A preliminary plan to move the Extended Care Unit from Adams Memorial Hospital was approved Wednesday night by the Adams Health Network (AHN) board of trustees at their regular monthly meeting.
Hospital officials emphasized the move of ECU to the "B" wing of the Woodcrest Nursing Home makes sense from an economical standpoint and should not be construed by people as meaning an ECU patient will become a nursing home patient.
AHN Chief Operating Officer Jo-Ellen Eidam noted that nearly 85 percent of patients admitted to the hospital's ECU last year went home when they had sufficiently recovered, a statistic she said would be contrary to what some people believe.
AHN Executive Director Marvin L. Baird told the board that several years ago Medicare changed the formula for how it reimbursed the hospital for ECU patients when AMH became a critical access facility.
"Reimbursement for a patient receiving skilled care in extended care is nowhere near what would be for that same patient in the hospital," Baird observed. He said that in 2010 the hospital received $1,200 per day from Medicare for a skilled care hospital patient but only $400 for an ECU patient.
"We lost nearly a million dollars last year in the reimbursement for extended care patients and that's a figure we simply cannot afford to be allowed to continue," he said.
After listening to a discussion of the pros and cons of moving ECU to Woodcrest, the board members agreed with administrative plans.
"Unless you can come up with something different or better, I don't see where we have a choice," said board member Dennis Bieberich.
Baird said the federal government decided care rendered in an extended care setting was not acute care so the reimbursement was slashed.
"We have always staffed ECU as an acute-care unit. Those costs simply are not be reimbursed to us by Medicare," he said. "ECU is something the community needs, likes the service, and uses."
The "B" wing at Woodcrest contained 20 beds of the facility which is licensed for 143 patients. Due to occupancy levels at Woodcrest, the "B" wing was shut down several years ago with the "A" wing and "C" wing now housing 120 patients (hospital officials said 119 patients were at the nursing home as of Wednesday).
The move of ECU to the Woodcrest "B" wing will involve some remodeling of rooms so that rooms will all house one patient per room. There will also be an apartment-like facility on the premises at which a patient can be moved to prior to going home to make sure the patient can perform active daily living skills such as cooking, showering on their own, and other activities.
Baird and Eidam both said they realize one of the downsides to the move will be the image that some families will have that a loved one "is now going to the nursing home."
Again stressing that a large percentage of people go home from ECU and not to a nursing home, Baird said a separate entrance to the "B" wing, a separate parking lot, and a separate name, something along the lines of "Woodcrest Rehabilitation Center," will be utilized.
Baird said moving the ECU to Woodcrest was the best option for the hospital "because it makes the most sense from a feasibility view and allows us to use a facility ("B" wing) that has already been built.
The remodeled "B" wing will also contain a large therapy room for patients to receive physical, occupational, and speech therapy. Doctors will continue to see their patients as before at the new location and Baird said staffing will be "an internal issue" with some realignment of positions necessary. No job losses are immediately envisioned with the move, he said.
As to what the rooms on the third floor of the hospital where the current ECU is located will be used for, Baird said no definite plans for that have been made but that moving the billing department there is one possibility.
Baird also said a total cost of the move has not determined, but since the existing "B" wing would be used, the remodeling portion could be started sometime in April and be finished by August.