Dept of Mental Health & Mental Retardation (ADMHMR)
Alabama Department of Mental Health & Mental Retardation
Agency Address 100 N. Union Street
Suite 408
Montgomery, Alabama 36064
Agency Phone (Main) 334-242-3208
Pam Ward
Accreditation Nurse
334-353-7506
pam.ward@mh.alabama.gov
LeeAnn Woodham
QA Specialist II
334-353-7506
leeann.woodham@mh.alabama.gov
Dr. Danielle Rowe
Director, MI Performance Improvement
334-353-7506
danielle.rowe@mh.alabama.gov
Dr. Beverly Bell-Shambley
Director, MI Facilities
334-353-7506
beverly.bell-shambley@mh.alabama.gov
Bryce Hospital (Bryce):0705_6Ad1Ca
Name Phillip Ward, Director of PI (Acting)
E-mail phillip.ward@bryce.mh.alabama.gov
Tel/Fax Numbers 205-759-0468
Name/Title (2° Rep) Brenda Guy, RN, PI Nurse
Email (2° Rep) brenda.guy@bryce.mh.alabama.gov
Tel/Fax (2° Rep) 205-759-0757
Name/Title (3° Rep) Name/Title (3° Rep)
Email (3° Rep) Email (3° Rep)
Tel/Fax (3° Rep) Tel/Fax (3° Rep)
Hospital CEO Charles R. Cutts
Jt Com Org ID# 1228
Hospital Address 2000 University Boulevard, Tuscaloosa, Alabama 35401
Hosp Website @ADMHMR, @Hospital-Data.com
# Beds - Adult (Civil only) 298
# Beds - Child & Adol (Civil only) 20
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 318
# Beds - CMS Distinct 96
# Units - Total 3
# Staff - Total 657
Survey Dates -TJC May 22-25, 2007
Survey Dates -CMS December 2006
Special Programs/Projects
Greil Memorial Psychiatric Hospital (GMPH)_2Ad*Deaf
Name Celso Backes, Director of Planning and Quality Improvement
E-mail Celso.Backes@greil.mh.alabama.gov
Tel/Fax Numbers 334-262.0363 ext 272
Name/Title (2° Rep)
Email (2° Rep)
Tel/Fax (2° Rep)
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO Allen Stewart
Jt Com Org ID# 723
Hospital Address 2140 Upper Wetumpka Road
Montgomery, Alabama 36107
Hosp Website @ADMHMR, @Hospital-Data.com
# Beds - Adult (Civil only) 66
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 0
# Beds - CMS Distinct 66
# Units - Total 3
# Staff - Total 165
Survey Dates -TJC 3/4-5/08, 3/15/2005,
Survey Dates -CMS 5/2004
Special Programs/Projects 10 Bed Deaf Unit
Mary Starke Harper Geriatric Psychiatry Center (MSHGPC)_2Ge
Name Jerry Doss, Director of Performance Improvement
E-mail jerry.doss@harper.mh.alabama.gov
Tel/Fax Numbers 205 759 0930
Name/Title (2° Rep) Pat Lyons, Risk Manager/Staff Development
Email (2° Rep) Patricia.Lyons@harper.mh.alabama.govPatricia.Lyons@harper.mh.alabama.gov
Tel/Fax (2° Rep) 205 759 0902
Name/Title (3° Rep) Beverly White, Facility Director
Email (3° Rep) beverly.white@harper.mh.alabama.gov
Tel/Fax (3° Rep) 205 759 0929
Hospital CEO Beverly White
Jt Com Org ID# 95728
Hospital Address P.O.Box 21231, Tuscaloosa, AL 35405
Hosp Website @ADMHMR, @Hospital-Data.com
# Beds - Adult (Civil only) 0
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 0
# Beds - Geriatric 96
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 96
# Beds - CMS Distinct 96
# Units - Total
# Staff - Total
Survey Dates -TJC 8/21/08, July 13 - 15, 2005
Survey Dates -CMS June 21 - 23, 2005
Special Programs/Projects
0905_North Alabama Regional Hospital (NARH)_2Ad*HBIPS
Name Schawana Stidham, PI Director
E-mail schawana.stidham@narh.mh.alabama.gov
Tel/Fax Numbers (256) 560-2204 Fax: (256) 560-2203
Name/Title (2° Rep) Dr. Richard Powers, Acting Clinical Director
Email (2° Rep) Richard.Powers@mh.alabama.gov
Tel/Fax (2° Rep) (256) 560-2226 Fax: (256) 560-2203
Name/Title (3° Rep) Peggy Shurney, PI Nurse
Email (3° Rep) Peggy.Shurney@narh.mh.alabama.gov
Tel/Fax (3° Rep) (256) 560-2333 Fax: (256) 560-2203
Hospital CEO Randy Phillips
Jt Com Org ID# 655
Hospital Address 4218 Highway 31 South
Decatur, Alabama 35603
Hosp Website @ADMHMR, @Hospital-Data.com
# Beds - Adult (Civil only) 74
# Beds - Child & Adol (Civil only) # Beds - Child & Adol (Civil only)
# Beds - Forensic # Beds - Forensic
# Beds - Geriatric # Beds - Geriatric
# Beds - MR/DD # Beds - MR/DD
# Beds - Sex Offender # Beds - Sex Offender
# Beds - Sub Abuse # Beds - Sub Abuse
# Beds - Total (all Civil & For) 74
# Beds - CMS Distinct 74
# Units - Total 2
# Staff - Total 179
Survey Dates -TJC 5/22/09, 5/3/2006
