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Kish Hospital gets state approval to close the Mental Health Unit

Daily Chronicle Sept. 2, 2009
KCH mental health unit to close
By DANA HERRA - dherra@daily-chronicle.com

SPRINGFIELD – A state regulatory board Tuesday gave Kishwaukee Community Hospital permission to close its acute mental illness unit. The closure is expected to occur within 30 days.

The Illinois Health Facilities Planning Board voted Tuesday morning to close the unit during a meeting in Springfield. The planning board, a division of the Illinois Department of Public Health, is tasked with ensuring the supply of medical space and services is in balance with demand across the state.

The decision ended a process that began last fall, when Kishwaukee asked for permission to close the six-bed unit, which administrators have said is underutilized and difficult to staff.

“There have been no patients on the unit since May,” hospital administrator Brad Copple said after the board’s decision. “When you’ve got more than 90 percent of your days trying to operate a quality, highly-effective unit with two patients or less and 70 percent of days no patients, it’s very challenging.”

Hospital administrators told the board they have had difficulty retaining qualified staff to work in the unit, despite spending millions on recruitment efforts in the last several years. They said most highly-skilled professionals prefer to work with a larger patient population or find outpatient care to be more lucrative.

Kishwaukee has provided inpatient mental health care since it opened more than 30 years ago, and its plans to end the service have met with strong opposition. Opponents have said the service is a necessary safety net for the most vulnerable members of the community.

“I’m very disappointed,” said Thomas Kirts, a retired psychiatrist who previously administered the unit. “When it was well-run and had competent administration, it was a good unit and patients were admitted. Instead of correcting any problems they had, they just decided to abandon it.”

Kirts and Jack Bennett, a member of citizens group DeKalb County Citizens for Better Mental Health Care, said the board appeared not to have read all of the testimony from a May public hearing about the closure. At that hearing, 17 people spoke out against the closure and 15 spoke in favor of the proposal; nearly all of the proponents at that meeting worked for KishHealth System, of which KCH is a part of.

Board members asked few questions of administrators, concerned mostly with what will happen to mental health patients who come into the hospital through the emergency room. If the patients require hospitalization, they will be transferred to one of several regional hospitals in Rockford and the suburbs that have agreed to take on patients from Kishwaukee, KCH administrators said.

Opponents have argued that transferring patients out of the area creates a lengthier admissions process and makes it difficult for family and friends to visit them. It also makes reintegrating into the community difficult, they said.

Ex-officio board member David Carvalho, deputy director of the Illinois Department of Public Health, tried to determine how IDPH found several months ago that the hospital’s planning area has a shortage of mental health beds, though none of the hospitals in the area were at the 85 percent utilization rate that is the state standard.

“Hospitals don’t admit patients, doctors admit patients, and just because you build it doesn’t mean they’ll come,” Carvalho said. “You really can’t run an inpatient (acute mental illness unit) unless you have psychiatrists who really want to do it. That leaves the board in something of a struggle, because our rules indicate your closure would create a need for beds, but just because you have the beds doesn’t mean anyone is using them.”

Copple said the unit is presently empty. Provided no new patients are admitted, administrators will meet with staff from both the unit and emergency department to determine a date for closure. The hospital’s request indicated it would close the unit within 30 days of board approval; it may close sooner, he said.
Copyright 2009 Daily Chronicle

Daily Chronicle editorial Sept. 5, 2009
Closing Kish mental health unit tough, but the right call

The Illinois Health Facilities Planning Board voted Tuesday to allow Kishwaukee Community Hospital to close its acute mental illness unit. The planning board, a division of the Illinois Department of Public Health, is tasked with ensuring the supply of medical space and services is in balance with demand across the state.?The decision ended a process that began last fall, when hospital officials sought permission to close the six-bed unit, which they said was underutilized and difficult to staff.

“There have been no patients on the unit since May,” KCH Administrator Brad Copple said after the board’s decision. “When you’ve got more than 90 percent of your days trying to operate a quality, highly effective unit with two patients or less and 70 percent of days no patients, it’s very challenging.”

