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TRANSCRIPT
The Value of Post Acute Care It Depends on When You Ask
Presentation to:The American Hospital Association
Nancy D. SchmidtVP, Referral Relations and AdmissionsTerrence A. O’Malley, MD
Medical Director for Non Acute Care ServicesJudith Flynn, RN, MBA
VP, Patient Care Quality Compliance Officer
1
Nancy D. SchmidtVP, Referral Relations and Admissions
Partners Continuing [email protected]
617-573-2251
Terrence A. O’Malley, MDMedical Director for Non Acute Care Services
Judith Flynn, RN, MBAVP, Patient Care Quality Compliance Officer
Partners HealthCare at [email protected]
781-290-4051
David E. StortoPresident,
Partners Continuing Care &Spaulding Rehabilitation Network
2
Outline
• Partners Healthcare and Partners Continuing Care
• The “Value” Proposition– Now: DRG and LOS Reduction– 2013: Readmission Reduction– Future: ACO
• Summary and Questions
3
Partners HealthCarePartners HealthCare
Massachusetts General Hospital Massachusetts
General HospitalNorth Shore
Medical Center North Shore
Medical Center
Newton-Wellesley Health Care System Newton-Wellesley
Health Care System
Partners Continuing CarePartners Continuing Care
Brigham & Women’s Physicians
Organization
Brigham & Women’s Physicians
Organization
Faulkner HospitalFaulkner Hospital
The General Hospital Corporation
The General Hospital Corporation
Massachusetts General Physicians
Organization
Massachusetts General Physicians
Organization
McLean Hospital Corporation
McLean Hospital Corporation
The MGH Institute of Health Professions
The MGH Institute of Health Professions
MGH Health Services Corporation
MGH Health Services Corporation
North End Community Health
Committee
North End Community Health
Committee
Salem Hospital North Shore
Children's Hospital
Salem Hospital North Shore
Children's Hospital
Union HospitalUnion Hospital
Charter Professional Services Corporation Charter Professional Services Corporation
Newton- Wellesley Hospital
Newton- Wellesley Hospital
NeWell Medical Delivery Organization
NeWell Medical Delivery Organization
Spaulding Rehabilitation
Network
Spaulding Rehabilitation
Network
Spaulding Cape CodSpaulding Cape Cod
Spaulding North ShoreSpaulding North Shore
Partners HealthCare at
Home
Partners HealthCare at
Home
Clark House at
Fox Hill Village
Clark House at
Fox Hill Village
Dana Farber/Partners Cancer CareDana Farber/Partners Cancer CareTwo Physicians Appointed
by Partners Two Physicians Appointed
by PartnersPartners Community HealthCare (PCHI)
Partners Community HealthCare (PCHI)
Martha’s Vineyard Hospital
Martha’s Vineyard Hospital
Nantucket Cottage Hospital
Nantucket Cottage Hospital
Brigham & Women’s/
Faulkner Hospitals
Brigham & Women’s/
Faulkner Hospitals
Brigham & Women’s Hospital
Brigham & Women’s Hospital
Spaulding CambridgeSpaulding Cambridge
Spaulding Center for Outpatient Care Spaulding Center for Outpatient Care
Spaulding Rehab HospitalSpaulding Rehab HospitalHome CareHome Care
Private CarePrivate Care
Health Products and Technologies
Health Products and Technologies
Partners HealthCare System (PHS)
4
PCC: Who Are We?
