Sep 30, 2009 staff reports Uncategorized
PHASE 12 GRANT is TO DOWNSIZE NURSING HOMES, EXPAND ACCESSIBILITY TO ASSISTED LIVING PROGRAMS, CREATE “GREEN HOUSE(r)” RESIDENCES FOR CENTRAL NEW YORK ELDERS, AND ENSURE NURSING HOME BED AVAILABILITY FOR DIFFICULT TO PLACE HOSPITAL PATIENTS:
Michael J. Sullivan, Loretto president and chief executive officer, today announced that the Loretto Health and Rehabilitation Center was officially awarded a $12 million grant from HEAL NY Phase 12 funding for its “Green Community” project, which supports high-quality, community-based services for older adults.
Earlier this year NY governor David A. Paterson announced the availability of $175 million in HEAL NY Phase 12 funding to support projects that provide an appropriate level of long term care services in settings that are viable alternatives to nursing homes, such as assisted living programs and residences.
Loretto Health and Rehabilitation Center will utilize the funds to support a two-year, comprehensive, multi-provider project that will downsize regional nursing home capacity and expand accessibility to Assisted Living Programs. The project will also create “Green House(r)” residences, a nationally recognized care model for the elderly of Central New York.
The project will also ensure the availability of nursing home beds for hospital patients who have difficulty obtaining access to nursing home beds because of advanced illnesses and other conditions. Without this accessibility, these patients effectively reduce access to care in hospital emergency departments and acute care beds. Historically, Loretto and Rosewood Heights Health Center have been major sources of care for this group.
Sullivan states, “We are thrilled about this announcement and the opportunity it provides us to collaborate with the local hospitals to begin reshaping the way eldercare is provided in Central New York. We believe our “Green Community” project will be a monumental step in the transformation of care from an institutionally based model to one that delivers person-centered care in intimate home-like environments.”
The project is a collaborative effort with Community General Hospital, Crouse Hospital, and St. Joseph’s Hospital Health Center, which, along with Loretto, own Rosewood Heights Health Center, a 242-bed skilled nursing facility, and is endorsed by University Hospital. Rosewood and Loretto Oswego, a 120 bed skilled nursing facility, will end their operations when the project is fully implemented in two years. Because Rosewood Heights is such a valuable community resource in responding to the needs of individuals being discharged from local hospitals with especially complex conditions, renovations will occur at Loretto’s Cunningham Skilled Nursing Facility to expand its capacity to serve that population.
With a total projected budget of $40 million, the “Green Community” project will construct 13 “Green Houses(r)”, small homes each housing 12 elders, as well as create 100 new Assisted Living Program (ALP) slots, providing a residential alternative to nursing home care. This project will ultimately eliminate the need for a total of 176 skilled nursing beds in our region, responding to demographic data and NYS Department of Health calculations that Central New York has an excess of skilled nursing beds.
The need for fewer nursing home and more Assisted Living beds is generated largely by the post World War II Baby Boom generation. The aging of this group will stimulate need for lower intensity long term care services, but not require additional nursing home capacity for approximately ten years.
“Green Community” Project Summary
LORETTO HEALTH AND REHABILITATION CENTER
HEAL NY SUMMARY
Loretto Health & Rehabilitation Center (LHRC) has been awarded $12 million in NYS HEAL funds to support a comprehensive, $40 million, multi-provider project that will downsize regional nursing home capacity, expand accessibility to Assisted Living Programs (ALP), and create “Green House(r)” residences, a nationally recognized care model, for the elderly of Central New York. This project is designed to respond to consumer interest in non-institutional skilled nursing level of care, introduce a new eldercare model to Central New York, and to rightsize the region’s long term care services to respond to financial and demographic realities. The region’s skilled nursing home beds will be reduced by 176.
