New state report on behavioral health and readmission shows need for stronger protections for essential healthcare services and real solutions to hospital staffing crisis

A report was issued by the Center for Health Information and Analysis October 13 Details of the impact of comorbidities among behavioral health patients on extended stays and unplanned readmissions

Nurses and healthcare professionals in the MENA region have long struggled to protect mental healthcare services and improve staffing to reduce avoidable readmissions.

Canton, Massachusetts.And the 14 October 2022 /PRNewswire/- Report released October 13 by the Center for Health Information and Analysis (CHIA) focused on patients with pathological behavioral health conditions and avoidable readmissions, sheds light on the structural problems in our health care system that Massachusetts Nurses Association (MNA) nurses and health care professionals seek. ) to be addressed long before the COVID-19 pandemic.

Massachusetts Nurses Association (PRNewsFoto/Massachusetts Nurses Association) (PRNewsfoto/Massachusetts Nurses Association)

Massachusetts Nurses Association (PRNewsFoto/Massachusetts Nurses Association) (PRNewsfoto/Massachusetts Nurses Association)

“Patients deserve the best from our healthcare system, especially patients who come to hospitals in dire need, and those with a combination of mental health, substance abuse, or medical problems,” He said Katie Murphya nurse practitioner in the intensive care unit and head of the MNA. “The hospital industry has long let down these patients by shutting down mental health services or working with barely enough staff to keep the lights on.”

“The government must also take responsibility for not protecting basic health care services and not treating mental health equally despite the parity law,” Murphy said. “Hospital managers have further exacerbated this crisis by focusing on profit margins on providing the level of care needed by patients with mental health challenges and comorbidities. As the industry responds only to financial incentives, increased reimbursement for mental health care may be the carrot that Convince hospitals to help alleviate this crisis.”

The CHIA report is part of a comprehensive state examination of all payers dating back to 2016 of the prevalence of comorbid behavioral health conditions and readmissions among adults in hospitals in Massachusetts acute care hospitals. The latest report, “Behavioral Health and Acute Care Hospital Readmission in Massachusetts SFY 2020”, is the first to include data from the pandemic, and covers the month of March to June 2020.

Among the report’s findings:

  • Nearly half (46%) of adults are hospitalized Massachusetts Acute care hospitals had at least one comorbid behavioral health condition, accounting for the majority of discharges (54%) in SFY 2020. This pattern continued during the first wave of the COVID-19 pandemic (April-June 2020).

  • More than sixty percent (62%) of hospitalized adult Medicaid patients have a satisfactory behavioral health condition.

  • Patients with no behavioral comorbidities had a hospital stay of 1.4 days longer than patients without behavioral comorbidities (6.0 days versus 4.6 days).

  • Readmission rates for patients with any comorbid behavioral health condition were approximately twice the readmission rates for patients without any comorbid behavioral health condition (20.6% vs 10.6%).

Loss of mental health family in Massachusetts

Nurses and healthcare professionals in the MENA region have struggled for many years to maintain mental health families and services. The association’s efforts have included aggressively advocating for laws that give the public more time and the ability to provide feedback on health care closures, and that Provides the state with greater executive powers. MNA is currently researching the impact of the mental health board on patients, caregivers, and healthcare facilities in Massachusetts.

The proposed closure or closure of mental health services in Massachusetts:

  • All (22) mental health beds at Baystate Franklin Medical Center in Greenfield.

  • All (28) mental health beds at Baystate Wing Hospital in Palmer.

  • All (20) mental health beds at Baystate Noble Hospital in Westfield.

  • The three closings mentioned above are part of an ongoing plan by Baystate Health to open a for-profit mental health facility in Holyoke.

  • In 2020, Trinity Health closed 74 child and adult mental health beds at Providence Hospital for Behavioral Health. These included at that time the only children’s mental health family of New York to me Worcester.

  • Norwood Hospital: Flooding caused hospital closures in June 2020. Plans to reopen do not include replacing a hospital mental health unit.

  • In 2021, Good Samaritan Medical Center announced plans to permanently close its inpatient detox unit, located in Foxborough. DPH found it an essential service, then the company issued a notice that it would be closing anyway.

  • In 2017, UMass Memorial Medical Center closed 13 psychiatric beds and then opened with US HealthVest, an independent for-profit mental health hospital.

  • Fibra Hospital in Springfielda facility for psychiatric and behavioral health unit in a nursing home and long-term acute care services, closed in 2017.

  • The state closed 125 of the 170 beds at Taunton State Hospital in 2012.

  • Westborough State Hospital, a mental health facility, closed completely in 2010.

  • In 2010, the UMass Health Alliance Burbank campus closed a 15-bed inpatient psychiatric unit.

  • In 2009, the Cambridge Health Alliance closed 60 of the 127 mental health beds at Whidden Memorial Hospital.