• The portion of post acute care service providers owned by PHS
• Components:– 2 LTACs 300 beds– 2 IRFs 256 beds– 4 SNFs 327 beds– Medicare Certified Home Care 25,000
admissions per year
5
Partners Continuing Care Basic Statistics
Entity LTAC Beds
IRF Beds
TCU/SNF Beds
FY 09 Home Health & OP
Visits
FY09 Total Admissions
FY09 % of Admits from
PHS
FY09 Total Revenue
(in millions)
SRH 196 143,816 2,650 69% 96,402SHC 180 2,191 55% 59,300SNS 120 40 58,251 1,906 79% 41,562SCC 60 86,317 1,139 17% 30,127SWR 77 1,113 93% 14,196SNE 140 509 92% 18,320PHH 380,393 24,758 55% 78,090Clark House (50% interest) 70 584 32% 10,200
Total PCC 300 256 327 668,777 34,850 348,197
6
PHS - Basic Statistics
• Total ACH beds: ~2400• Discharges per year: ~155,000• 50,000 patients use post acute care
– 25,000 use Home Care– 15,000 use SNF– 10,000 use LTAC or IRF
• PHH takes 55% of PHS home care referrals• PCC facilities take 20% of PHS SNF referrals • PCC facilities take 50% of PHS LTAC/IRF
referrals7
Partners Continuing Care Basic Statistics
Entity LTAC Beds
IRF Beds
TCU/SNF Beds
FY 09 Home Health & OP
Visits
FY09 Total Admissions
FY09 % of Admits from
PHS
FY09 Total Revenue
(in millions)
SRH 196 143,816 2,650 69% 96,402SHC 180 2,191 55% 59,300SNS 120 40 58,251 1,906 79% 41,562SCC 60 86,317 1,139 17% 30,127SWR 77 1,113 93% 14,196SNE 140 509 92% 18,320PHH 380,393 24,758 55% 78,090Clark House (50% interest) 70 584 32% 10,200
Total PCC 300 256 327 668,777 34,850 348,197
8
Important Points
• PHS needs more Home Care, SNF, LTAC and IRF services than can be provided by PCC
• PHS hospitals struggle with balancing access to post acute care services, quality of care and patient demand
• Control through ownership is important but expensive and limited
• How to exert control without using capital?
• The Times they are a Changing
9
The Three Post Acute Care Value Propositions
Now- DRGs and LOS2013- ReadmissionsFuture- ACOs
10
The “Now” Value PropositionNow Readmission
EraACO Era
Financial DRG Driven LOS reduction DRG/LOS plus Financial penalty
Common bottom line with shared responsibility for cost
Quality Quality – Site specific – state and federal criteria, no
reflection on ACH
Post Acute quality matters in so far as it impact
readmissions
Quality impacts finances, efficiency and market share
Access Access - More is better Access to the right provider = can provide the reduced
admissions
Access balanced by cost effectiveness
Efficiency Ease of Access, no impact on overall cost or efficiency
Access + low readmissions Essential under global payment, readmissions
become an efficiency measure
Reputation No impact No impact Reputations are linked and based on satisfaction across
the entire episode of care
Patient Satisfaction No tangible impact No impact Sites are Interdependent
Characteristics of the relationship
ACH and PAC providers are silos, no shared incentives
other than to drive utilization.
ACH now cares about post acute as partner in
readmission reduction
ACH now cares about post acute partner as part of
financial success
Shared measures None: each measures and manages separately.
Readmission rates Cost, quality, patient satisfaction
Value to the ACH
11
Maximize Access Minimize LOS
• Developed 4NEXT– Web based application available to all CMs– Information on all post acute care providers in
searchable database, hand-out for family– Secure information exchange with PACPs
• Results– Rapid identification of appropriate providers– Rapid identification of available beds
12
4NEXT II
• Tracks all referrals to all PACPs• Tracks “acceptance” rate• Identifies providers who make extra effort
to accept PHS patients• Helps monitor referral patterns to
encourage referrals “in network”• Provides the data to inform decisions
regarding “buy, build, lease”13
Current State
• In-network referrals have consistently increased• Percent of “referrals-accepted” has increased• Referral processing has changed from multi-site
to central assessment and referral by liaison staff
• All referrals go through liaisons who find an alternative provider if PCC providers can’t meet need
• As a result, PHS has been able to maximize in system referrals while maintaining wide access
• We still live in this system, but the rules are changing
14
2013 -Readmissions
15
Lewis Carroll on Readmission Reduction
"Cheshire Puss, she began, rather timidly, as she did not know at all whether it would like the name: however, it only grinned a little wider. Come, it's pleased so far, thought Alice, and she went on. Would you
tell me please, which way I ought to go from here?
