The new facility in Cleveland will combine a range of services, including intensive rehabilitation, skilled nursing, and a multi-specialty geriatric practice on-site.
Two Ohio-based health systems have signed a collaborative agreement to operate a comprehensive skilled nursing and rehabilitation center in the Old Brooklyn neighborhood of Cleveland.
Traditional skilled nursing facilities are often standalone institutions with limited connections to acute care hospitals and home health services. The new facility in Cleveland, which is set to open by the end of the year, is being designed to have smooth transitions of care from the hospital setting to the home setting.
The new partnership features Toledo-based ProMedica and The MetroHealth System in Cleveland. The new facility, which will be located in the former Deaconess Hospital, will be called ProMedica Skilled Nursing and Rehabilitation at MetroHealth and will serve a mainly senior population.
ProMedica Skilled Nursing and Rehabilitation at MetroHealth is envisioned as a new approach to post-acute care for seniors, says Julie Jacono, MBA, senior vice president and chief strategy and innovation officer at MetroHealth.
"Most skilled nursing facilities are a disconnected campus. The patients get transported from one place to another. Physicians from a health system may come into the facility or they may not come into the facility. What is different with our new facility is this is a fluid continuity of care from multiple stages of care. It is one team following the patients all the way through their care. We feel that continuity of care and joint accountability for how the patient does in the end is what makes this new facility very different," she says.
The new facility will have 96 beds for lengths of stay expected to be less than 30 days. It will provide medically complex and intensive rehabilitation services for patients transitioning from hospital to home as well as 24-hour skilled nursing care. The facility will offer outpatient care and convenient access to inpatient rehabilitation services, geriatricians, and geriatric specialists.
ProMedica Skilled Nursing and Rehabilitation at MetroHealth is being designed as the skilled nursing facility of the future, says Randy Oostra, DM, president and CEO of ProMedica.
"We have tapped healthcare industry experts, architects, infection preventionists, and other specialists. A lot of their features are included in this partnership such as all private rooms. The facility will have some rehab capabilities that will be enhanced. And there will be the kind of monitoring you would expect in more modern facilities. When people walk in, the facility will look, operate, and feel very different than the senior facilities that were built 20 years ago," he says.
Key elements of the partnership
ProMedica Skilled Nursing and Rehabilitation at MetroHealth will be jointly staffed by the health systems, Jacono says.
"With the exception of the physicians and the therapists, the caregivers will be ProMedica staff. They will be hired and managed by ProMedica Senior Care. That is why this is a partnership. We will be jointly staffing elements of the care team. It is why we feel very optimistic about this partnership because ProMedica has done this before, and they were open and excited to work with us collaboratively," she says.
ProMedica and MetroHealth are well-suited for this kind of partnership, Oostra says. "We are both strongly mission-based in that we are committed to addressing social determinants of health and we have a lot of focus on working in our neighborhoods. In talking with MetroHealth, we have a lot of focus on the next level of care coordination for seniors as they come out of acute care and how you integrate that better."
ProMedica Skilled Nursing and Rehabilitation at MetroHealth will be a cornerstone of the Old Brooklyn neighborhood, Jacono says.
"That entire campus is dedicated to the unique needs of seniors as they move across the continuum of care, and it is in a great neighborhood. Surrounding that campus, there are several apartment complexes that serve large numbers of seniors. At both ProMedica and MetroHealth, we see this as a community facility. So, we have worked diligently with community partners, and they see this facility as a new asset in the Old Brooklyn community. It can drive quality of life and economic development in that community. Residents in this community see this facility as a great alternative for them to remain healthy and age in place," she says.
Preparing patients for success
For seniors, the new facility will serve as a bridge between the hospital setting and the home setting, Oostra says.
"Patients coming out of a hospital are often not prepared to go about their normal lives. With penalties for rehospitalizations, what we have been seeing at health systems is the need to link hospitals more closely with senior facilities to prevent rehospitalization or declines in health. One of the services this new facility will be providing is intensive rehabilitation to set up patients to thrive at home," he says.
A comprehensive approach to care will be a crucial aspect of ProMedica Skilled Nursing and Rehabilitation at MetroHealth, Jacono says.
"It is innovative because it is part of a larger system of care. In one campus, we are having some of the top physical medicine and rehabilitation doctors and our geriatric doctors working together. What we envision is a physical representation of a patient-centered medical home. We have the physical asset to be able to bring patient-centered care around our seniors," she says.
A wide array of services will be available in the new facility, Jacono says.
"Over the past five years, we have made a series of investments to make the Old Brooklyn Campus our primary hub for acute rehabilitation, spinal cord injury, and bringing the rest of our assets around geriatrics. On this campus, you are going to have a comprehensive personality for outpatient geriatric care, skilled nursing geriatric care, acute rehab, and research related to rehabilitation. McGregor PACE is a partner in that building—they have a great day program for seniors who are trying to avoid going to a nursing home," she says.
The new facility will help seniors make the transition to their homes, Jacono says.
"Our teams will work collaboratively, so that when a senior is ready to be discharged from the skilled nursing facility back into their home, we will have the right home care set up to be successful. We will assess social determinants of health, so if what a patient needs to be successful at home are additional services, we have the McGregor PACE program and a strong relationship with our local agency on aging to make sure that discharge is not just a checked box. We will not be saying, 'You are done with your rehab—good luck!' We will be taking responsibility for a patient's success and outcomes as they transition home," she says.
ProMedica Skilled Nursing and Rehabilitation at MetroHealth will provide a model of care that should be attractive to other health systems, Oostra says.
"We think these kinds of partnerships will start to evolve across the country, and that more and more health systems that may not have traditionally focused on senior care will look at this as a model for what they can do not only for patients leaving their hospitals but also what they can do to address aging in neighborhoods," he says.
Christopher Cheney is the senior clinical care editor at HealthLeaders.
The new partnership provides a model for health systems to offer continuity of care for seniors after an acute hospitalization.
The new Cleveland facility is also a model for how senior care can be integrated into a community.