Plans to end the service met with strong opposition. We understand those passionate advocates who believe the service is a necessary safety net and fought for the service to continue, but passion is unfortunately not enough to keep the unit in service. Not when other pressing needs in the community require the use of finite and, particularly in this economy, shrinking resources.

Like any business or government entity operating in a brutal economy, Kishwaukee Community Hospital officials have to make difficult decisions about how best to serve the community. We believe officials made a convincing argument that the resources being allotted to an underutilized acute mental illness unit that rarely housed a patient could be better used elsewhere. State regulators who reviewed the situation came to a similar conclusion.

There were certainly valid arguments to oppose the closing, and opponents were given an ample forum in which to express those concerns. Unfortunately, some chose to turn their arguments into personal attacks against hospital administrators, straying from the issue at hand to rail against an administrator’s pay, or to assign a motive that did not exist. This tactic tends to generate sympathy and passion around extraneous details rather than contribute to an informed debate. Most health care issues are highly complex and require thoughtful, well-considered advice from many different voices before making the final, difficult decision.

It is important the community continues to be one of those voices. But with that comes the responsibility to stay focused on real issues, and not allow the conversation to be dominated by extraneous details.

We believe hospital officials made the correct assessment that Kishwaukee Community Hospital is not the best place to provide inpatient mental health services at this time. We appreciate that this unit has operated for 30 years, but after three decades, it’s easy for something to become so entrenched it is overlooked. We applaud administrators for taking a hard look at the unit, assessing its value and working through the difficult regulatory and public comment process.

We sympathize with those who will have to use a regional hospital farther away, but the harsh reality is that keeping this unit open would ultimately lead to reducing other services. A community hospital can only function by providing the best possible range of care to its patients. When services are required that involve a very small number of patients, we believe better solutions can be found than a community hospital.

We hope with the closing of Kishwaukee’s acute mental health unit, discussion can now turn toward better alternatives rather than artificially supporting the status quo.

Copyright 2009 Daily Chronicle

Chronicle letter to the editor Wednesday, September 9, 2009


Problems with Kish hospital and the Daily Chronicle


To the editor:

Kishwaukee Community Hospital and the Daily Chronicle upheld the view that the only acute behavioral health inpatient unit within DeKalb County available to the nearly 100,000 residents should be closed.

Certainly, the unmet needs of the mentally ill and their families are the most important issues at stake. But also strikingly unnerving is the fact that a community paper would take sides in a local discussion that could be an opportunity for investigative reporting that would shed light on a vital issue – mental health.

Hospital staff in the behavioral unit at McDonough Hospital in Macomb reported that inpatient care is needed every week. How could there be no one needing behavioral health inpatient treatment in DeKalb County since May? By eliminating the behavioral health unit, Kish fails to acknowledge the medical underpinnings of behavioral health.

The Daily Chronicle’s poll showed approximately 73 percent of readers disagreed with the decision to close the unit. Many voices understand what is at stake, and the Daily Chronicle presumes to “understand those passionate advocates.” It is incredibly patronizing and demeaning to suggest the advocates of mental health treatment are somehow emotionally involved beyond reason or are acting out of sympathy rather than fact. The remark about “state regulators coming to a similar conclusion as the hospital,” when those three state regulators are what is left of a seven-member board, are lobbied by representatives of the hospital association, and did not allow testimony on Sept. 1 from a single opponent of the hospital’s petition is worse than being emotional. It’s misleading.

The Daily Chronicle suggested opponents used personal attacks. Did the Daily Chronicle feel the sting when CEO and other administrator salaries were exposed? That’s not getting personal. Nonprofit organizations with integrity welcome such scrutiny.

Reading the opinion page on Saturday filled me with some disgust to once again hear the hospital bemoan its “difficult decision.” Beginning the process without preliminary, extensive community input, answering questions only privately and preferably individually – not in any kind of a forum, changing the focus when it was found there is actually a shortage of inpatient mental health beds in the area and pushing a decision through a three-member board down in Springfield sound less than painstaking.

