Many Iowans with mental illnesses have found themselves marooned in hospitals for months after they were cleared by physicians to be released, costing hospitals millions, according to the Des Moines Register.
In one case, a Des Moines man who had been approved for discharge spent an extra 14 months in Des Moines-based Broadlawns Medical Center's psychiatric unit because the hospital staff could not find an agency that would supervise him in the community. They eventually found one, but taxpayers spent nearly $500,000 housing the man in the public hospital until he was finally released, according to the report.
Long-term patients frequently remain in hospital units in Iowa, taking up beds needed by patients enduring mental health crises. Hospital leaders say the bottleneck is getting worse and blame the problem on a lack of options for patients who do not require full hospitalization but need some degree of supervision.
According to Janice Landy, MD, a psychiatrist who leads mental health services at Broadlawns, on any given day, one-fourth of the hospital's 30 psychiatric beds are used by people who are cleared to be transferred. Some patients end up staying at the hospital for months after they've been stabilized.
However, there are few residential care agencies in the community that are willing to take in complicated cases for the amount of money Medicaid reimburses them. As a result, hospitals end up eating the costs, as Medicaid ceases reimbursement after it is determined hospitalization for a patient is no longer medically necessary, according to the report.
Broadlawns lost approximately $4.8 million on such cases in 2015, according to the report. Additionally, the hospital was forced to turn away 345 psychiatric patients because there weren't enough available beds.