That depends a good deal on where you want to get to said the cat.
I don't much care where, said Alice.
Then it doesn't matter which way you go, said the cat.
... So long as I get somewhere, Alice added as an explanation.
Oh, you’re sure to do that, said the cat, if you only walk long enough“
“Alice in Wonderland” Lewis Carroll
16
The “Readmission” Value PropositionNow Readmission
Era ACO Era
Financial DRG Driven LOS reduction DRG/LOS plus Financial penalty
Common bottom line with shared responsibility for cost
Quality Quality – Site specific – state and federal criteria, no
reflection on ACH
Post Acute quality matters in so far as it impacts
readmissions
Quality impacts finances, efficiency and market share
Access Access - More is better Access to the right provider = can provide the reduced
readmissions
Access balanced by cost effectiveness
Efficiency Ease of Access, no impact on overall cost or efficiency
Access + low readmissions Essential under global payment, readmissions
become an efficiency measure
Reputation No impact No impact Reputations are linked and based on satisfaction across
the entire episode of care
Patient Satisfaction No tangible impact No impact Sites are Interdependent
Characteristics of the relationship
ACH and PAC providers are silos, no shared incentives
other than to drive utilization.
ACH now cares about post acute as partner in
readmission reduction
ACH now cares about post acute partner as part of
financial success
Shared measures None: each measures and manages separately.
Readmission rates Cost, quality, patient satisfaction
Value to the ACH
17
Build the foundation of your “ACO”
• Interim step to;– Develop administrative structures to manage
the continuum of care – Improve clinical transitions– Identify potential partners– Experiment with cross continuum and
episode-based clinical management– Figure this out one patient at a time
18
Value Stream Management
• Include all components of 30 day episode of care– In-patient– ED– PCPs/Specialists– Post Acute– Community based services
• Why? Each contributes to readmissions• Improve each component, but also…• Improve the clinical transitions among them:
– The right information– At the right time – In the right way
19
New Performance Metrics
• More than just access: now its readmission rate and access
• Need these Essential capabilities– Enhanced Clinical Management – Communication (IT) links– Shared process improvement– Integration into hospital readmission
reduction programs• Facilities that reduce readmissions
could be future ACO partners20
Where do Unplanned Medicare Readmissions Come From?
• Readmissions by days after discharge– 19.6% readmitted at 30 days– 34%% at 90 days– 56.1% at 180 days
• Most common discharge diagnoses– Medical: heart failure, pneumonia, chronic obstructive
pulmonary disease, psychoses, and gastrointestinal problems
– Surgical: cardiac stent placement, major hip or knee surgery, vascular surgery, major bowel surgery, and other hip or femur surgery.
– 70% of surgical patients readmitted with medical diagnosis (UTI, pneumonia)
Jencks, Williams and Coleman NEJM April 2, 2009 360(14):1418-2821
PHS Post Acute Care Experience
• 50,000 patients a year sent to– ~500 SNFs– ~25 LTAC/IRFs– ~50 HHA
• 25-33% of all readmissions come through Post Acute• Readmission rates from Post Acute vary widely
– IRF 15-25%– LTAC 26-55%– SNF 10-40%– Home Care 14-25%
• A 30% reduction in post acute readmissions translates to a 40-50% reduction in overall readmissions
22
• Estimated CMS penalty for PHS- > $50M• 25% of 30 day readmissions come through
PCC• Readmission rates within PCC varied but
were in line with the ACH rates• Virtually all PCC readmissions come
through the ED• Strategy: start with owned PAC then
expand
Post Acute Care and PHS
23
Finding the “Right” Post-acute Care Providers
• In the absence of effective financial leverage, you need willing partners
• Identify entities that:– Understand where health care is heading and
embrace it– Want to be part of your future “ACO”– Are willing to forego some short term gains to
establish their credentials as efficient, high quality partners
• Count yourself lucky if that’s more than 10% of what you need
24
What to do when you find them
• Understand that change is a two way street
• Establish an administrative mechanism to– Meet regularly for problem identification– Develop shared performance metrics
• Readmissions• Returns to ED
25
PHS Readmission Performance
• Overall 30 day readmission rate is lower than State average ~19%
• >50% of discharges go to Non-PHS Post Acute facilities
• ~50% of their readmissions go to Non-PHS hospitals
• PHS owned facilities have some of the lowest readmission rates
26
Life is Just One Big Pareto Chart
• Here are some targets– 90% readmitted through the ED– 10% readmitted from follow-up appointment or test
site– 30% readmitted within 72 hours– 50% within 7 days
• Two big questions– What to do?– Who to do it with?