Kishwaukee Community Hospital and the Daily Chronicle made their priorities clear and won. Too bad it was all about closing doors instead of opening them.

Christi Slavenas


Online Comments on Chronicle editorial about closing the Mental Health unit

BF51 wrote on September 4, 2009 6:26 p.m.

"Actually as Mr Carvalho politely pointed out to the kish administrators. "Just because you have the beds, doesn't mean that they are going to be used" telling the hospital administrators that running a successful ward takes leadership as well.This hospital is starting to look like their exclusive club. I heard they celebrated a marriage in the healing garden!!!! This greedy administration is so focused on making money that they are defacing our hospital in the most unbelieveable way. And yes when you are facing a failing administration, it does matter how much we are paying them."


BF51 wrote on September 4, 2009 6:39 p.m.

"I suppose the 3 million that the hospital sinks into paying Kevin Poorten and his vice presidents is one of the "pressing needs" of the hospital. Unquestioneably, if the president and the VPs donated one year of their lavish wages to the hospital selflessly,then we would have been able to keep the ward open and they wouldn't have to"sympathize " with the mentally ill who will be transfered to a far away hospital. This is why exposing the pay of the top officials is very relevant and not a personal attack. BTW who is "we"? Why don't you sign yourname."


BF51 wrote on September 4, 2009 7:06 p.m.

"and since when is the chronicle interested in discussion? They have erred from their mission as neutral reporters and licked Kish administration's boots. You guys don't look like somebody who has the public's interest at heart.I am glad that you did describe the closed/open psychiatric ward as "artificially maintained".I don't think that there is one person in this county who doesn't understand why the psychiatrists couldn't work with these reckless inept so called administrators.Half the time they don't make sense and the other half they don't know what they are talking about!!!! "


galipolopoly wrote on September 4, 2009 10:10 p.m.

"And just for the record, in Barry Schrader's defense, since KCH is not for profit, the administrators' salaries is a matter of public record. It is a matter of public interest as well for all the reasons you so eloquently stated, BF."


Kay Shelton wrote on September 4, 2009 11:35 p.m.

"The Planning Board's three voting members all have terms that started during Blago's era and only one of them has Doctor in front of his name: http://www.idph.state.il.us/about/hfpbmembers.htm What is up with all of that?"


BF51 wrote on September 5, 2009 6:27 a.m.

"Absolutely Goli! There is also evidence that they have taken funds from the operating cost of the new hospital to finish the construction, including a lavish and expensive healing garden that they are renting out for weddings and fundraisers. Now they claim to be in a cash crunch to the point that they have to close down core competencies, because the operational funds are already spent. Looks to me that they are running a hotel only they are receiving subsidy from the taxpayers for it. "


BF51 wrote on September 5, 2009 6:41 a.m.

"Besides they have tried to squeeze money out of Dekalb County Board in exchange for keeping the ward open. I think that the people of Dekalb County are weary of enabling people who hold people's health as hostage for getting money. I believe they just executed their hostage, the mental health ward. And Kay, the chronicle has gone out of it's way to expose Illinois officials as corrupt and biased. It seems that the author of theletter has had a change of heart lately and sings the praises of the government now."


Antiskeptic wrote on September 6, 2009 10:32 a.m.

"Closing the mental health unit is not the only indication of misspent funds. They outsource their doctors which would explain why they botched a surgery on my daughter after a car accident caused a tear in her intestines. They put them back in wrong and only a crisis surgery to remove an intestinal blockage and infected appendix which almost cost my daughter her life while in the Army alerted my family. The Army docs are a tough bunch but this even amazed them."


Antiskeptic wrote on September 6, 2009 10:42 a.m.

"The psychiatric patients are better off at hospitals where there illnesses are recognized as biological disorders of the brain and they are treated with dignity. I would not advise anyone togo to either Kish campus for medical care. We travel to St. Charles for our doctors and hospital care."


Antiskeptic wrote on September 6, 2009 10:45 a.m.