Survey Dates -CMS 10/4/2006
Special Programs/Projects Hospital- Based, Inpatient Psychiatric Services (HBIPS) Candidate Core Measure Set
Searcy Hospital (SH)_7Ad1Fr
Name Renee Presley, Quality Improvement Nurse RN III
E-mail renee.presley@searcy.mh.alabama.gov
Tel/Fax Numbers 251-662-6766 / fax 251-662-6936
Name/Title (2° Rep) Abigail Young, Planning and Quality Improvement Specialist III
Email (2° Rep) abigail.young@searcy.mh.alabama.gov
Tel/Fax (2° Rep) 251-662-6863 / fax 251-662-6936
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO Beatrice McLean
Jt Com Org ID# 1403
Hospital Address (725 East Coy Smith Highway ) P O Box 1090, Mt Vernon, AL 36560
Hosp Website @ADMHMR, @Hospital-Data.com
# Beds - Adult (Civil only) 285
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 40
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 325
# Beds - CMS Distinct 140
# Units - Total 3
# Staff - Total 565
Survey Dates -TJC 1/25/07
Survey Dates -CMS 2/07
Special Programs/Projects
1001_Taylor Hardin Secure Medical Facility (THSMF)_3Fr*HBIPS
Name Adele Brouchee, Acting Dir of PI
E-mail
Tel/Fax Numbers 2055567060
Name/Title (2° Rep) Clay Shealy. Director of Clinical Services
Email (2° Rep) Clayton.shealy@hardin.mh.alabama.gov
Tel/Fax (2° Rep) 2055567060
Name/Title (3° Rep) Shelia Taylor
Email (3° Rep) shelia.taylor@hardin.mh.alabama.gov
Tel/Fax (3° Rep) 2055567060
Hospital CEO James F. Reddoch, Jr.
Jt Com Org ID# 1143
Hospital Address 1301 Jack Warner Pkwy, Tuscaloosa, Al, 35404
Hosp Website @ADMHMR, @Hospital-Data.com
# Beds - Adult (Civil only) # Beds - Adult (Civil only)
# Beds - Child & Adol (Civil only) # Beds - Child & Adol (Civil only)
# Beds - Forensic 115
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 115
# Beds - CMS Distinct 24
# Units - Total 3
# Staff - Total
Survey Dates -TJC 1/9/10, 1/19/07
Survey Dates -CMS Survey Dates - ????
Special Programs/Projects Hospital- Based, Inpatient Psychiatric Services (HBIPS) Candidate Core Measure Set
X090331_Arizona State Hospital (AzSH)_4Ad1Ca4Fr
Name Debra Taylor, Chief Quality Officer
E-mail taylord@azdhs.com
Tel/Fax Numbers (602) 220-6102/(602) 220-6288
Name/Title (2° Rep) Christel Snodgrass, PI Specialist
Email (2° Rep) snodgrc@azdhs.com
Tel/Fax (2° Rep) (602) 220-6524/(602) 220-6288
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO John Cooper
Jt Com Org ID# 1572
Hospital Address 2500 E. Van Buren Street
Phoenix, AZ 85008-6079
Hosp Website www.azdhs.gov/azsh
# Beds - Adult (Civil only) 160
# Beds - Child & Adol (Civil only) 16
# Beds - Forensic 162
# Beds - Geriatric N/A
# Beds - MR/DD N/A
# Beds - Sex Offender N/A
# Beds - Sub Abuse N/A
# Beds - Total (all Civil & For) 338
# Beds - CMS Distinct 176
# Units - Total 14
# Staff - Total 620
Survey Dates -TJC 11/12/2008, 10/7/05
Survey Dates -CMS 02/07
Special Programs/Projects N/A
First heard about SHCC from: Blank
Saint Elizabeths Hospital (SEH)__4Ad5Fr2Ge*TxMall
Name: Michael Hartley, Director of QI
E-mail: michael.hartley@dc.gov
Tel/Fax Numbers: 202-645-8862 / 202-645-8865
Name/Title (2° Rep): Martha Pontes, Risk Manager
Email (2° Rep): martha.pontes@dc.gov
Tel/Fax (2° Rep): 202-645-8897 / 202-645-8865
Name/Title (3° Rep): Denise Blakely, PI Dept Staff Assistant
Email (3° Rep): denise.blakely@dc.gov
Tel/Fax (3° Rep): 202-645-5888 / 202-645-8865
Hospital CEO: Patrick Canavan
Jt Com Org ID#:
Hospital Address: 2700 Martin Luther King, Jr,SE Wahsington, DC 20032
Hosp Website: http://dmh.dc.gov/dmh/cwp/view,a,3,q,516064.asp
# Beds - Adult: 170
# Beds - Child & Adol: 0
# Beds - Forensic: 225
# Beds - Geriatric: 78
# Beds - MR/DD:
# Beds - Sex Offender:
# Beds - Sub Abuse:
# Beds - Total: 473
# Beds - CMS Distinct: 92
# Units - Total: 22
# Staff - Total: 877
Survey Dates -TJC:
Survey Dates -CMS: 2/26-28/07
Special Programs/Projects: Treatment Mall
New Orleans Adolescent Hospital (NOAH)__!1Ad1Ca
Name Ilana Reisin, Performance Improvement Director
E-mail ireisin@dhh.la.gov
Tel/Fax Numbers (504) 896-4843/(504) 896-4841
Name/Title (2° Rep) Deidra Smoot/Adm. Sec.
