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Tukwila psychiatric hospital to close, lay off nearly 300 staff

Seattle Times - 6/3/2023

Jun. 2—Less than two years after a lengthy showdown with health care staff over workplace safety, a large psychiatric hospital in Tukwila is closing and plans to lay off an estimated 288 employees, the facility announced Friday.

Cascade Behavioral Health Hospital, a 137-bed psychiatric facility owned by Tennessee-based Acadia Healthcare, has begun to rapidly discharge patients and expects to cease operations by July 31.

By Friday, fewer than 40 patients remained in the hospital's open wards, officials confirmed.

The facility has served an estimated 25,000 patients since it opened a decade ago, according to its estimates. The hospital takes voluntary patients as well as those who are committed to treatment involuntarily because they're a threat to themselves or others, or because they're unable to care for their own physical and mental well-being.

Its closure adds pressure to an already strained mental health system that's plagued by workforce shortages, long patient wait times and a severe lack of inpatient beds. Most patients receive treatment at Cascade for seven to 10 days, officials said. But staff acknowledged that some people stay weeks or months because it takes so long to find safe and appropriate places to discharge them to, raising concerns that some current patients may discharge into homelessness.

The hospital declined to offer specifics about its financial situation or reasons for the abrupt nature of the closure, which was announced at an all-staff meeting Thursday around 11:30 a.m., according to a staff member who attended.

Medical staff, kitchen workers, finance and admissions employees filled the facility's cafeteria after being called in with little warning about what was to come. The room went quiet when the closure was announced.

"Everybody was in shock. Nobody was expecting this," said Meseret Amare, a behavioral health technician who has worked at Cascade since 2015 and was at the meeting. "They didn't give us a lot of explanation."

The company didn't offer severance pay, staff said, something members of the Service Employees International Union Healthcare 1199NW union say they plan to address with management. Company officials declined to discuss employee termination agreements.

The hospital has in recent years been roiled by concerns over safety and staff-to-patient ratios, and in 2021, SEIU Healthcare 1199NW members went on strike for over three months before signing a new contract containing more workplace protections.

The strike sowed deep tension between the union and management — at least 24 workers were fired for striking — but staff morale improved and workplace injuries dropped since workers returned, said Meskerem Ereso, a nurse at Cascade.

It seemed like the hospital was moving in the right direction, she said. News of the closure, she said, is most alarming for the vulnerable people she serves each day.

"We can find a job," she said. "It's easy to find a job. But closing a big hospital? That's a harbor place for our patients, and where do they go now?"

Finding suitable care for patients, especially those with chronic or severe symptoms, will be difficult during a shortage of psychiatric beds at the state's hospitals and treatment centers. Even before news of the closure Cascade "often" discharged people to shelters, Ereso added.

Cascade plans to work with local and state agencies to transition patients "to the appropriate services," officials said in the emailed statement. Every patient will have a discharge plan, said a consultant hired by Cascade who asked not to be named because he wasn't authorized to speak publicly on behalf of the company; he declined to respond to questions about whether that plan could include dropping patients off at shelters.

King County officials were concerned by the closure announcement, which comes just months after voters approved a countywide property tax to fund several new mental health crisis centers. The county is investigating whether it could save the hospital through a partnership with the state and Cascade, said county spokesperson Chase Gallagher, though he didn't have details about what such a partnership would entail.

A spokesperson from the state's Department of Health said the agency is aware of Cascade's decision to close, but could not immediately provide additional information. Staff said DOH investigators were seen at the hospital in May, but the DOH spokesperson declined to respond to questions about whether the agency has any open investigations into Cascade. Hospital officials also declined to comment.

Acadia has not announced closures of any additional psychiatric facilities in recent months, and the company's consultant declined to discuss whether it had plans to downsize or shutter other hospitals. The company owns several other facilities in Washington, including treatment centers in Kent, Lynnwood and Lakewood.


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