27
First: Develop Infrastructure
• Learn about and join existing efforts– STAAR (State Action to Avoid Re-
hospitalizations) (www.ihi.org)– INTERACT II (www.interact2.net)– Project Red
(www.bu.edu/fammed/projectred/) – BOOST (www.hospitalmedicine.org)
• Readmission review teams• Cross continuum teams
28
STAAR State Action to Avoid Re- hospitalizations
• A four year multi-state, multi-stakeholder initiative funded by The Commonwealth Fund
• Partnership between the Institute for Healthcare Improvement and State Leaders to:– Reduce state-wide 30-day rehospitalization rates– Increase patient and family satisfaction with transitions in care
and with coordination of care
• Initial Phase– May 2009 – October 2010– Three states: Massachusetts, Michigan, and Washington
29
• Goal: 30% reduction in 30 day re-admissions
• Cross Continuum Teams in each hospital– PCC Representatives on each
• IHI Rapid cycle improvements (“tests of change”)
• Initial focus on one of four areas:– Risk stratification– Management– Preparation for discharge (teach back)– Post Discharge management (call back, early follow-
up)
STAAR
30
Second: Measure and Report
• Developed shared quality metrics including uniform definitions for– Transfers to ED– 30 Day readmissions
• We report quarterly to the PCC Board and report on the PHS Quality Dashboard
• We “budget” readmission reduction and report progress quarterly
31
Partners Healthcare At Home 30 Day Readmissions- 14%
3700 patients per year
1/3 in first seven days
1/3 between day 8 & 14
1/3 day 15-30
32
Spaulding RehabAcute Discharges by LOS Jan-Jun 09
N=227
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
LOS
Perc
ent o
f Tot
al A
cute
Dis
char
ges
• 16% readmission rate at 30 days
• Approximately 1/3 of readmissions occurred in the first 72 hours
33
SRH Acute Discharges to MGH by LOS Jul-Dec 09N=82
0%
1%
2%
3%
4%
5%
6%
7%
8%
9%
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
LOS
Per
cent
of A
cute
Dis
char
ges
Evaluating differences by hospital referral source
SRH Acute Discharges to BWH by LOS Jul-Dec 09N=59
0%
2%
4%
6%
8%
10%
12%
14%
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45
LOS
Perc
ent o
f Acu
te D
isch
arge
s
34
Third: Analyze and Intervene
• 30% of 30 Day readmissions occur within 72 hrs of transfer for PCC facilities– Changes in Mental status, Respiratory status
and hemodynamic status– Feedback and review with ACH referrers– Developed Transitions Committee PAC/ACHs– Refine transfer of information at transitions– Change management model for more overlap
35
Third: Analyze and Intervene
• Virtually all PAC readmissions come through the ED
• Interventions– Improve PAC to ED communication– Provide ED with alternatives to readmission– Review role of ED in readmission reduction
36
Readmission Pathways- Now The opportunity to control readmissions through Post Acute
Emergency Department
ReadmissionEval and Return Observation
Patient Selection
Discharge Preparation
Patient Management
Care Transition
Post Discharge
Post AcuteEnhance management of patient to reduce transfers from post acute
Enhance staff capabilities to manage more complex patients
37
Readmission Pathways-Soon
Emergency Department
ReadmissionEval and Return Observation
Patient Selection
Discharge Preparation
Patient Management
Care Transition
Post Discharge
Post AcuteProvide ED with alternatives to admission
Enhance Post Acute resources to accept patients return of patients
38
Readmission Pathways
Emergency Department
ReadmissionEval and Return Observation
Patient Selection
Discharge Preparation
Patient Management
Care Transition
Post Discharge
Template for transfer information (INTERACT II)Phone call after transfer to discuss findingsPhone call prior to disposition“PCC Rounder” to see patient in ED (?)