Email (2° Rep) dsmoot@dhh.la.gov
Tel/Fax (2° Rep) (504) 896-2622/(504) 896-4841
Name/Title (3° Rep) Arnette Alston/Training Education Director
Email (3° Rep) aalston@dhh.la.gov
Tel/Fax (3° Rep) (504) 896-4914/(504) 896-4841
Hospital CEO Richard Kramer, CEO
Jt Com Org ID# 1629 !BHC
Hospital Address 210 State Street
New Orleans, LA 70115
Hosp Website http://10.56.204.251/
# Beds - Adult (Civil only) 30
# Beds - Child & Adol (Civil only) 15
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 45
# Beds - CMS Distinct
# Units - Total 2
# Staff - Total # Staff - Total
Survey Dates -TJC Survey Dates -2/26-29/08 4/25-27/05
Survey Dates -CMS Survey Dates -CMS
Special Programs/Projects Special Programs/Projects
Southeast Louisiana Hospital (SELH)_3AD1Ca*S&R*AdolNeuro¥
Name Joy Callahan, Administrative Assistant
E-mail jcallaha@dhh.la.gov
Tel/Fax Numbers 985 626 6573 985 626 6698
Name/Title (2° Rep) Rhonda Zuvich, Administrative Assistant
Email (2° Rep) rzuvich@dhh.la.gov
Tel/Fax (2° Rep) 985 626 6560, 985 626 6559
Name/Title (3° Rep) Name/Title (3° Rep)
Email (3° Rep) Email (3° Rep)
Tel/Fax (3° Rep) Tel/Fax (3° Rep)
Hospital CEO Patricia Gonzales
Jt Com Org ID# 1511
Hospital Address
Physical: 23515 Highway 190, Mandeville, LA 70448
Mailing: P. O. Box 3850 Mandeville, LA 70470-3850
Hosp Website http://www.dhh.louisiana.gov/offices/?ID=335
# Beds - Adult (Civil only) 118
# Beds - Child & Adol (Civil only) 30
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 148
# Beds - CMS Distinct 118
# Units - Total 4
# Staff - Total 540
Survey Dates -TJC 07/12-14/2006
Survey Dates -CMS 04/01-04/2008
Special Programs/Projects :
Dept of Public Welfare (PaDPW) - OMHSAS
Office of Mental Health and Substance Abuse Services- DPW- Pennsylvania
Agency Address: DPW - OMHSAS
DGS Annex Complex
1st Floor Beechmont Building
P.O. Box 2675
Harrisburg Pa 17105
Agency Phone (Main): 717-772-6731
******************************************
CO Staff #1: Jessica Bradley, Mental Hospital Service Area Representative
E-mail: jebradley@state.pa.us
Tel: 717-772-6731
0902_Allentown State Hospital (ALSH)_4Ad*HBIPS
Name Brandi Kennedy, Chief Performance Improvment Executive
E-mail brkennedy@state.pa.us
Tel/Fax Numbers 610-740-3416
Name/Title (2° Rep) Betsy Zimmerman, Chief Social Rehab Executive
Email (2° Rep) bezimmerma@state.pa.us
Tel/Fax (2° Rep) 610-740-3406
Name/Title (3° Rep) Karen Wolfe, Chief Nurse Executive
Email (3° Rep) kawolfe@state.pa.us
Tel/Fax (3° Rep) 610-740-3296
Hospital Name (AAAA) Allentown State Hospital (ASH)
Hospital CEO Gregory Smith
Jt Com Org ID# 1560
Hospital Address 1600 Hanover Ave.
Allentown, Pa 18103-2498
Hosp Website http://www.dpw.state.pa.us/PartnersProviders/MentalHealthSubstanceAbuse/StateHospitals/003670147.htm
# Beds - Adult (Civil only) 175
# Beds - Child & Adol (Civil only)
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 175
# Beds - CMS Distinct 175
# Units - Total 6
# Staff - Total 475
Survey Dates -TJC 2/20/09, 3/17/06
Survey Dates -CMS 8/16/04-8/18/04
Special Programs/Projects :
- HBIPS core measure test site
- Currently drafting research article on "The Effects of Seclusion and Restraint Reduction on Patient to Patient and Patient to Staff Assault."
