s
s
Sections
Sections
Subscribe

The slow comeback

Until recently, facilities like Aurora Hospital weren’t being built. Instead, they were either closing or decreasing the number of beds, primarily due to the following:

  • Workforce shortage, exacerbated by the 2004 nurse-to-patient ratio (one nurse for every six patients in a psychiatric hospital)
  • Hospitals not meeting seismic retrofitting requirements
  • The overall complexity of the behavioral health system, including variances in health plans among the state’s 58 counties.

Source: California Hospital Association

Aurora Santa Rosa Hospital, a freestanding acute psychiatric hospital in Santa Rosa, is growing in a health care segment that historically has been shrinking.

Aurora, which currently has 95 licensed beds, is adding another 49. And construction is underway on a building expansion that will double the size of Aurora’s outpatient program, adding 3,500 square feet.

The hospital will begin filling the additional 49 beds in January, according to CEO Susan Rose. Even with the expansion, the hospital still will be short 100 beds based on need, she added.

Aurora is one of just 15 freestanding acute psychiatric hospitals (APH) in the state, and one of two in the North Bay — the other is Adventist Health Vallejo in Solano County, according to the California Hospital Association. In addition, of the state’s 58 counties, there are 24 with no inpatient psychiatric services at all.

“I think, historically, we have seen a downturn in the number of new openings, but since about 2015, we’ve started to see an uptick,” said Sheree Lowe, vice president of behavioral health, California Hospital Association. “The population is growing and the state of California has significantly increased the health insurance for individuals that now can access treatment.”

Since 1995, the state’s population has grown by nearly 25%, she added.

“It’s small growth and it’s slow growth, but it’s also very expensive in the state of California to build a new hospital,” Lowe said.

But for Aurora’s parent company, Corona-based Signature Healthcare Services LLC, the expense comes with its business model. Signature (SHS), is a privately-held psychiatric hospital chain with 16 hospitals nationwide, according to Alan Eaks, senior vice president and chief operating officer.

“The cost of construction of new beds in the region is approximately $500,000 per bed, so a large investment has been made in this expansion effort for the Santa Rosa community,” Eaks said, adding that the total project cost is approximately $24.5 million. “The expansion has been in the works for three to four years, due to the demand for additional mental health services in the region.”

The company’s largest concentration of hospitals is in California, totaling six hospitals, and soon to be seven with the opening of its 117-bed hospital in Sacramento, Eaks said.

“The total project cost of the Sacramento hospital is approximately $40 million,” he said. “Signature chose Sacramento to build because there is an unmet need for services in the area. Although services exist, the demand is greater than the current provider footprint in the area.”

Elsewhere in California, Signature so far this year has added 21 beds to its Aurora San Diego Hospital and is currently building a new 120-bed expansion facility in Pasadena, at its Las Encinas Hospital, he said.

“In the next five years, we have aggressive expansion plans in California, with approximately five more new hospitals in development,” Eaks added.

Signature’s hospitals — most branded as Aurora — provide a variety of inpatient and outpatient programs. Each Aurora hospital contracts with most managed care companies, and accepts patients on Medi-Cal and those without insurance, according to Signature. All of its facilities are accredited by the federal Centers for Medicare & Medicaid Services (CMS) and The Joint Commission, the U.S.-based nonprofit organization that accredits more than 21,000 health care organizations and programs nationwide.

The slow comeback

Until recently, facilities like Aurora Hospital weren’t being built. Instead, they were either closing or decreasing the number of beds, primarily due to the following:

  • Workforce shortage, exacerbated by the 2004 nurse-to-patient ratio (one nurse for every six patients in a psychiatric hospital)
  • Hospitals not meeting seismic retrofitting requirements
  • The overall complexity of the behavioral health system, including variances in health plans among the state’s 58 counties.

Source: California Hospital Association

Referrals are how Aurora Santa Rosa Hospital receives its inpatients, whose average stay is between five and nine days, Rose said. The facility serves a wide swath, from the Central Valley to the Oregon border. Only 23% of Aurora’s inpatient referrals come from Sonoma County. The facility employees 260 people and has approximately 30 physicians on staff.

Although local patients don’t make up the majority of Aurora’s hospital admissions, its outpatient programs are largely targeted close to home, according to Rose.

“Since we’re based here in Sonoma County, we look at our county’s needs first,” Rose said, explaining program development is her primary focus. “New programs emerge from looking at the data, speaking with our referral sources and asking ourselves what is missing. We also consider our staff’s areas of clinical interest and expertise.”

So far this year, the hospital has added programs that include treatment for victims of traumatic events; an adolescent-intensive outpatient program; twice-weekly equine therapy; and monthly “lunch and learn” presentations on behavioral health topics.

Aurora also is collaborating with Stanford Medicine to develop programs for families traumatized from the October 2017 wildfires, an initiative facilitated by Cynthia Kane-Hyman, director of quality assurance and performance improvement at Aurora. Her background also includes trauma-focused psychotherapy.

And Rose is in the process of developing a perinatal mood disorders and anxiety program, which includes post-partum depression — a hot topic nationwide, as recently evidenced on the state level.

When Gov. Gavin Newsom signed the state’s budget on June 27, the bill included the expansion of Medi-Cal services for low-income women diagnosed with post-partum depression, from two months post-birth to a full year post-birth. The expanded law also extends to the uninsured.

Aurora also is in negotiations with the San Francisco Veterans Affairs Medical Center to transfer some of its patients to Aurora while the medical center remodels its inpatient psychiatric unit, according to Rose.

She also is tackling the shortage in nurses and physicians who specialize in psychiatry.

Aurora has agreements with Santa Rosa Junior College, Sonoma State University and the College of Marin that allows nursing students to complete the psychiatric-nursing portion of their residency program at the facility for five to six weeks.

And Rose hopes to attract more psychiatrists to the facility as part of what she calls her “wish list” for Aurora’s future development. One of those wishes is to build medical offices on the site, which could be a vehicle to attract more physicians, largely because they would be able to perform both their inpatient and outpatient work in one place.

“It can take about two years from concept to completion to see big ideas go from a wish list to actualization,” she said, adding that there are many variables, such as timing and the right people to champion a project. “But once I see the green light, it will take me two weeks to start making it happen.”

Staff Writer Cheryl Sarfaty covers tourism, hospitality, health care and education. Reach her at cheryl.sarfaty@busjrnl.com or 707-521-4259.