St. Joseph Health Services plans to all but vacate the South Providence building it has occupied for a century, moving out its psychiatric and rehabilitation programs –– but leaving intact the outpatient health center that serves the poor in the surrounding community.

The move, to be completed near the end of 2009, springs from financial pressures and changes in patient needs. Approved by the Health Department in the fall, the plan has met with little opposition, and hospital officials say the changes won’t harm care for any of its various types of patients.

But the move will eliminate about 70 jobs, most in support positions such as engineering, housekeeping and cafeteria.

And the hospital’s two towers on Broad Street –– the five-story west wing, built early in the 20th century, and the eight-story east wing, built in 1960 –– will stand mostly empty until the hospital finds a buyer.

“The St. Joe’s facility is running essentially 70 beds in what was once a 250-bed hospital,” said John M. Fogarty, hospital president. The hospital expects the changes to save about $4.2 million a year from its $200-million budget. The move will also avoid some looming capital costs. If the hospital stayed there, the Broad Street building would need about $5 million in repairs over the next five years.

Although St. Joseph is a single hospital affiliated with the Roman Catholic Diocese of Providence, it has always had two locations –– Our Lady of Fatima, a general hospital in North Providence, and St. Joseph Hospital in Providence. In the early 1990s, the Providence unit shut its emergency room and ended its medical-surgical services. Now called the St. Joseph Hospital for Specialty Care, it houses a 36-bed rehabilitation unit, a 29-bed psychiatric service, and the health center, which provides primary care, dental care and other outpatient services.

Under the new plan, the rehabilitation program will move into rented space at Roger Williams Hospital, in Providence. The 10,000-square-foot unit, scheduled for renovation, will be less than half the size of the current unit, but there will also be fewer beds. Like rehab hospitals everywhere, St. Joseph has seen a decline in patients because of changes in reimbursement policy and a trend toward treating problems in nursing homes and outpatient centers. The new unit will have only 18 beds.

Although Roger Williams and St. Joseph have announced plans to eventually merge, for now Roger Williams will merely be the landlord, Fogarty said.

The psychiatric program will move to Fatima, which already has 40 psychiatric beds. Five psychiatric beds will be taken out of service, leaving a total of 71 psychiatric beds at Fatima. The hospital will renovate a unit at Fatima to accommodate the additional beds. Fogarty said that, although the psychiatric service is busy, the hospital believes it can do away with five beds, in part because new programs to divert people from hospitalization are having an effect.

Fogarty said hospitalized patients in both the rehab and psychiatric programs tend to have medical illnesses as well and will benefit from proximity to the full range of medical services.

In August 2007, a psychiatric patient who had just been transferred from the Providence to the Fatima unit died after forcing open a third-floor window and jumping out. Among the problems identified in the Health Department investigation of the incident was inadequate communication between clinicians in Providence and in North Providence. The transfer may have exacerbated the patient’s distress.

Fogarty said that incident, which prompted a reprimand from the Health Department, was not the reason why the hospital wanted to consolidate the two psychiatric programs. He said that Fatima had already implemented an action plan intended to prevent such incidents. “We do feel having everything on one site certainly will simplify the overall management,” Fogarty added. “It certainly won’t hurt having everyone on one campus.”

The psychiatric and rehabilitation programs draw patients from throughout state, and those patients are not expected to mind having to go a few miles north.

The health center, however, draws all its patients from the surrounding community, and it will stay in South Providence. “The health center really stays –– status quo, unchanged, untouched,” Fogarty said. “The services in the health center remain the same, a core element to our mission and commitment to the community.”

The center’s services, now scattered around the building, will be consolidated in the west wing, and the east wing will be closed. Once someone buys the property, the hospital will either use the proceeds to build a new center or the center will become a tenant of the new owners, Fogarty said.

ffreyer@projo.com