0903_Clarks Summit State Hospital (CSSH)_5Ad
Name Monica Bradbury, Chief Performance Improvement Executive (CPIE)
E-mail mobradbury@state.pa.us
Tel/Fax Numbers 570-587-7340/570-587-7114
Name/Title (2° Rep) Timothy Corcoran, Chief Nurse Executive
Email (2° Rep) tcorcoran@state.pa.us
Tel/Fax (2° Rep) 570-587-7190
Name/Title (3° Rep) Robert Rhodes, IT
Email (3° Rep) robrhodes@state.pa.us
Tel/Fax (3° Rep) 570-587-7320
Hospital Name (AAAA) Clarks Summit State Hospital
Hospital CEO Thomas Comerford
Jt Com Org ID# 974
Hospital Address 1451 Hillside Drive
Clarks Summit PA 18411
Hosp Website http://www.dpw.state.pa.us/PartnersProviders/MentalHealthSubstanceAbuse/StateHospitals/003670148.htm
# Beds - Adult (Civil only) 242
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 0
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For)
# Beds - CMS Distinct 242
# Units - Total 8
# Staff - Total # Staff - Total
Survey Dates -TJC 3/6/09, 4/6/2006
Survey Dates -CMS 8/2005
Special Programs/Projects
0905_Danville State Hospital (DSH)_4Ad
Name Linda Lesher
E-mail lilesher@state.pa.us
Tel/Fax Numbers 570-271-4585/570-271-4599
Name/Title (2° Rep) Anthony Montecalvo, MD
Email (2° Rep) amontecalv@state.pa.us
Tel/Fax (2° Rep) 57-271-4538/570-271-4802
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital Name (AAAA)
Hospital CEO Donna M. Ashbridge, RN, MS
Jt Com Org ID# 3107
Hospital Address 200 State Hospital
Danville, Pennsylvania 17821-9198
Hosp Website DSH Website
# Beds - Adult (Civil only) 170
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 170
# Beds - CMS Distinct 170
# Units - Total 6
# Staff - Total 387
Survey Dates -TJC 5/22/09, 6/23/06
Survey Dates -CMS 6/20-22/2007
Special Programs/Projects
0902_Norristown State Hospital (NSH)_7Ad3Fr
Name John Stoltz, Quality Assurance Risk Mgr.
E-mail jostoltz@state.pa.us
Tel/Fax Numbers 610-313-1060/fax:610-313-1254
Name/Title (2° Rep) Bill Ryan, Patient Care Coordinator
Email (2° Rep)
Tel/Fax (2° Rep) 610-313-5322/fax:610-313-????
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital Name (AAAA) Norristown State Hospital (NSH)
Hospital CEO Gerald Kent
Jt Com Org ID# 1706
Hospital Address 1001 Sterigere Street, Building 19 Administration, Norristown, PA 19401
Hosp Website http://www.dpw.state.pa.us/PartnersProviders/MentalHealthSubstanceAbuse/StateHospitals/003670158.htm
# Beds - Adult (Civil only) 324
# Beds - Child & Adol (Civil only)
# Beds - Forensic 118
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 442
# Beds - CMS Distinct 324
# Units - Total 14
# Staff - Total 795
Survey Dates -TJC 2/13/09, 2/11/06
Survey Dates -CMS 4/5/06
Special Programs/Projects
0903_South Mountain Restoration Center (SMRC)_4Ge*Demtia,SNF
Name Pamela Lynn Wagaman, RN, Chief Performance Improvement
E-mail pwagaman@state.pa.us
Tel/Fax Numbers 717-749-4006 Fax 717-749-4068
Name/Title (2° Rep)
Email (2° Rep)
Tel/Fax (2° Rep)
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital Name (AAAA) South Mountain Restoration Center
Hospital CEO J Michael Hogarth, NHA
Jt Com Org ID# 4643 SNF
Hospital Address 10058 South Mountain Road
South Mountain, PA 17261
Hosp Website http://www.dpw.state.pa.us/PartnersProviders/MentalHealthSubstanceAbuse
# Beds - Adult (Civil only) # Beds - Adult (Civil only)
# Beds - Child & Adol (Civil only) # Beds - Child & Adol (Civil only)
# Beds - Forensic # Beds - Forensic
# Beds - Geriatric 159
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 159
# Beds - CMS Distinct
# Units - Total 5
# Staff - Total 300
Survey Dates -TJC 3/20/09, 5/16/2006
Survey Dates -CMS 3/20/2008
Special Programs/Projects:
- Dementia Care Unit
- Dual Certified/Skilled Nursing Facility
0906_Torrance State Hospital (TSH)_5Ad1Sx*SexualResp&Tx
Name Angela R. Harris, Chief Performance Improvement Executive
E-mail angharris@state.pa.us
Tel/Fax Numbers 724-675-2009/724-459-4498
Name/Title (2° Rep) Roxanne Grimm, Quality Assurance/Risk Management Coordinator
Email (2° Rep) rgrimm@state.pa.us
Tel/Fax (2° Rep) 724-459-1236
Name/Title (3° Rep) Edna McCutcheon, Chief Executive Officer
Email (3° Rep) emccutcheo.state.pa.us
Tel/Fax (3° Rep) 724-459-4511
Hospital Name (AAAA) Torrance State Hospital
Hospital CEO Edna McCutcheon
Jt Com Org ID# 1507
Hospital Address Torrance State Hospital
PO Box 111
Torrance, PA 15779
Hosp Website: Torrance State Hospital
# Beds - Adult (Civil only) 218
# Beds - Child & Adol (Civil only)
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender 21
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 239