39
Sidebar: What are Readmission Dollars?
• They appear to be “negative dollars”– Interventions will reduce a “loss” rather than
produce a “gain”• Potential ways to “book” readmission dollars
– Charge against margin targets– Line item for projected repayment– Deal with it when it comes
• How you answer may determine how you allocate resources
40
Future – ACO
Cost, Quality and Patient Satisfaction will be Key
41
Emphasis on Accountable Care The reality
– The incentives and reimbursement structures are not aligned– Regulations will always ‘lag and drag’
To get from ‘Here’ to ‘There’• Accountability within each entity for efficiency, quality
and outcomes from beginning to end– Transitions in care both at acceptance and at hand off to the next
provider– Highly reliable, efficient, effective care with high quality
outcomes and patient satisfaction
• Thinking outside the box with innovative and collaborative approaches plus risk sharing early on
42
What will be important? Finding the lowest cost /most effective / most efficient/ highest quality site of care
43
The “ACO” Value PropositionNow Readmission
EraACO Era
Financial DRG Driven LOS reduction DRG/LOS plus Financial penalty
Common bottom line with shared responsibility for cost
Quality Quality – Site specific – state and federal criteria, no
reflection on ACH
Post Acute quality matters in so far as it impact
readmissions
Quality impacts finances, efficiency and market share
Access Access - More is better Access to the right provider = can provide the reduced
admissions
Access balanced by cost effectiveness
Efficiency Ease of Access, no impact on overall cost or efficiency
Access + low readmissions Essential under global payment, readmissions
become an efficiency measure
Reputation No impact No impact Reputations are linked and based on satisfaction across
the entire episode of care
Patient Satisfaction No tangible impact No impact Sites are Interdependent
Characteristics of the relationship
ACH and PAC providers are silos, no shared incentives
other than to drive utilization.
ACH now cares about post acute as partner in
readmission reduction
ACH now cares about post acute partner as part of
financial success
Shared measures None: each measures and manages separately.
Readmission rates Cost, quality, patient satisfaction
Value to the ACH
44
Care Transitions and Coordination Critical to Success in ACO
Preventable readmissions reflect low quality (care that should be unacceptable for patients) and low value
(waste in dollars).
