Greenwood Leflore Hospital physicians say they do not want the hospital to reopen the building’s holding unit, a transitional space for mentally ill patients.
At a recent hospital board meeting, the board members, physicians and city and county officials argued over whether the unit should be reopened as such. Ultimately the hospital board voted to form a committee to study the issue.
The unit was closed in October because of risk related to the hospital’s accreditation with Centers for Medicare or Medicaid Services (CMS).
Recently, the hospital was visited by Joint Commission, a nonprofit organization that nationally certifies and accredits health care organizations and programs. The nonprofit can conduct surveys for CMS for health care organizations to receive national accreditation. According to the Joint Commission website, for a hospital to receive federal payments and participate in Medicare or Medicaid programs, it must be up to code with CMS standards and program requirements.
Jim Jackson, executive director of the hospital, said at the board meeting Tuesday that a Joint Commission consultant had said before the hospital’s visit that the commission would be reviewing ligature risks in behavioral health settings.
Jackson said the hospital temporarily closed the unit in October before the Joint Commission visit. It was decided that after the commission survey was done, any needed corrective action would be taken and then they would make plans to reopen the unit, he said.
Stephen Ladd, a senior architect and health care planner with McCarty Architect in Tupelo, was hired to assess the unit.
A series of codes concerning ligature risk have come into effect in recent years, and given the unit’s age, it is “just rife with ligature risks,” Ladd said. “By the time you have addressed all of those, you might as well have gutted the whole place and started over.”
The cost to update the holding unit to meet the CMS standards would be $530,000 to $650,000, according to Jackson and Ladd’s report.
Some of the hospital’s physicians say they are concerned about the prospect of reopening the unit.
Dr. Craig Clark, a neurosurgeon and chairman of the Medical Executive Committee, said that the holding unit was not equipped to treat these patients and the area was not up to par.
“The holding unit never really met CMS criteria for ligature or physical restraint criteria,” Clark said. “There is concern among the medical staff to now go and open a unit that is completely out of compliance. (It) changes the whole complexion of that site visit with the commission.”
Clark also said the staff was concerned about safety in working with these patients. CMS criteria don’t allow the physical or chemical restraint of a mentally unstable patient, he said.
“The difficulty that arises — especially in court-committed people — you are looking often at the most violent and most unpredictable behavior that you can have,” Clark said. “A lot of these people are a danger to themselves, they are a danger to the hospital employees working in the unit, they are a danger to other patients in the unit and they are a danger to the medical staff.”
Dr. Henry Flautt, the hospital’s chief of staff, said agreed that the danger to the medical staff is a real concern among physicians.
“We are not a psychiatric hospital, we are not Whitfield, we are not a crisis center, and our medical staff is uncomfortable caring for these people,” he said.
Clark said the unit also lacks needed on-site psychiatrist and psychologist services. The hospital’s geriatric unit, which provided these services, closed in August because of a lack of patients. Now, the hospital has one psychiatrist who only provides some consultations.
Without this staff, Clark said, the unit “raises real concerns with regards to both quality and the appropriateness of the care that’s being given there.”
The Board of Trustees and the physicians could not agree on whether to reopen or close the holding unit.
“We have a responsibility to the community. I feel like it was a holding unit, and that’s what it still will be,” said Sammy Foster, a board member. “We need to do whatever it takes to bring it up to standard.”
Clark was adamant that the staff could not care for the patients.
“You cannot make somebody take care of a violent patient, and we are not psychiatrists,” he said.“Who is going to care for these people?”
The holding unit has six beds — four for males and two for females. At least two nurses and an orderly are present, according to attorney Floyd Melton III.
“When we don’t have a holding unit, we are generally juggling,” he said.
Patients once were sent to jail, and they now are either sent to a crisis center or evaluated at Life Help. The holding unit had about four Leflore County patients a week, Melton said.
According to Melton, a patient would be evaluated within 48 hours, have a hearing and wait to be sent to a crisis center in Cleveland or Grenada. If the patient were sent to the state hospital at Whitfield, the wait would be longer because of the lack of room.
Leflore County District 1 Supervisor Sam Abraham said at the board meeting that this issue needed to be addressed because the mentally ill cannot be sent to jail, left on the streets or sent home.
“A crisis in this country is mental illness. It is a major crisis, and the state is not addressing it either,” he said. “If y’all don’t do it, then the county is going to have to do something and the city is going to have to do something.”
Abraham suggested a committee be created with city, county and the hospital officials to make suggestions for what to do with the holding unit.
The Board of Trustees approved this motion, with one opposed, and the committee will present ideas at the board’s December meeting.
•Contact Lauren Randall at 581-7239 or lrandall@gwcommonwealth.com.