# Beds - CMS Distinct 212
# Units - Total 10
# Staff - Total 500
Survey Dates -TJC 6/19/09, 8/18/06
Survey Dates -CMS June 5 - 7, 2007
Special Programs/Projects: Sexual Responsibility and Treatment Program - Act 21; civil com
0903_Warren State Hospital (WaSH)_5Ad1FR*HBIPS
Name Carol Barnickel, RN, Chief PI Executive
E-mail cbarnickel@state.pa.us
Tel/Fax Numbers 814-726-4384
Name/Title (2° Rep) Hannah Fry, RN, Dir of Forensic Services
Email (2° Rep) hfry@state.pa.us
Tel/Fax (2° Rep) 814-726-4128
Name/Title (3° Rep) Kim Sivak, RN, Chief Nurse Executive
Email (3° Rep) ksivak@state.pa.us
Tel/Fax (3° Rep) 814 726-4184
Hospital Name (AAAA) Warren State Hospital
Hospital CEO David Kucherawy
Jt Com Org ID# 1668
Hospital Address 33 Main Drive, Warren, PA 16365
Hosp Website http://www.dpw.state.pa.us/PartnersProviders/MentalHealthSubstanceAbuse/StateHospitals/003670893.htm
# Beds - Adult (Civil only) 223
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 27
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 250
# Beds - CMS Distinct 250
# Units - Total 8
# Staff - Total 454
Survey Dates -TJC 3/12/09, 5-9-06 to 5-11-06
Survey Dates -CMS 10-29-07 to 10-29-07
Special Programs/Projects HBIPPs pilot participant
0904_Wernersville State Hospital (WeSH)_5Ad*HBIPS
Name John A. Deegan, Chief PI Executive
E-mail jdeegan@state.pa.us
Tel/Fax Numbers Tel - 610-670-4117 Fax - 610-927-4741
Name/Title (2° Rep) Andrea Kepler, CEO
Email (2° Rep) akepler@state.pa.us
Tel/Fax (2° Rep) Tel - 610-670-4111 Fax 610 - 670-4101
Name/Title (3° Rep) Name/Title (3° Rep)
Email (3° Rep) Email (3° Rep)
Tel/Fax (3° Rep) Tel/Fax (3° Rep)
Hospital Name (AAAA) Wernersville State Hospital
Hospital CEO Andrea Kepler
Jt Com Org ID# 1008
Hospital Address P.O. Box 300 Wernersville, Pa. 19565-0300
Hosp Website http://www.dpw.state.pa.us/PartnersProviders/MentalHealthSubstanceAbuse/StateHospitals/003670162.htm
# Beds - Adult (Civil only) 220
# Beds - Child & Adol (Civil only)
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 220
# Beds - CMS Distinct 220
# Units - Total 7
# Staff - Total # Staff - Total
Survey Dates -TJC 4/3/09, 4/21/06
Survey Dates -CMS Sept 20-22, 2006
Special Programs/Projects
Norfolk Regional Center (NRC)__2Ad2Sx
Name: Tylynne Bauer
E-mail: Tylynne.Bauer@nebraska.gov
Tel/Fax Numbers: 402-370-3362/402-370-355
Name/Title (2° Rep):
Email (2° Rep):
Tel/Fax (2° Rep):
Name/Title (3° Rep):
Email (3° Rep):
Tel/Fax (3° Rep):
Hospital CEO: William Gibson
Hospital State: NE
Jt Com Org ID#:
Hospital Address: 1700 North Victory Road
Norfolk, NE 68702
Hosp Website: http://www.hhs.state.ne.us/beh/rc/nrcserv.htm
# Beds - Adult: 60
# Beds - Child & Adol:
# Beds - Forensic:
# Beds - Geriatric:
# Beds - MR/DD:
# Beds - Sex Offender: 60
# Beds - Sub Abuse:
# Beds - Total: 120
# Beds - CMS Distinct: 120
# Units - Total: 4
# Staff - Total: 206 FTEs
Survey Dates -TJC:
Survey Dates -CMS:
Special Programs/Projects: Adult Mental Health and Sex Offender Program
NY Central Office
New York State Office of Mental Health
44 Holland Avenue
Albany, New York 12229
Home: http://www.omh.state.ny.us/index.html
FAcilities: http://www.omh.state.ny.us/omhweb/aboutomh/omh_facility.html
Bronx Children's Psychiatric Center (BCPC)_2Ca*Clozaril
Name Emily Harf, Director of Quality Management
E-mail BCSWEAH@omh.state.ny.us
Tel/Fax Numbers Phone: 718 239-3622 Fax: 718 239-3669
Name/Title (2° Rep) Ann Culver Director of Nursingr
Email (2° Rep) BCNRAMC@omh.state.ny.us
Tel/Fax (2° Rep) Phone: 718 239-3626 Fax:718 239-3669
Name/Title (3° Rep) Marilyn Gobbo Program Evaluation
Email (3° Rep) BCPEMLG@omh.state.ny.us
Tel/Fax (3° Rep) Phone 718-239-3662 Fax: 718-239-3669
Hospital CEO Christopher Meyers, PhD
Jt Com Org ID# 3288 !BHC
Hospital Address 1000 Waters Place, Bronx, NY 10461
Hosp Website http://www.omh.state.ny.us/omhweb/employment/list.htm
# Beds - Adult (Civil only) 0
# Beds - Child & Adol (Civil only) 78
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD N/A
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 78
# Beds - CMS Distinct 0
# Units - Total 4
# Staff - Total 286
Survey Dates -TJC 7/11/08, 3/15-3/17/05
Survey Dates -CMS N/A
Special Programs/Projects Clozaril study
Bronx Psychiatric Center (BPC)_7Ad
Name Gerald Peet, ?Position?
E-mail brqagsp@omh.state.ny.us
Tel/Fax Numbers 718 862 3315
Name/Title (2° Rep) Pam Turner/ acting exec director
Email (2° Rep) brispgt@omh.state.ny.us
Tel/Fax (2° Rep) 718 862 3300
Name/Title (3° Rep) David Otis/ dir of ????