Payment reform, by itself, won’t correct all the issues. Some form of integration of the healthcare delivery
system addressing care transitions and coordination will also be needed
Barry M. Straube, M.D.CMS Chief Medical Officer & Director of Clinical Standards and QualityJune 2010
45
PHS Efforts to Improve Transitions
2006
STAAR
The Joint Commission
Interact II
2008
Initiative Time lines
2007 2009 2010
RTI – CARE Tool
Started in 2002 Partners Care Transitions – HPM 2
2011
CMS Demo Design
CMS Demo - MGH CMS Demo Expansion to BWH & NSMC
Advance Care Planning Module
2002
Started in 1998 4NEXT
46
• Inclusion of all required elements in Discharge Documentation– Goal: ‘Defect Free Rate’ in Discharge Information
• ‘All or Nothing’ scoring- no partial credit• Scores reported to senior management
• Timely completion of Discharge Documentation– To sub-acute facilities: same calendar day– To home: within 24 hours of discharge– For all patients: not written more than 2 days prior to discharge
• Templated Discharge documentation in EMR
High Performance Medicine Transitions in Care
47
Phase:I. Acute facilities self audit of discharge
documentation in inpatient record
II. Post Acute Facilities audit of discharge documents received
III. Home Care audit of discharge documents from acute and post acute care facilities
IV. Emergency Department audit of transfer documents from post acute facilities
V. Emergency Department audit of transfer documents from home care
Audit Methodology
We are here
48
• Participants:
• Goals• Define essential elements of a hand-off• Define process and goals for rapid cycle improvement• Create a template for other hospitals to follow
• PHS Pilot• Handoffs from Partners Continuing Care Facilities to
PHS Emergency Departments using Interact II tool
– Mayo– Stanford– Intermountain– Kaiser
– Fairview– North Shore– New York-Presbyterian– MGH/PHS
TJC- Center for Transforming Health Care Hand-off Communications Pilots
49
Allocation of Incentive Awards• Acute Care Hospitalization – 30%
– 22.5% to Performance– 7.5% to Improvement
• Emergent Care – 20%– 15% to Performance– 5% to Improvement
• Five Remaining Outcomes – 50% (10% each)– 7.5% to Performance– 2.5% to Improvement
Year 1 results 167 home health agencies saved over $15 million
Partners Healthcare at home in to 20% in four outcomes including ACH and EC
Home Care P4P Demonstration What does it tell us
Hospital and Home care Incentives are starting to align
50
Dilemmas: Getting from Now to Then
• ACO: – Well managed, willing to invest in enhanced
communications, patient management, shared quality reporting and performance
• How to identify preferred providers– Now, mission driven, early adopters are
approximately 10-15% of providers– Geographic spread vs. patient preference vs.
management control51
Dilemmas
• How to merge/share clinical information
• How to achieve transparency in quality and performance reporting
• How to extend administrative control– How to adjudicate funds flow under ACO structure– What will administrative structures be– How to begin building these capabilities without using
capital
52
How to begin practicing like an ACO in a Fee For Service world
• Consider some risk sharing pilots or programs with preferred vendor
• Innovate and collaborate building on identified strengths of your potential partners
• Define high quality, efficiency and effectiveness and start measuring it
53
Risk Sharing
PHH ‘ED Phone Home’ program
• Liaison/RSC nurses are available by phone, cell phone and Partners pager to accept referrals immediately with one call, – Monday – Friday 8:00 AM to 9:00 PM– Saturday- Sunday 8:00 AM to 7:30 PM
• Admission within 24 hours of referral acceptance and processing by Referral Service Center includes:– Thorough home safety evaluation and assessment– Medication reconciliation and management– Referral for additional home care as needed– Medical Social Worker (MSW) phone contact
54
Innovation and Collaboration
Connected Cardiac Care Program• Telemonitoring for CHF patients not qualified for home
care– 7 days a week– Physician support - Telemonitoring nurse as case manager– Scheduled and just in time teaching to bring patient to greater
self management
• System payment of monthly monitoring costs
• Designed to connect the physician and patient for greater self management support.
55
State and National Quality Initiatives Implications for Post Acute Care
American Recovery and Reinvestment Act• The ‘Meaningful Use’ definition will guide
IT Infrastructure strategy not only in the hospital but across the continuum
Value Based and Bundling of Payments• Accelerates need for increased
efficiency, effectiveness and coordination within PCC and across the PHS system.
Massachusetts Quality Reporting• Accelerates consumer driven health care
with increased demand for transparency of our quality, safety, effectiveness and efficiency
56
57
Measuring Quality PCC Quality Dashboard
IT Infrastructure Patient Perception of Care
Quality and Safety
Publicly Reported Outcomes:
58
Metrics to ConsiderIT capabilities
The key to continuity of patient care communication across the continuum
•Ability to communicate internally and externally– Electronic clinical documentation (nursing, therapy and physician)– CPOE – Electronic discharge/transfer– Portals
•Electronic Patient Safety Tools– EMAR– Bedside medication verification– Smart pumps
59
Metrics to ConsiderPatient Safety and Quality
– 30 day readmissions– Falls with injury– Acquired pressure ulcers– Other infection rates (MRSA, VRE, CVC - BSI)
Publicly Reported Outcomes• Home Health Compare• Nursing Home Compare
60
Metrics to ConsiderEfficiency and Effectiveness • Functional Independence Measures (FIM)
– FIM Change – Admission to Discharge– FIM Change per day / LOS Efficiency
Patient ExperienceThe score and percentile rank• Overall Satisfaction• Likelihood to Recommend
61
A few last thoughts….