"unfortunately, Kish hospital is the only location for DeKalb county residents during a 911 emergency. DeKalb County needs a new state of the art hospital but that will never happen because kish 's powers that be will boycott it just as they did the opening of an emergency clinic in the southeast part of the county. The center would have interfered with their profit margins."


The King wrote on September 6, 2009 10:59 a.m.

"Pathetic. Private rooms, big screen plasma TV's, internet access, meals made to order, the best of everything for our country-club set. The IRS needs to reconsider their not-for-profit status. Pathetic."


galipolopoly wrote on September 6, 2009 2:02 p.m.

"Hmm, perhaps they are not-for-profit only because all the profits go to the administrators."


BF51 wrote on September 6, 2009 8:02 p.m.

"It is a government subsidized country club that you would book if you have a wedding, but don't go there if you are sick!"


Kay Shelton wrote on September 6, 2009 9:56 p.m.

"The hospital books weddings? OK, maybe I can see that if two hospital employees got married because there are lots of people who meet at work and decide to get married at work but that does not make any sense to me for non-hospital employees to get married there. Is that really happening? People go to the hospital when they are sick, not to get married. Hi Antiskeptic, perhaps what we need is not a new hospital but new hospital administrators. I dealt with someone today who was off her meds-she-could-barely-function. The-need-is-there-for-better-care-for-people-with-problems. "


BF51 wrote on September 6, 2009 10:20 p.m.

"Kay it doesn't make any sense for hospital employees to get married at the hospital either. My point, there is a lot of fundraising, weddings, best cook of the year events, but we don't have resources to support core competencies.I really cannot understand the attack on Barry Schrader for revealing the salaries. I cannot believe any reporter calling that a personal attack.You would think that the chronicle would be a little discrete in their support of this inept administration. "


Otis The Cockatoo wrote on September 7, 2009 12:05 a.m.

"Antiskeptic, how much did the family get from the malpractice lawsuit if what you say is true? Unlike the city of DeKalb , Kish Hospital has a vibrant risk management function."


lime60178 wrote on September 7, 2009 1:39 a.m.

"Well, after all, who really needs a mental health ward with all of those empty buildings in Park 88? We could go back to the olden days and simply warehouse our menatlaly ill, or give them bus tickets to California or Vermont . Maybe if we denied that we had any such issues in the community, it would all go away. Or, we could get the City to build a free standing MH clinic with TIF money, complete with a skating rink. Is it beginning to seem like we have too many government entities involved in our lives?"


lime60178 wrote on September 7, 2009 1:42 a.m.

"By the way, was the KCH Healing Garden arranged using Feng Shui? Also, have they bought the magic unicorn yet to solve all the mystery diseases? And do they have an area for smoking when the medical marijuana law gets passed (perhaps they can call it the Cheech and Chong Pavillion)? "


BF51 wrote on September 7, 2009 8:40 a.m.

"Otis, how much who got from their law suit is really between them and the hospital. There were a few deaths related to poor mental health care over the summer andearly fall of 2008. I suppose then the "vibrant risk management department" advised the administration to turn to hosting parties and weddings instead of treating the mentally ill. Jo Dant and Brad Copple have made a "convincing argument" that they cannot run a psychiatric unit. My question is, why should we leave them in charge of the remainder of the hospital after such a pathetic failure."


resident955 wrote on September 7, 2009 9:13 a.m.

"I think it is a SHAME to close the unit when there are alot of people out there with Mental Issues. And they say keeping the unit open will reduce in other Services? I think that has already happened. "


katied2 wrote on September 7, 2009 9:30 a.m.

"The Chronicle is not going to say anything against Kish Hospital because Kish is one of the largest advertisers. It is obvious Kish built the new unit with the intention to close it. They didn't want doctors to admit patients, and there was no difficulty staffing as they had enough nursing and tech staff. The Chronicle has never been critical of the hospital, but then again, they're never critical of the hand that feeds them."


Kay Shelton wrote on September 7, 2009 10:54 a.m.