Email (3° Rep) bricdbo@omh.state.ny.us
Tel/Fax (3° Rep) 718 862 3318
Hospital CEO Pamela Turner (acting)
Jt Com Org ID# 1625
Hospital Address 1500 waters pl
bronx ny 10461
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/brpc/facility.htm
# Beds - Adult (Civil only) 350
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 350
# Beds - CMS Distinct 350
# Units - Total 12
# Staff - Total 900 (approx)
Survey Dates -TJC 4/19 - 4/22/05
Survey Dates -CMS 6/02
Special Programs/Projects
Creedmoor Psychiatric Center (CPC)_!9Ad*DBT*Lang
Name (1° Rep) Kevin Lynch, LCSW Deputy Dir.
E-mail Craskll@omh.state.ny.us
Tel/Fax Numbers 718 264 3662
Name/Title (2° Rep) Connie Mitchell, Chief Information Officer
Email (2° Rep) CRFMCMM@omh.state.ny.us
Tel/Fax (2° Rep) 718 264 4186
Name/Title (3° Rep) Ann Marie Barbarotta, Assoc Dir of Quality Improvement
Email (3° Rep) CRASAMB@omh.state.ny.us
Tel/Fax (3° Rep) 718 264 3665
Hospital CEO Kathleen Iverson
Jt Com Org ID# 1620 - !BHC
Hospital Address 79-25 Winchester Blvd., Queens New York 11426
Hosp Website CRPC_INFO@omh.state.ny.us or http://www.omh.state.ny.us/omhweb/facilities/crpc/facility.htm
# Beds - Adult (Civil only) 420
# Beds - Child & Adol (Civil only): 0
# Beds - Forensic: 0
# Beds - Geriatric: 0
# Beds - MR/DD: 0
# Beds - Sex Offender: 0
# Beds - Sub Abuse: 0
# Beds - Total (all Civil & For) 420
# Beds - CMS Distinct
# Units - Total
# Staff - Total 1100
Survey Dates -TJC 4/11/08, 2/18/05
Survey Dates -CMS 9/10-9/14/07
Greater Binghamton Health Center (GBHC)_3Ad1Ca1Ge*Smoke
Name Cheryl Minnier , Director of Quality Management
E-mail biqacbm@omh.state.ny.us
Tel/Fax Numbers 607-773-4026
Name/Title (2° Rep) Bert Prohaska, Program Evaluation Specialist IV
Email (2° Rep) bipebsp@omh.state.ny.us
Tel/Fax (2° Rep) 607-7734028
Name/Title (3° Rep) Deborah Hoppe, Clinical Nurse Specialist, Quality Management
Email (3° Rep) binsdal@omh.state.ny.us
Tel/Fax (3° Rep) 607-773-4051
Hospital CEO Margaret R. Dugan
Jt Com Org ID# 1619 - !BHC
Hospital Address 425 Robinson St
Binghamton Ny 13904
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/bipc/facility.htm
# Beds - Adult (Civil only) 123
# Beds - Child & Adol (Civil only) 16
# Beds - Forensic
# Beds - Geriatric 31
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 170
# Beds - CMS Distinct 169
# Units - Total 6
# Staff - Total 405
Survey Dates -TJC 08/13/07 - 8/17/07
Survey Dates -CMS 11/07/05 - 11/09/05
Special Programs/Projects Smoke Free Campus
SHCC Contributions:
Kirby Forensic Psychiatric Center (KFPC)_3Fr
Name Precious Stepney, Mental Hygiene Program Evaluation Specialist 3
E-mail krqapts@omh.state.ny.us
Tel/Fax Numbers 646-672-5813
Name/Title (2° Rep) Joseph Freebern, Director of Quality Management
Email (2° Rep) Krqajef@omh.state.ny.us
Tel/Fax (2° Rep) 646-672-6767
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO Steve Rabinowitz
Jt Com Org ID# 1257
Hospital Address Kirby Forensic Psychiatric Center
Ward's Island Complex
Ward's Island, NY 10035
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/krpc/facility.htm
# Beds - Adult (Civil only)
# Beds - Child & Adol (Civil only)
# Beds - Forensic 164
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For)
# Beds - CMS Distinct
# Units - Total
# Staff - Total
Survey Dates -TJC 7/16/08, 4/27/05
Survey Dates -CMS
Special Programs/Projects
Pilgrim Psychiatric Center (PPC)_!11Ad3Ge
Name Marianne S. Miller, Ph.D., Director of Quality Management
E-mail pgurmsm@omh.state.ny.us
Tel/Fax Numbers Tel: 631-761-2911; Fax:631-761-3082
Name/Title (2° Rep) Suan Alvar, Associate Director Quality Management
Email (2° Rep) pgnssaa@omh.state.ny.us
Tel/Fax (2° Rep) Tel: 631-761-2882; Fax: 631-761-3082
Name/Title (3° Rep) Shiela Graf, Associate Director Quality Management
Email (3° Rep) pgnssmg@omh.state.ny.us
Tel/Fax (3° Rep) Tel: 631-761-2359; Fax: 631-761-3082
Hospital CEO Dean R. Weinstock
Jt Com Org ID# 1614 - !BHC
Hospital Address 998 Crooked Hill Road
Brentwood, New York 11717
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/pgpc/facility.htm
# Beds - Adult (Civil only) 506
# Beds - Child & Adol (Civil only) 0
# Beds - Forensic 0
# Beds - Geriatric 104
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 610
# Beds - CMS Distinct 610
# Units - Total 23
# Staff - Total 1600
Survey Dates -TJC 7/16/07-7/20/07
Survey Dates -CMS 4/12/04-4/15/04
Special Programs/Projects
Manhattan Psychiatric Center (MPC)_??????*Viol*Polydip*Hisp
Name Charles Herrmann, Deputy Director for Quality Management
E-mail krqacah@omh.state.ny.us
Tel/Fax Numbers 646-672-6016/ 646-672-6446
Name/Title (2° Rep) Jonathan Keigher, Survey Coordinator
Email (2° Rep) Maqajsk@omh.state.ny.us
Tel/Fax (2° Rep) 646-672-6012/ 646-672-6446
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO Steve Rabinowitz