In addition to, a December 2021 Report by the Massachusetts Health and Hospitals Association and the Massachusetts Association for Behavioral Health Systems showed that psychiatric units and hospitals in Massachusetts Took at least 154 mental health beds offline only due to staffing needs in the past 10 months.

“Patients are missing out on mental health care in their communities because our health care system is failing them,” Murphy said. “In Massachusetts, after all we’ve learned about mental health and the effects of trauma, it’s an absolute shame. Patients should get quality care close to where they live, not less care many miles away because the hospital CEO decided profits and executive pay are more valuable than the care of The most vulnerable members of our community.”

Staff and mental health crisis

Just as the COVID-19 pandemic is no excuse for a blanket caregiver crisis, it is not an excuse for not having enough staff to care for patients with mental health care needs and comorbidities. As documented by WBURThere is no shortage of nurses there Massachusetts. Instead, there is a shortage of nurses willing to work under the current bedside conditions.

“The poor employment conditions that affected mental health care did not start with the COVID-19 pandemic,” Murphy said. “For years, the hospital industry has been exploiting nurses and healthcare workers by overburdening patients with tasks and forcing them to work overtime. Hospitals are increasingly using just-in-time staffing models, scheduling enough nurses to be able to move patients through an income-generating system. This approach increases profits and Leads to an increase in the salaries of executives. It completely fails nurses who are trying to fulfill their professional and ethical obligations to provide safe, high-quality care to patients.”

Nurses survey results show the impact of staff shortages

  • 55% of nurses in 2022 State of Nursing in Massachusetts exploratory study He said understaffing was the biggest obstacle to providing quality care, especially for new nurses, with 68% of nurses with 0-5 years of experience saying staffing was the biggest obstacle they faced.

  • The number of certified nurses who said they did not feel they had enough time to provide patients with the care and attention each individual needed jumped to a record 71%, up from 60% last year.

  • Percentage of nurses who said this year that the overall quality of care in Massachusetts Hospitals have worsened (83%) which is about 30 points higher than in any other year.

  • Nearly two-thirds (64%) of nurses said that insufficient pay or benefits is a major challenge. This response was up from 48% who reported lack of wages or benefits in 2021 and 27% in 2019 — a 37-point increase in nurses who had concerns about pay and benefits over a three-year period.

  • 33% of certified nurses reported planning to leave nursing sooner than originally planned. Among new nurses with 0 to 5 years of experience, 37% plan to leave early—the highest of any experience group.

Employment Improvement Efforts for MNA Nurses and Healthcare Professionals

  • For decades, the MNA has advocated safe staffing levels and enforceable patient limits at the local, state, and national levels. The effect of the number of patients a nurse is assigned at one time is One of the most studied topics in healthcare. Huge peer-reviewed evidence shows that maintaining a safe patient limit helps protect the quality of patient care, including by reducing avoidable readmissions.

  • MNA Code titled Workforce Development and Patient Safety Law Examines current nursing practice, including the impact on the quality of patient care, the makeup of the current nursing workforce, and the future needs of nursing care in the state.

  • Next to MassachusettsMNA nurses and healthcare professionals work together as union members to negotiate improved employment levels, wages, benefits, and working conditions. These are key to recruiting and retaining caregivers.

Top MNA Solutions for Mental Health Care

  1. The Commonwealth shall designate an agency or department to collect comprehensive information on all aspects of mental health care.

  2. The Commonwealth should streamline the overlapping responsibilities of the Departments of Public Health, the Department of Mental Health, and the Department for Children and Families to facilitate agency accountability.

  3. To ensure that profitability is not the only factor in maintaining essential health services, the state must have the legal authority to compel the establishment or maintenance of “essential health services.”

  4. Improve and expand access to a centralized 24/7 bed search tool to quickly find the right position.

  5. Require parity for mental health reimbursement rates. **The Legislative Council passed a bill last summer It takes steps to address MNA solutions 4 and 5, although these have not yet been implemented.

  6. Establish criteria for the distance traveled to reach “essential health services”.

  7. Establishment of intensive treatment and stabilization units within the state system for severely abused patients who sit for longer due to lack of available places.

  8. Establish an ED referral program for hypersensitive and dual-diagnosed patients to reduce boarding and provide appropriate care while awaiting permanent placement.

  9. The state should require comprehensive programs to prevent violence in the workplace in all health care facilities.

  10. Issuing regulations requiring staffing levels and removing other procedural barriers to transfer and admission on weekends.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth Massachusetts. Its 25,000 members advance the nursing profession by promoting high standards of nursing practice, promoting the economic and general well-being of nurses in the workplace, giving a positive and realistic view of nursing, and by lobbying legislative and regulatory bodies on health care issues affecting nurses. And the audience.

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Source: Massachusetts Nurses Association

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