""dekalb bee wrote on September 7, 2009 7:14 a.m. "Rumor has it the aforementioned couple used the birthing suite for their ahemmmmm "honeymoon" suite."" **IF** that rumor is true, then EEEEEEEWWWWWWWWWWW!!!!!!!! Now there is a couple that NEEDS the MENTAL HEALTH WARD!!!!!! Also, obviously DeKalb needs better hotels, too."


Heiden Zeek wrote on September 7, 2009 12:50 p.m.

"Instead of shutting down the Mental Health Ward, maybe someone should have just shut down the entire hospital. Get rid of the pretend doctors and nurses and get a real hospital in here. With real doctors and nurses and a real staff that actually cares about patients."


Concerned-Dekalb-Citizen wrote on September 7, 2009 4:36 p.m.

"Shame on you Dekalb Chronicle for supporting this decision! By suggesting that to keep the behavioral unit risks compromising other services only communicates to me that those with MI issues are LESS THAN and not valuable members of our community! Closing this unit puts many individuals at risk and compromise thier health. KISH decision is not about Community Services but about MONEY. The real story here is about profit and not about service! Your article is flawed since you didn't report that KISH hasn't taken MI patients for QUITE A LONG TIME - easy to justify its closing then!"


BF51 wrote on September 7, 2009 8:33 p.m.

"Kay I think bee was joking. However the wedding at the hospital was no joke. Rather an odd choice for any couple I must say. But aren't hospitals supposed to be noise free. How can the administration allow somebody to disturb the peace by hosting a wedding at a hospital!!! Anoter example of this administration'svision for the future of the healthcare in Dekalb. "


Kay Shelton wrote on September 7, 2009 9:41 p.m.

"I hope Bee was joking!! Nothing would surprise me in this town!! I have yet to be in a hospital that was noise free. I spent time in five of them, and could not sleep in any of them. This time, I had ear plugs with me and I still could not sleep. I was hooked to an IV pump that tick, tick, tick, tick, etc. bump, tick, tick the whole time, with the pump going off once an minute. Had the thing not been attached to me, I-might-have-opened-the-door-and-kicked-it-down-the-hall."


Kay Shelton wrote on September 7, 2009 9:45 p.m.

"I spent time at old Kish Hospital and had a room right outside some storage closet. Every few minutes some nurse would punch in the security code, beep, beep, beep, etc. to get let into the thing. Then, I could hear the staff goofing off down the hall. My goodness, where are the design engineer's brains? The security key pad did not need to make noise, the IV pump this last time did not need to be so loud, and no patients should have to hear staff goofing off down the hall-in-the-middle-of-the-night!!"


yo_ribbit wrote on September 8, 2009 8:16 a.m.

"It's sad to hear all the negativity that follow these articles. Has anyone traveled outside of DeKalb to any of the other hospitals? With the new hospital, Kish is finally up to par with all the other hospitals. It's a community hospital. We're blessed to have one so close by. It's all about the healing environment and trying to make the patients feel a little more at home. I still don't think anyone fully understands the mental health closing. Kish fully explains the reasoning here http://www.kishhospital.org/CBH_Learnthefacts.html."


Mr Kevin wrote on September 8, 2009 2:23 p.m.

"Who is to say what administrators should make? Apparently someone allowed this to happen, and there wasn't a big squawk about it, so it must be sanctioned and okay. Do I think it is excessive? Yes, but I also think professional sports players are way overpaid, CEO's are overpaid, most of America is overpaid, which is why we can't compete globally. The point here is Kish saw a need to eliminate a wasteful program, but don't see a need to "tidy their own house" so to speak."


galipolopoly wrote on September 8, 2009 2:39 p.m.

"Wasteful? You think that psychiatric care is wasteful? Well, all I can say is that I hope your friends and family will never have to require emergency psychiatric services because only then you will understand what family members of the mentally ill have to go through every day."


Altamonte09 wrote on September 8, 2009 4:00 p.m.

"It is not surprising that Kish closed the unit. There were rumors that they would before they opened the new hospital. They have little intentions to help people in crisis but to send them to the state hospital once they find out that these patients have no insurance. One of their requirements were to have patients to voluntary admit themselves. How could patients in crisis recognize that they need this kind of care and agree to admitting themselves? The state laws need to be changed as well."