Jt Com Org ID# 1617
Hospital Address Manhattan Psychiatric Center
Ward's Island Complex
Ward's Island, NY 10035
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/mapc/facility.htm
# Beds - Adult (Civil only) 360
# Beds - Child & Adol (Civil only)
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender 20
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 380
# Beds - CMS Distinct 340
# Units - Total 14
# Staff - Total 800
Survey Dates -TJC 8/15/08, 5/5/05
Survey Dates -CMS 9/18/07
Special Programs/Projects: STAIR (interpersonal violence), Polydipsia Ward, Hispanic Ward
Mid-Hudson Psychiatric Center (MHPC)_6Fr
Name Michael P. McDonald / QM Director
E-mail mhpempm@omh.state.ny.us
Tel/Fax Numbers 845-374-8749 / 845-374-8860
Name/Title (2° Rep) Peggi A. Healy / Executive Director
Email (2° Rep) mhdoepeh@omh.state.ny.us
Tel/Fax (2° Rep) 845-374-8741 / 845-374-8860
Name/Title (3° Rep) Lawrence Decker / Director of Administration
Email (3° Rep) mhdolpd@omh.state.ny.us
Tel/Fax (3° Rep) 845-374-8745 / 845-374-8860
Hospital CEO Peggi A. Healy
Jt Com Org ID#: 1258
Hospital Address PO Box 158
New Hampton N.Y.
10958-0158
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/mhpc/facility.htm
# Beds - Adult (Civil only)
# Beds - Child & Adol (Civil only)
# Beds - Forensic 300
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 300
# Beds - CMS Distinct
# Units - Total ?????
# Staff - Total 583
Survey Dates -TJC 4/3/08, 2/25/05
Survey Dates -CMS
Special Programs/Projects
Queens Children Psychiatric Center (QCPC)_!2Ca
Name Tom McOlvin, Deputy Director
E-mail qcqatfm@omh.state.ny.us
Tel/Fax Numbers 718 264 4578 / 718 264 4939
Name/Title (2° Rep) Keith Little. Executive Director
Email (2° Rep) keith.little@omh.state.ny.us
Tel/Fax (2° Rep) 718 264-4505 / 718 264-4954
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO Keith Little
Jt Com Org ID# 3287 - !BHC
Hospital Address 74-03 Commonwealth Blvd
Bellerose, NY 11426
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/qcpc/facility.htm
# Beds - Adult (Civil only) 0
# Beds - Child & Adol (Civil only) 84
# Beds - Forensic 0
# Beds - Geriatric 0
# Beds - MR/DD 0
# Beds - Sex Offender 0
# Beds - Sub Abuse 0
# Beds - Total (all Civil & For) 84
# Beds - CMS Distinct 0
# Units - Total 6
# Staff - Total 84
Survey Dates -TJC 6/13/08, 3/7/2005
Survey Dates -CMS N/A
Special Programs/Projects
Sagamore Children'sPsychiatric Center (SCPC)_!2Ca
Name/Title (1° Rep) Stephen Ferrante, Director of Quality Improvement
E-mail: scqassf@omh.sate.ny.us
Tel/Fax Numbers: voice: 631-370-1721 fax: 631-370-1717
Name/Title (2° Rep)
Email (2° Rep)
Tel/Fax (2° Rep)
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO: Dennis R. Dubey Ph.D.
Jt Com Org ID# 3289 - !BHC
Hospital Address: 197 Half Hollow Road, Dix Hills, NY 11746
Ogdensburg NY
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/scpc/facility.htm
# Beds - Adult (Civil only)
# Beds - Child & Adol (Civil only): 69
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 69
# Beds - CMS Distinct: 0
# Units - Total: 5
# Staff - Total: 269
Survey Dates -TJC: 8/18-20/08
Survey Dates -CMS
Special Programs/Projects:
St. Lawrence Psychiatric Center (SLPC)_!2Ad1Ca2Sx*Risk*S&R*Polydip
Name Aimee Dean, RN, Director of Quality Management
E-mail SLNSAMG@omh.state.ny.us
Tel/Fax Numbers 315.541.2202/315.541.2014
Name/Title (2° Rep) Aimee Dean, RN, Clinical Risk Manager
Email (2° Rep) SLNSAMG@omh.state.ny.us
Tel/Fax (2° Rep) 315.541.2279
Name/Title (3° Rep) Emma Foster, RN, Utilization Review Coordinator
Email (3° Rep) SLNSESF@omh.state.ny.us
Tel/Fax (3° Rep) 315.541.2254
Hospital CEO Samuel A. Bastien, IV, PhD
Jt Com Org ID# 1623 - !BHC
Hospital Address 1 Chimney Point Drive
Ogdensburg NY 13669
Hosp Website http://www.omh.state.ny.us/omhweb/facilities/slpc/facility.htm
# Beds - Adult (Civil only) 65
# Beds - Child & Adol (Civil only) 28
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender 80
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 173
# Beds - CMS Distinct 93
# Units - Total 3
# Staff - Total 533
Survey Dates -TJC 4/24/07-4/27/07
Survey Dates -CMS 5/03
Special Programs/Projects: Health and Wellness Initiative, Polydipsia Protocol PI Team, Risk Assessment Process, Restraint/Seclusion Reduction
South Beach Psychiatric Center (SBPC)_!7Ad1Ca*Consumer Ntwrk
Name Natalie Toomey,LCSW,RN/ Director of Quality & Risk Mgmt
E-mail sbnrnmt@omh.state.ny.us
Tel/Fax Numbers 718-667-2826/fax 718-667-2749
Name/Title (2° Rep) Carol Capper/ Director of Utilization Review
Email (2° Rep) sburcjc@omh.state.ny.us
Tel/Fax (2° Rep) 718-667-2850/fax 718-667-2656
Name/Title (3° Rep) Anne Marie Bove/ Asst. Dir. Community Svces
Email (3° Rep) sbisamb@omh.state.ny.us
Tel/Fax (3° Rep) 718-667-2506/fax 718-667-2344
Hospital CEO William F. Henri, M.S., M.P.A.
