Aging Population

Is an Inpatient Geropsychiatric Program Right for Your Hospital?

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Prepared by Horizon Health Behavioral Health Services

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Is Your Hospital Meeting the Mental Health Needs of the Geriatric Population in Your Service Area?

  • Are you currently treating geropsychiatric patients in medical/surgical beds?
  • Can your hospital benefit from establishing a geropsychiatric program that meets the needs of the community, and produces additional revenue for your facility?

Healthcare facilities typically offer very little in the way of geriatric psychiatric services. Too often, care takes a “one-size-fits-all” format where an adult psychiatric unit is thought to be adequate to provide services for all adults. Typically, because older patients often have concomitant medical issues, they are admitted to a medical/surgical unit where they receive treatment in a system where reimbursement is made based on the diagnosis code, not the number of days necessary for treatment. If geriatric patients are treated in a geropsychiatric unit, their treatment would be reimbursed on a per diem basis. The result: a more positive clinical outcome for the patient, and a more positive financial outcome for the hospital.

Why can’t these patients be treated on an adult psychiatric unit with the other adults? A secure, geropsychiatric unit, designed to address the unique physical and emotional needs of adults over age 65 with mental health issues, is not the same as an adult psychiatric unit. In addition, the clinical programming required for a geropsychiatric unit is markedly different than the programming required for younger adults.

Unfortunately, when hospitals assess the need for an inpatient geropsychiatric program, they may overlook two key areas. First, they do not appreciate that these programs, if marketed properly, can develop into regional treatment centers of excellence. The second, and more common oversight, is to not move forward because one or more of their competitors has an existing inpatient psychiatric program. The irony is that the existence of these programs may be a compelling reason to introduce a geropsychiatric program.

The Mental Health Needs of an Aging Population

Retirement is usually regarded as a positive, relaxing experience, but for some it can be the source of a great deal of worry and confusion about the future. Death of a loved one, debilitating injury or illness, and loss of independence can affect physical, mental, and emotional well-being. “Depression, one of the conditions most commonly associated with suicide in older adults, is a widely under-recognized and under-treated medical illness. Studies show that up to 75% of older adults who die by suicide visited a physician within a month before death.”1

The Geriatric Population

  • “Persons 65 years and older numbered 39.6 million in 2009, and are expected to grow to be 19% of the population by 2030.”2
  • “Six and a half million Americans aged 65 years or older are affected by depression. “3
  • “As many as one half of all older people living in nursing homes have depression.”4
  • “Disability due to mental illness in individuals over 65 years old will become a major public health problem in the near future because of demographic changes.”5

Is a Geropsychiatric Program Right for Your Hospital?

Today’s healthcare environment is complex and challenging, especially when it comes to understanding the potential need for a geropsychiatric unit in your hospital.

Before you make a decision on this ques­tion, consider enlisting the assistance of a behavioral health services company that can help you make informed decisions.

  1. What are the demographics of the populations in your primary and secondary service areas?
  2. How will you develop your referral base for a geropsychiatric unit which will differ from the referral base for your medical/surgical units?
  3. How will you staff a geropsychiatric unit, and who will train the new staff?
  4. How will you establish a geropsychiatric unit that meets your clinical and financial goals?
  5. How will you benchmark clinical improvement for your treatment program?

The Horizon Solution

A behavioral health contract management organization is a great resource in the process of establishing a geropsychiatric program that is viable and responsive to the changing needs of today. Horizon Health Behavioral Health Services is a psychiatric contract management organization with a demonstrated rec­ord of assisting hospitals to develop inpatient geropsychiatric units. Our development experts will work with you to assist with physical plant requirements, certification and licensure necessary for approval and implementation, and help you establish timelines for opening a new unit. Our client hospitals also benefit from Horizon’s financial and marketing guidance, resulting in programs with positive fiscal per­formance that are positioned as leaders in the delivery of behavioral health services in their communi­ties.

The resources, demographics, and unmet needs of a community must all be considered in developing and improving geropsychiatric care.

Reach out to an organization with a demonstrated record of operat­ing inpatient geropsychiatric units.

  1. NIMH-Older Adults: Depression and Suicide Facts.
  2. Aging Statistics. Department of Health & Human Services, Administration on Aging.
  3. National Alliance on Mental Illness: Depression.
  4. American Geriatrics Society Foundation for Health in Aging.
  5. Surgeon General Report. Available here. Accessed January 2012

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