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BJC acquires psychiatric hospital, cites lack of Medicaid expansion for facility's demise

(Rachel Lippmann/St. Louis Public Radio)
When fully open, the new Psychiatric Stabilization Center at 5351 Delmar Blvd. will provide immediate treatment for those in mental distress, as well as short-term inpatient stays.

BJC HealthCare took over operations of a 25-bed, psychiatric acute-care hospital near the West End neighborhood in St. Louis on Wednesday. BJC officials said the move was necessary because the psychiatric hospital was financially unstable.

The St. Louis Regional Psychiatric Stabilization Center, or PSC, serves people experiencing a psychiatric emergency, such as an episode of schizophrenia or a suicide attempt. Many patients are transferred to PSC from nearby emergency rooms at Barnes Jewish Hospital and SSM St. Mary’s Health Center. During an average, week-long stay, the PSC stabilizes patients and refers them to medical care.  

“If PSC had closed, then there would be no avenue for those emergency rooms to transfer those patients out, and they’d have very long lengths of stay in the emergency room,” said Rich Liekweg, an executive vice president of BJC HealthCare.

PSC replaced the Metropolitan Psychiatric Center at 5351 Delmar Blvd. three years ago. The hospital is funded by about $500,000 in contributions from BJC and SSM Health Care annually, which is matched by the Missouri Department of Mental Health.

“Eighteen months ago we realized that unless there was going to be Medicaid expansion in the state of Missouri, PSC as we know it was not going to be a viable entity,” Liekweg said.

Coupled with cuts to federal funding programs through the Affordable Care Act, he said PSC was caught in a perfect storm:  

  • Funding from a temporary Affordable Care Act program, the Medicaid Emergency Psychiatric Demonstration, expires in July of 2015.
  • A temporary pay bump for primary care doctors who serve Medicaid patients expired at the end of 2014.
  • Most significantly, the lack of Medicaid expansion in Missouri meant PSC provided care for more uninsured patients than it could afford.

Initially, the hospitals had expected fewer than 20 percent of PSC’s patients to be uninsured, pending Medicaid expansion. But because Missouri’s legislature voted not to expand Medicaid coverage to people making less than 138 percent of the federal poverty level, the number of uninsured patients at PSC shot up to an average of 42 percent last year.
“The difference between 20 percent of uninsured patients and 40 percent is the difference between being open or closed,” said PSC’s president Jon Eiler, who will now serve as its Administrative Director under BJC.

“There’s a huge need in the community, to stop this revolving door for folks with chronic mental illness,” Eiler said.

BJC will double the capacity of the facility by opening PSC’s vacant third floor and closing the psychiatric emergency unit at Christian Hospital in north St. Louis County. Psychiatric beds at Christian will be converted to beds for trauma and surgical care. PSC will re-named the ‘Barnes-Jewish Hospital Psychiatric Support Center.” 

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