The nursing home industry is in the midst of a culture change toward person-centered care, and it’s also figuring out how to benefit from healthcare reform initiatives seeking to cost-effectively improve care quality and reduce hospital readmissions. Here’s what Genesis HealthCare is doing to diversify its skilled nursing offering to accommodate both short-term and long-term needs.
There’s a trend in skilled nursing to diversify businesses that primarily offer traditional models of long-term care nursing homes to include a larger focus on short-term care services, according to Paul Bach, executive vice president at Genesis HealthCare and president of the company’s Central Area, encompassing Eastern Pennsylvania and all of New Jersey.
Genesis recently introduced its “PowerBack” model of short-term skilled nursing and rehabilitative care, citing a need in the market for a more efficient type of nursing facility that focuses on getting patients back into the home as quickly as possible rather than a nursing home that lumps all patients together, regardless of varying needs or acuity level.
“We think in the future that CMS will want to reimburse for care based on what the patient needs, and not necessarily the type of care the facility delivers,” says Bach. Working with consulting firms to build a financial model along with a brand identify for the new PowerBack product validated Genesis’ belief—and research—that the market was ripe for this model of care.
A typical nursing home serves short-term and long-term residents under the same roof, Bach says, but those are often very different populations.
“We think that model is becoming outdated,” he says, adding that people in need of just a couple weeks of post-acute rehabilitative care don’t necessarily want to be in the same environment as someone who has dementia or other long-term care needs. “We’re creating a model for both, [but] in separate buildings. We think that’s what the market is calling for.”
In the PowerBack model, the intensity of therapy and medical services is enhanced, Bach says, allowing patients to “float through” the rehab process much quicker. The program also focuses on educating patients after discharge and following up with them regarding appropriate post-acute care.
As hospitals and health plans begin to narrow their networks of skilled nursing facilities to which they refer patients, they will only discharge to facilities that have the best outcomes in terms of readmissions, says the Genesis executive. “The facility model that we’ve developed fits squarely into the middle of that strategy.”
Genesis has existing partners in the acute care health system and health plan sectors, but now the company is getting “a lot of attention” from both hospitals and health plans regarding this short-stay model, according to Bach. The company has even established some shared-savings agreements with some Medicare Advantage health plans where Genesis can share a portion of the health plan’s savings as hospital readmissions are reduced.
In the Pipeline
Three Philadelphia-area skilled nursing facilities are currently undergoing the transformation process to the PowerBack model, chosen by virtue of their location in areas where other Genesis long-term care facilities are located.
The company is making what Bach terms “fairly significant capital investments” to convert those facilities by adding more private rooms, substantially expanding rehab gym space, and adding other space with plans for other new amenities, including spa-like services, cafes and bistros, and more space for residents to meet with their families.
The idea is to create an environment that is medical-intensive, but overlaid with higher-end hospitality services and amenities, Bach says. The new facilities feature hydrotherapy pools and specialized rehab equipment, including equipment geared toward cardiac management, as heart problems are a leading cause for rehospitalization.
So far, one existing facility in Baltimore, Md. has been converted to the PowerBack model, and in addition to the three conversion projects, Genesis is currently working on a $30 million brand new facility in Voorhees, Pa. The new rehab center’s 124 beds will all be in private rooms. All four projects are expected to open later this year.
But while Bach says this diversification of services will become a trend, it won’t necessarily be possible for all skilled nursing providers.
“The key is, it has to be organizations that have the capability to deliver higher-end rehabilitative care and the higher-end medical care,” he says. Genesis owns and operates its own national rehab company, Genesis Rehabilitation Services, and has its own physician organization. “Not all of our peers have those types of capabilities; that’s really a key of success.”
Ultimately, as healthcare reform seeks to improve care quality while saving money, skilled nursing is bound to play an important role.
“There’s a lot of attention being paid to the rehospitalization rate of patients flowing out of the hospital into skilled nursing facilities,” says Bach. “This is a tremendous opportunity.”
Written by Alyssa Gerace
New
Hi,
The term "acuity level" is used in the piece. Acuity is not synonymous with the term acute. Acuity means keeness in a sensory way like visual acuity…, not acute as in a stage of disease.
It can be difficult to see past marketing terms like 'PowerBack' and jargon like 'we have capabilities that our peers don't have', but there is no ignoring capital investments like $30 million facilities. Bach speaks of 'what people want' as the driver of the market, and new models seem long overdue, but if CMS is the only 'payer' (its the only one Bach refers to) the reality is that the government will not, or cannot afford, to pay for what people want. New models need to address how average and high risk people in the general population can afford "higher-end rehabilitative care and the higher-end medical care". I'm not trying to be critical of what Genesis is doing, but I would like to hear more about how such enormous challenges can be faced.