• Metrics are defined, compiled and reported differently across PAC
• Some metrics may not be available and will need to be defined and requested
• Benchmarks and goals may need to be established– Where they don’t exist:
• Benchmark PAC against it’s own baseline year• Set arbitrary goal
62
Thank you for your Time
Questions?
Comments?63
Nancy D. SchmidtVP, Referral Relations and Admissions
Partners Continuing [email protected]
617-573-2251
Terrence A. O’Malley, MDMedical Director for Non Acute Care Services
Judith Flynn, RN, MBAVP, Patient Care Quality Compliance Officer
Partners HealthCare at [email protected]
781-290-4051
David E. StortoPresident,
Partners Continuing Care &Spaulding Rehabilitation Network
64
Appendix
65
Overview of Partners Continuing Care
66
Partners Continuing Care (PCC)Inpatient
Rehabilitation Facilities (IRF)
Inpatient Rehabilitation Facilities (IRF)
Long TermAcute Care
Hospitals (LTAC)
Long TermAcute Care
Hospitals (LTAC)
Skilled NursingFacilities (SNF)Skilled NursingFacilities (SNF)
Home Care & Hospice
Home Care & Hospice
67
Partners Continuing Care Specialty Hospitals
Spaulding Rehabilitation Hospital (SRH)• 196 bed inpatient rehabilitation facility (“IRF”) hospital• About 2,600 inpatient admissions and 10 outpatient centers with over 140,000 outpatient visits • Harvard teaching hospital and leader in rehabilitation research • Ranked by US News & World Report as one of the best rehabilitation hospitals, moving from number 14 to number 4 in the nation during
the last 10 years
Spaulding Hospital for Continuing Medical Care North Shore (SNS)• Formerly Shaughnessy-Kaplan Rehabilitation Hospital• 120 bed long term acute care (“LTAC”) hospital and 40 bed “subacute” skilled nursing facility that serves NSMC• About 2000 inpatient admissions and 8 outpatient centers with over 58,000 outpatient visits
Spaulding Rehabilitation Hospital Cape Cod (SCC)• Formerly Rehabilitation Hospital of the Cape and Islands• Developed by Spaulding • 60 bed IRF• About 1100 inpatients and 5 outpatient centers with almost 86,000 outpatient visits
Spaulding Hospital for Continuing Medical Care Cambridge (SHC) • 180 bed LTAC hospital• About 2100 inpatient admissions
68
Partners Continuing Care Who We Are Skilled Nursing Facilities
Spaulding Nursing and Therapy Center North End (SNE)• Formerly North End Rehabilitation and Nursing Center• 140 beds including a 40 bed “subacute” SNF unit• Subacute unit established to serve the MGH
Spaulding Nursing and Therapy Center West Roxbury (SWR)• Formerly The Boston Center for Rehabilitative and Subacute Care• 77 “subacute” SNF beds that serve BW/F Hospitals
Clark House at Fox Hill Village• 70 SNF beds in Continuing Care Retirement Community that includes
senior housing and assisted living• Joint Venture with Kindred
69
Home Care• Represents what once were 30 individual agencies• Each day, more than 3,000 people are under care• 1,400 employees - 364 RNs/ 112 PT/OT/ 608 Aides/Hmkrs
Partners Continuing Care Who We Are Partners HealthCare at Home
Private Care • Merger of 3 individual agencies• Each day, more than 1,500 people are under care
Health Products and Technologies• Lifeline – 4000 subscribers• Telemonitoring – 300 patients• Medication Dispenser
70