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County psychiatric health facility reports higher admissions, cleaner audits and improved revenue mix
Summary
Behavioral Wellness officials said the county’s 16‑bed psychiatric health facility (a federally certified "super PUFF") is seeing rising admissions, lower average length of stay, improved acute‑day revenue mix and clean clinical audit results; the board received the FY24–25/25–26 report.
Behavioral Wellness Director Tony Navaro told the Board on May 12 that the County’s 16‑bed psychiatric health facility — designated in state/federal terms as a "super" facility because it meets CMS and DHCS criteria — reported a rise in hospitalizations, a drop in average length of stay and improved billing mix that is producing the highest medical revenue the unit has seen in recent decades.
Navaro explained staff efforts to distinguish acute days (patients meeting 5150 criteria) from administrative days and to strengthen discharge pathways and step‑down placements. "We're on track this year to have the highest producing medical revenue that the PUFF has seen in at least the last 20 years," he said. Director Navaro also noted partnerships with local hospitals and new electronic packet transfers to speed placements.
State auditors found no clinical findings during their onsite reviews in the past two years; Navaro told the board the auditors — each with decades of experience — were "astonished and pleased" to encounter clean clinical audits and identified only minor operational deficiencies that the facility has already addressed with improvement plans.
The facility is a 16‑bed acute inpatient unit serving persons on 72‑hour holds (5150). Staff said the mix between acute and administrative bed‑days has moved toward a roughly 50/50 split, which helps reimbursement because acute days bill at a higher rate. Navaro outlined investments in staffing (a new psychiatric nurse supervisor), infection prevention and an accreditation readiness assessment by an outside consultant.
Supervisor Caps, the board’s PUFF representative, praised the staff and the monthly governing‑board oversight process and asked whether shorter lengths of stay were driven by increased downstream capacity; Navaro attributed the improvement to added step‑down beds, enhanced discharge planning and better coordination with crisis residential services.
The board voted unanimously to receive and file the PUFF report. Staff will continue monthly oversight through the PUFF governing board and provide the board with performance measures and any material changes to operations.
Why it matters: The PUFF is a rare county‑operated, CMS‑certified inpatient psychiatric unit; strong audit results and improved revenue may preserve local acute psychiatric capacity and reduce out‑of‑county placements.
