would not affect our accreditation,” Rothenberg said. The commission’s decision won’t be official until the new facility is open.
Rothenberg said he’s waiting for CMS approval of the Morrisville site before asking about the possibility of a transfer.
“We’re hopeful that they will (allow the transfer),” he said, but he acknowledged that such an allowance would be rare. “I think it’s unique for New England, it’s certainly unique for Vermont.”
The previous state psychiatric hospital in Waterbury lost its CMS certification and was unable to recover it before closing due to flooding after Tropical Storm Irene.
Rothenberg maintains that a transfer of certification or accreditation makes sense, because Morrisville and Berlin are essentially the same facility.
In his opinion, it’s the same hospital opening in a new place with a new name but with the same management and some of the same staff, Rothenberg said.
Rep. Anne Donahue, R-Northfield, a longtime advocate on issues facing Vermont’s mental health system, was not optimistic about the potential for a transfer.
“My personal opinion, it’s not the same program,” she said, “If two-thirds of the staff is new, I’m not sure it can be considered that way.”
Though several current staff at the Morrisville facility will make the move to Berlin, Rothenberg said they have to hire 99 new staffers to run the new hospital.
Job fairs hosted by the Department of Mental Health earlier this month yielded 400 applicants, Rothenberg said.
“The area we anticipated we would have the most trouble recruiting is for nursing, and so far that has been true,” he said in a followup email, “We do have a backup plan to work with companies that provide traveling nurses, if we need to, to open on time.”
Nurses who worked at the old state hospital in Waterbury were given first crack at the new jobs, but Rothenberg said only a few have applied.
The hospital is set to open June 29 and at that time it will make use of eight beds depending on the number of patients transferred from Morrisville, which is slated to close at that time.
“The Vermont Psychiatric Care Hospital will open with 25 beds and will fill the beds as quickly and responsibly as possible,” Rothenberg said.
The Department of Mental Health expects that it will fill all beds by mid-August, he said.
Donahue expressed concern that the Department of Mental Health’s timeline for hiring and training new staff so it can open and fill up with patients over the summer is too aggressive.
“As much as the system is in crisis and needs the beds, given where we are now, I’d rather see it done right than open too rapidly with unprepared staff and have something bad happen or struggle to get CMS certification,” she said.
