Many nursing home operators understand how critical building hospital partnerships can be to their business success, but what exactly that looks like – and how to get started – can be tricky to navigate.
Hospitals and NFCs operate in vastly different worlds with different payment models, policies and regulations.
According to Stephanie Chedid, president and CEO of Luther Manor, a partnership should be more than just a place where the hospital sends its patients and a way to fill nursing home beds.
“Don’t take your business model to your hospital partner. Talk about your capabilities,” Chedid said during a presentation at the LTC 100 conference held this week.
Chedid has established a relationship with the Wisconsin-based Froedtert Health System over the past 15 months, establishing a 12-bed “intermediate unit” in the single-site nursing home staffed by Luther Manor and Froedtert employees.
Luther Manor is a single-site facility offering a full continuum of care that includes 99 specialty nursing beds and 45 short-term acute care beds.
The unit provides the rehabilitation, clinical services, complex social services and financial support needed to transition a resident to their final level of cre.
And it’s paid off so far. Since its launch in February 2021, the Intermediate Unit has accepted 193 referrals at an acceptance rate of 48%. Luther Manor’s Intermediate Unit also opened an acute care bed 631 times for a five-day stay during this period.
The patient population ranges from 35 to 80+.
Ultimately, the partnership also led to a better understanding of the work that hospitals and NFCs do, and how they can better align in the future.
“What’s really important is to understand each other’s world, because that’s how you will solve problems together,” said Diane Ehn, vice president of post-acute care at Froedtert.
Inside the unit
When the collaboration was first introduced, the plan was to develop its own special unit in a separate wing with its own entrance, Chedid said. The COVID-19 pandemic changed many of those plans, but ultimately for the better.
Staff include a Froedtert physician and nurse practitioner who supports qualified nursing staff, psychiatrist and wound care physicians, CNA nurses, social workers, financial counselors and therapy, among other roles.
“We have a much larger staff who are qualified and who deal with high acuity patients. It allows us to rotate the workload of our nurses so that one group doesn’t always have… the toughest assignments, and we have layoffs, but it’s also allowed us to bring in some great talent,” said said Chedid during the session.
This staff mix has presented opportunities for Luther Manor to be a more attractive recruiting employer given its newly developed complex clinical capabilities.
“We’ve really created a pretty compelling career ladder and a set of opportunities for our staff that has been really fantastic here,” she said.
But it required significant training, which Chedid said was crucial to being able to provide the care Froedtert needed when it came to the types of referrals sent.
“We said, ‘look if you want us to take type X, Y and Z patients, we need you to train our staff.’ We have a medical director and a nurse practitioner from their system who are also on our campus every day, and that makes a big difference as well,” she added.
The way Froedtert and Luther Manor have been able to collaborate and work together regularly through this unit has created a model of integrated care.
“It’s not a system where the hospital sends the patient to the SNF to lose them and say good luck,” Ehn said.
Subverting the traditional idea of an SNF-hospital relationship in many ways is exactly why this program has been successful, according to Chedid.
“Don’t let hospitals or a payer dictate your business model. Own it and show up with your abilities, and you can create things like this as long as there’s mutual respect and will,” she said.