RepoDeKalb wrote on September 8, 2009 4:21 p.m.

"Life imitating art, in this case that General Hospital soap opera. I wonder if connected DeKalb elites often drop in for lunch? Do you think they had the wedding reception at the hospital also? "


opportunities wrote on September 8, 2009 4:50 p.m.

"Administrators at a "community" hospital would listen to the community. The community spoke in favor of keeping the mental health unit, and we got ignored."


Altamonte09 wrote on September 8, 2009 6:34 p.m.

"I am wondering if the local psychiatrists will have to relocate since they will not be able to admit anyone localy. What is the assentive for them to stay? Where would their After the shooting at NIU, people loosing the jobs and their homes, now there will not be any care given the local hospital.This puts a greater demand on the mental health system, not at Kish tho. Why should they care? It is not their problem. "


lifeisbeautiful wrote on September 8, 2009 8:19 p.m.

"let's please not bring up the shootings without factual information, atlamonte... many organizations within the community had the back of all the NIU students, faculty and staff by "offering" their staff, both support and clinical to the university to work thru the tragedy. Did you happen to read up on this before you blogged, or were you even in the area when it occurred? People need to be assessed before they see a psychiatrist or psychologist anyway. Therapy dogs, professionals from Virginia Tech were also brought in. This truly is not fodder for this topic."


Mr Kevin wrote on September 8, 2009 8:35 p.m.

"I was being sarcastic with the term "wasteful" although it must be so in the eyes of decision makers."


galipolopoly wrote on September 8, 2009 11:27 p.m.

"From what I understand, the remaining psychiatrists must fulfill their contracts by remaining at Kish to do consults until their contracts expire. One of the reasons behind the closure is that these psychiatrists prefer not to work in an inpatient setting. In other words, after their contracts expire, these psychiatrists would be perfectly happy to see patients in their offices and then sent them outside the community for inpatient care as needed."


BF51 wrote on September 9, 2009 5:45 a.m.

"Gali,wrong again!I spoke to them, The psychiatrists had no objection to working on a "safe" inpatient ward. But as I said before the level of care was declining every year in this "wasteful" ward and the administration turned a deaf ear to their warning that patients were in harm's way. When a few deaths occurred the hospital concluded that they should close the ward and told the psychiatrists. If the administration had kept the ward open they would still be working. They have no choice but to provide services, if the hospital offers them. "


BF51 wrote on September 9, 2009 5:52 a.m.

"The only one unfavorable to working on the inpatient ward is , surprisingly the medical director, Dr Hadi!!! Dr Dennison a hasn't worked at the inpatient ward for many years now. I believe Dr Kraft never worked inpatient. This has nothing to do with the contracts.By law the hospital can require the psychiatrists to work , but my understanding was that the hospital didn't want the ward and made sure that the conditions were such that no physician dared to admit. Why don't you go and ask the Drs what they want to do later instead of guessing"


BF51 wrote on September 9, 2009 5:56 a.m.

"3 of the psychiatrists are still under contract and they are sending patients out. That should tell you that sending patients out has nothing to do with whether or not a dr is under contract.The reason is that Kish is no longer providing the services. They cannot admit them locally."


BF51 wrote on September 9, 2009 6:26 a.m.

"who told you these lies?"

" Kish administration probably!"

Links to Corespondence, and Testimony

Kish Hospital gets state approval to close the Mental Health Unit

Mental Health Advocate- October 2009

Dr. Foroutan Letter to the State

the DeKalb County Citizens for Better Mental health Care

State decision on mental health unit postponed



Letter to the Editor 1

Letter to the Editor 2

Letter to the Editor 3

Letter to the Editor 4

Letter to the Editor 5

Letter to the Editor 6

Letter to the Editor 7

Letter to the Editor 8

Hospital execs' salaries revealed

Letter to the Editor 9

Article 1

Article 2

Article 3

Article 4

NAMI Letter

Highlights of Application

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Barry Schrader
PO Box 851
DeKalb, Ill 60115