Jt Com Org ID# 677 !BHC
Hospital Address 777 Seaview Avenue
Staten Island, NY 10305
Hosp Website: http://www.omh.state.ny.us/omhweb/facilities/sbpc/facility.htm
# Beds - Adult (Civil only) 306
# Beds - Child & Adol (Civil only) 10
# Beds - Forensic
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 316
# Beds - CMS Distinct
# Units - Total
# Staff - Total
Survey Dates -TJC 5/9/08, 3/4/05
Survey Dates -CMS May 2005
Special Programs/Projects: The Consumer Network
Utah State Hospital (USH)__4Ad2Ca2Fr*S&Rntac
Name Isaac Thomas / QR Director
E-mail ithomas@utah.gov
Tel/Fax Numbers 801-344-4273 / 801-344-4248
Name/Title (2° Rep) Richard Spencer, MD / Clinical Director
Email (2° Rep) rspencer@utah.gov
Tel/Fax (2° Rep) 801-344-4200 / 801-344-4291
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO Dallas Earnshaw
Jt Com Org ID# 1670
Hospital Address 1300 East Center Street
P.O. Box 270
Provo, Utah 84603-0270
Hosp Website www.ush.utah.gov
# Beds - Adult (Civil only) 182
# Beds - Child & Adol (Civil only) 72
# Beds - Forensic 100
# Beds - Geriatric
# Beds - MR/DD
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 354
# Beds - CMS Distinct
# Units - Total 13
# Staff - Total 820
Survey Dates -TJC 1/17/08, February 2005
Survey Dates -CMS May 2003
Special Programs/Projects NTAC will be at USH in January to assist with seclusion / restraint reduction.
Western State Hospital (WSH)__9Ad6Fr4Gr*ViolenceNTAC
Western State Hospital (WSH)__9Ad6Fr4Gr*ViolenceNTAC
Name Rae Simpson,
E-mail
Tel/Fax Numbers
Name/Title (2° Rep) Deyna Hall, Dir of Hospital Improvement
Email (2° Rep) halldey@dshs.wa.gov
Tel/Fax (2° Rep) 253-756-2714
Name/Title (3° Rep) Barbara Hawkins, Research Investigator
Email (3° Rep) hawkibb2@dshs.wa.gov
Tel/Fax (3° Rep) 253-756-2839
Hospital CEO Andy Phillips
Jt Com Org ID# 1630
Hospital Address 9601 Steilacoom Blvd
Tacoma, WA 98498
Hosp Website Hosp Website
# Beds - Adult (Civil only) 452
# Beds - Child & Adol (Civil only) # Beds -
# Beds - Forensic 270
# Beds - Geriatric 205
# Beds - MR/DD # Beds -
# Beds - Sex Offender # Beds -
# Beds - Sub Abuse # Beds -
# Beds - Total (all Civil & For) 927
# Beds - CMS Distinct # Beds -
# Units - Total 32
# Staff - Total 2244
Survey Dates -TJC 2/29/08, Jan 2000
Survey Dates -CMS May 2008
Special Programs/Projects NASMHP - NTAC's Non-violence initative
Milwaukee County Behavioral Health Division (MCBHD)_2Ad1Ca2Ge2Mr
Name Patricia Meehan, R.N., Director, Quality Assurance/Quality Improvement
E-mail pmeehan@milwcnty.com
Tel/Fax Numbers 414-257-4826
Name/Title (2° Rep)
Email (2° Rep)
Tel/Fax (2° Rep)
Name/Title (3° Rep)
Email (3° Rep)
Tel/Fax (3° Rep)
Hospital CEO John Chianelli
Jt Com Org ID# NA
Hospital Address 9455 Watertown Plank Rd
Milwaukee, WI 53226
Hosp Website/Online Info Milwaukee County Gov, Mental Health America of WI
# Beds - Adult (Civil only) 96
# Beds - Child & Adol (Civil only) 22
# Beds - Forensic
# Beds - Geriatric 72
# Beds - MR/DD 68
# Beds - Sex Offender
# Beds - Sub Abuse
# Beds - Total (all Civil & For) 258
# Beds - CMS Distinct
# Units - Total 13
# Staff - Total 900
Survey Dates -TJC NA
Survey Dates -CMS
Special Programs/Projects
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