THE NEW GILDED AGE (Part 2)
THE NEW GILDED AGE (Part 2)
07th October, 2010 0
It’s been two years since Saginaw county voters approved a building renovation and operations millage for HealthSource Saginaw; but now the wait is over. On Friday, October 29th the public is invited to a gala Open House geared to showcase the remarkable remodeling and improvements made at the facility, which provides 213 beds in the nursing facility and 61 beds in the psychiatric and chemical dependency unit.
In addition to special remarks that will be made by Dr. Malcolm Fields, refreshments and tours will be available to the public from 2:00 – 6:00 PM.
Recently I had the opportunity to sit down with HealthSource President & Chief Executive Officer Lester Heyboer, Jr. to discuss the many improvements made at HealthSource, along with his prognosis on what the renovations mean for the future of the facility.
Review: When you look at this project from inception to completion are you pleased with the evolution?
Heyboer: Yes, because it marks the first stage in moving from an older building and evolving the process of becoming a more user-friendly place, especially for residents and families using our services. In the previous building we had multi-floor elevators that were not compatible with long-term care residents in walkers and wheel chairs; plus the rooms for patients are larger. In the old facility the rooms contained three or four beds and some would share a large bathroom. Now all the units have their own bath & shower, with a mix of 70 percent private and 20 percent semi-private.
Plus as we evolved we increased our capacity in the psychiatric unit. The total number of beds didn’t change here, but the compliment of what we do with psychiatric and chemical dependency did, so we went from 41 to 61 beds, which was almost a 50% increase in capacity. This proved to be a good move.
Review: What was the total cost of the renovation?
Heyboer: When all the figures are in we were under a budget of $35 million provided by the millage approval, with about $2-3 million in interest earnings that we funneled back into the program; and then we contributed $6 million internally, so it came in somewhere between $41-44 million.
Review: The overall feel and amenities such as a theatre, café, and gift shop for residents and their families are impressive. This must be one of the nicest care facilities in the state.
Heboer: We invested about $2 to $3 million in technology that would prevent someone from wandering outside the facility, plus we have new fire alarms and camera systems that can monitor people throughout the building that weren’t there before. We have a much safer facility than before.
When we were in the design aspect of putting the new next to the remodeled the middle section became what we call ‘Main Street’ – a collection of shops based upon village type concepts that encourage people to move along and visit the theatre or gift shop. Plus we provided a chapel for moments people want to be there and the religious services that we conduct here, all with the goal of giving people choices. I feel this is a big plus for folks staying here that need access to media or computers or might require it to conduct business.
We’re trying to get away from the old health care model, which was a pretty prescriptive one, and move to a more progressive model, which is more flexible.
Review: What do you feel was the most challenging thing about the renovation?
Heyboer: I would say two things: one is merging a remodeled section with a new section and within that the number of moves required to make it all happen in a staged approach that would not affect patient care. This was mainly a matter of logistics. Some departments moved five different times, quite willingly. For example, I’ve been here for almost 16 years now and this is the first time all of our Administrative Services are in one place. Before if I wanted to go to the Finance Department, I had to walk over to the other side of the building. This makes everything more efficient.
Review: Since the renovation have you noticed an increase in the response or demand from the public?
Heyboer: We didn’t always have the ability to fill our licensed capacity until the renovation was finished; but now that we have, we are pretty much filled in the substance and psychiatric departments, as well as our 213 rooms via the nursing capacity.
The average length of stay for people in psychiatric is six to ten days. That almost looks like an emergency room for psychiatric purposes and is a pretty intense area, with a 61-bed availability. Last month we had 160 to 170 admissions for psychiatric, so they came in and went out fairly quickly.
With the skilled area or nursing facility what happens is when you are discharged from an acute care hospital, the majority of patients come into the nursing unit as a Medicare recipient because of their age. They may not qualify for 35 or 40 days, so they go home or into one of the long term nursing facilities. But the duration of stay coming from acute care into our skilled Medicare unit is 35 to 45 days, which is a fairly short transitional stay, unless intense medical conditions arise that need to be treated differently.
Review: Last year’s audit showed that HealthSource had a $3.6 million loss in 2008 purportedly due to overestimating patient revenue. How are things looking now and are you concerned about the new 1000 page Health Care bill that became law this year and how that will impact the facility?
Heyboer: Well, we are seeing some components of that bill being rolled out now, but the one main thing that I see which will affect health care providers from a financial standpoint is the ratcheting down of the payment system for Medicare payees that will require funding the difference in another way. With a decrease in Medicare funding, a lot of folks are using services covered by it.
Theoretically this will be made up by increased contributions from the wealthy, but if not, many providers will get saddled with uncompensated accounts. Do I think the amount of Medicaid cuts will be offset by new revenue sources? Probably not, which is why support from the community is now more critical than ever.
I’m hopeful that with the support the community has given us to build this new building and become more efficient, coupled with our higher occupancy levels, our fixed costs will be covered better, so financially we’ll be okay. But I’m not in control of the state or federal budget and because we are so highly dependant on Medicare and Medicaid, if something dramatic were done in cutting reimbursement, it could really adversely affect us.
Review: Anything in particular you would like to add about the Open House?
Heyboer: This is our opportunity to show the residents of Saginaw what they’ve paid for and the values we attempt to instill. For many years our primary purpose was to show the community there was value in their vote for this facility. Dr. Fields was at our initial opening and one of the first to support HealthSource, so we felt he would be an appropriate commentator on what this facility means to our community.
Things are never ‘over’ when it comes to health care, so our first objective with the Open House is to say ‘thank you’ for your support, the second is to show what is available here as a community resource and how it all works; and finally, we want to stress that we’ll continue our objective to become the best at what we do, and are continuing to makes changes to do that.
There’s always going to be bumps on the road along the way, but we’re really proud of what we’ve achieved and want to show the community that the investment they made in HealthSource carries an important value.
Review: Any final thoughts you would like to share?
Heyboer: I really have to thank the community for their support. If people see the facility its value is obvious. The $35 million from the millage invested is now down to $25 million because we were able to invest additional funds; and our operating funding for this is 3 percent of the total budget, which isn’t a big slice, but a healthy slice.
The new health care bill may create untold demands on the health care community because the details aren’t really there, so I’m not sure how it will come out. I am a little concerned with the funding aspect of it, because when you take from one thing and don’t necessarily get back from the other, it can be problematic. I don’t like to see things being taken from Medicare, but it’s hard to comment on many of these things.
We’ve increased our employment by 50 people, some part-time; but we have more people to care for now with our increased occupancy levels. We are one of the few employers that have added jobs while other sectors have gone down. We have 500 employees now; not all full time; but our payroll used to be $450,000 every two weeks and the last one that I signed was for $700,000, which is a lot of money.
Hospitals have deep pockets but are fragile. I think our country has to get back to work. The State of Michigan had around 900,000 folks on Medicaid at one point and right now it has 1.8 million on the rolls in less than four or five years. If you get people back to work a lot of that goes away. Everything comes down to jobs.
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THE NEW GILDED AGE (Part 2)