The numbers of frail elderly in Central New York is anticipated to remain stable through the year 2020, and the current capacity of regional nursing homes already exceeds the need. Substitution of Assisted Living Program slots for Skilled Nursing Home beds can further limit this need. At the same time numbers of Difficult to Place (DTP) patients being discharged from area hospitals continue to increase as a result of the expanding scope of acute care programs and increasing longevity of existing frail elderly. This situation requires long term care services for the Difficult to Place population that are not available in many existing facilities.
Two major providers of skilled nursing care within the Loretto network are the Loretto Health and Rehabilitation Center (LHRC), also referred to as Cunningham/Fahey (C/F), and Loretto Oswego (LO). LHRC is the largest skilled nursing facility in Central New York, with 554 beds, and provides care to nearly 2,000 individuals annually. LO operates with 120 skilled nursing beds. The third provider in this initiative is Rosewood Heights Health Center (RHHC), the 242-bed skilled nursing facility located in the City of Syracuse, critical to meeting the needs of difficult to place patients — those with special needs such as multiple clinical diagnoses and chronic conditions, intravenous therapy, wound care, bariatric care, and mental health conditions. Rosewood Heights is owned by Community General Hospital, Crouse Hospital, St. Joseph’s Hospital Health Center and Loretto.
These essential providers of critical services to the elderly are threatened by the current economic and demographic environment. The most immediate impact of the severe economic downturn has been actions by New York State to reduce the level of Medicaid reimbursement. While necessary, it has produced a widening revenue shortfall of between 5 and 15 percent from years 2008 through 2010 for these providers.
LHRC, primarily due to its long term care expertise and size is best positioned to manage this crisis through both persistent attention to operational efficiencies and new approaches to structuring and delivering services. Both LO and RHHC were challenged to maintain financial viability before the economic crisis of 2008, and the outlook for their ability to maintain quality services in the current environment is poor.
The project includes the following major components:
Close the 120 bed Loretto Oswego (LO) facility. The rationale for this action is based on several factors including the age of the current facility, particularly the mechanical infrastructure, and Loretto’s lack of market share/presence in the Oswego community that has three other very qualified providers of nursing home care;
Be a partner in the closure of the 242 bed Rosewood Heights Health Center (RHHC), a 40 year old building long recognized as ill-suited to meet the needs of its special populations (including a high percentage of Difficult to Place discharges from local hospitals) and located in densely developed urban setting without practical opportunity for expansion or cost effective renovation;
Move 30 long term care beds to the main Loretto Health & Rehabilitation Center (LHRC) campus on Brighton Avenue to maximize efficiencies and use existing available space on the 13th floor of the main building that would be retrofitted to a more homelike “neighborhood” setting designed to serve complex difficult to place discharges from the four (4) major local hospitals;
Construct 13 “Green Houses(r)” with 12 long term care beds in each house, to be constructed in the northern area of Onondaga County, the center of the emerging market and accessible to major population centers of the CNY Region;
Create 100 Assisted Living Program slots to replace some of the decommissioned nursing home beds as an appropriate response to changing consumer preferences.
Respond to the needs of the Syracuse hospitals Difficult to Place (DTP) population needing nursing home placements. LHRC will have the capacity to cohort a variety of DTP patients on the 15 floors that will be reconstructed and reconfigured at Cunningham/Fahey to respond in a high quality manner to specialty care, subacute care, and transitional care needs of the combined DTP residents from both RHHC and LHRC. This restructured system of care will assure that at least twenty percent (20%) of all new hospital admissions to the reconfigured Loretto skilled nursing facility beds will be DTP admissions on an annual basis. This will include more than 300 Difficult to Place admissions annually. Although concentrating such a large volume of DTP at LHRC will be challenging fiscally, the location of new community-based skilled nursing home beds (green houses) is anticipated to provide a very competitive and attractive array of services that will allow this initiative to be fiscally viable as a total system of long term care.
Loretto Health and Rehabilitation Center requested and has been awarded $ 12 million from HEAL NY to support this $40 million project.
Funded projects are expected to begin in October of 2009 and be completed within 24 months.
For more information about Loretto, log on to HYPERLINK “http://www.loretto-cny.org” www.loretto-cny.org.
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