The geriatric psychiatry unit is a 31-bed locked inpatient unit on the 10th floor of the main hospital tower. The unit is divided into two hallways, one currently operational and one available for expansion. This design gives the hospital flexibility to run them as two smaller units or open the connecting door and operate a single combined unit.
Current census runs between 14 and 16 patients due to prior restrictions on admission criteria. Leadership is confident the unit can reach 28 active beds once those restrictions are removed and referral pipelines are rebuilt. The volume is there; the program just needs a physician willing to treat the full geriatric psychiatric population.
| Detail | Information |
|---|---|
| Total Beds | 31 |
| Target Census | 28 active beds |
| Current Census | 14–16 patients |
| Room Types | Private and semi-private (no ward-style rooms) |
| Oxygen-Capable Rooms | 5 rooms with oxygen access for medically complex patients |
| Unit Type | Locked |
| Floor | 10th floor, main hospital tower |
The program targets patients 55 and older across the full spectrum of geriatric psychiatric presentations. Leadership is committed to accepting medically and socially complex patients who are often difficult to place elsewhere.
The program accepts patients with significant social and medical complexity, including:
Patients with a history of violence or those who are not appropriate for the therapeutic milieu are transferred to higher-acuity facilities. Self-pay patients with higher violence risk are directed to the adult unit at the Archer campus.
The physician participates in a consult rotation for patients admitted to medical floors. Consults are typically aligned with the physician's call week, keeping the schedule predictable.
| Detail | Information |
|---|---|
| Consult Volume | 0–6 consults per day depending on census |
| Rotation | Approximately 1 week per month |
| Response Timeframe | Within 24 hours of request |
Nursing home coverage is a core part of this role and one of the primary drivers of inpatient referrals. The hospital previously supported an active nursing home psychiatry program and is rebuilding it.
Nursing home visits are expected to become the primary volume driver over time. As the network expands, outpatient clinic days are expected to decrease accordingly.
Outpatient clinic participation is optional and flexible. Current structure, if included, runs three days per week in four-hour afternoon blocks.
| Detail | Information |
|---|---|
| Clinic Days | Up to 3 days per week (flexible) |
| Session Length | Half-day afternoon blocks |
| Patient Volume | 8–10 patients per session |
| New Patient Appointments | 1 hour |
| Follow-Up Appointments | 30 minutes |
As nursing home volume grows, clinic days are expected to be reduced or eliminated based on physician preference.
| Detail | Information |
|---|---|
| Call Frequency | Approximately 1 week per month |
| Call Days | Monday through Friday |
| Weekend Coverage | Covered by psychiatric nurse practitioners |
| Overnight Call | Primarily phone-based; rare need to return to hospital |
| Holiday Coverage | One holiday per year on rotation |
The unit's 24-hour intake team manages admission logistics overnight, including reviewing referrals and issuing standing orders based on physician preferences. Physicians are rarely called in for physical returns. Most overnight contact involves phone consultations or medication orders.
The program uses a structured interdisciplinary model. The physician focuses on psychiatric evaluation and medication management. The team handles everything else.
Hospitalist coverage is available 24 hours a day, 7 days a week for medical complications. Hospitalists manage physical illness, medical decompensation, and transfers to medical floors. Psychiatrists focus exclusively on psychiatric care and are not expected to manage medical issues independently.
The hospital also has a direct admission pipeline from nursing homes with a dedicated $85,000 wheelchair-accessible transport van, bypassing the emergency department for appropriate geriatric admissions.
The unit is designed for lower-acuity behavioral patients. Staff are trained in crisis intervention and de-escalation techniques. Physical restraints were used only three times in the past year, down significantly from prior practice.
Patients who escalate beyond the unit's capability are transferred to higher-acuity facilities rather than managed in-unit.
The hospital transitioned to Epic in October 2024. Billing is managed in-house by a dedicated coding team that audits documentation and assists physicians with appropriate coding. The physician does not manage billing independently.
Epic's AI documentation tools are available and increasingly used across the medical group. Physicians report significant improvements in note completion and billing accuracy.
Leadership has expressed interest in restoring and expanding services that were previously active under prior medical director leadership. Opportunities under discussion include:
The hospital has experience with all of these services and the infrastructure to support them. Timing depends on physician interest and program readiness.