Tuesday, June 17, 2014

The $15M-$20M plan for Parkhouse nursing home in Montgomery County



Mid-Atlantic Health Care is seeking approval for its first major renovation project at Parkhouse, the nursing home it acquired from Montgomery County for $41 million in March.

Melanie McGarry, administrator at the 467-bed skilled-care facility in Royersford, Pa., said the $3 million project includes creating a short-term stay unit that will feature nine private rooms with their own bathrooms and showers. The project will also include, along with renovations to the lobby, three rehabilitation gyms and one long-term care unit.

Dr. Scott Rifkin, president of Mid-Atlantic, said his Maryland company plans to invest a total of $15 million to $20 million for renovations and improvements at Parkhouse over the next 10 years.

The long-term improvements include refurbishing every unit in the nursing home, creating more private rooms, and renovating the parking lot. Rifkin said Mid-Atlantic has no plans to develop the surrounding 200 acres that was part of the acquisition. He said they’d be willing to work with the community in the future if there was a development idea that was needed and they supported.

“We are looking to modernize all of our nursing homes not just for today, but for what nursing homes will need to be 10 and 20 years from now,” said Rifkin, whose company operates 16 skilled-care centers in Pennsylvania, Maryland and Delaware. It entered the Philadelphia market in 2011 by buying five facilities from NewCourtland.

“We want to help reduce health-care costs systemwide, not just reduce nursing home costs. That will mean raising the level of acuity (or level of illness) of who we can take care of,” he said.

Rifkin said his goal at Parkhouse and the company’s other nursing homes is to build closer alliances with health systems, which are now penalized by Medicare and some private insurers when patients discharged from hospitals are re-admitted.

Mid-Atlantic has developed its own data-mining software, at a cost of $1 million, to monitor the health status of, and care delivered to, its residents. The system tracks 130 data points, gathered from the company electronic medical records system, that cover everything from a resident’s bowel movements to what percentage of a meal they ate to their vital signs.

“If we can see something early and intervene, we can prevent somebody from having to be re-admitted to the hospital,” he said. “When hospitals started getting dinged [by Medicare] for re-admissions, it had a big impact on the nursing home industry.”

Rifkin said the re-admission rates at the Philadelphia nursing homes it acquired were averaging around 45 percent, well above the national average of 24 percent, when Mid-Atlantic took over. Those rates are now averaging about 17 percent. McGarry said the data-mining will be integrated into Parkhouse’s clinical operations over the next six months. She said one change already instituted since the Mid-Atlantic acquisition is morning and afternoon staff meetings in the facility’s “Criterion Room,” where any negative changes in the health status of residents are discussed and a plan is developed to address those changes.

“And accountability [for implementing the plan] is assigned,” she said.

McGarry started working in the kitchen at Parkhouse more than three decades ago but went on to become a nurse aide, nurse and supervisor. She was named administrator 14 years ago.

“Our responsibility,” she said, “is to keep people at their highest possible level.”

Another change Mid-Atlantic made at Parkhouse — which had been owned and operated by the county for the past 76 years — was to bring in Tender Touch out of Lakewood, N.J., as the new provider of physical, occupational and speech therapy services to residents. McGarry said the number of Parkhouse residents receiving therapy services has tripled to 135 from 45 since the change.

Mid-Atlantic’s business model, Rifkin said, is to build relationships with health systems and develop a reputation in the communities they serve for delivering quality care in clean and modernized facilities so their nursing homes stay full.

In today’s health-care environment, nursing homes aren’t places people go for long stays. “About 95 percent of our patients do not come to our facilities for long-term care,” he said. “They stay for two-to-four weeks, then go home. The other 5 percent are long-term-care patients.”

Mid-Atlantic has 1,176 nursing home beds in Philadelphia, which represents about one-fourth of nursing home beds in the city. Its occupancy rate at its Philadelphia nursing homes is 98 percent.

“If you can keeps beds full, the economics can work,” Rifkin said. “We don’t make huge profits [at any one facility], but we don’t expect to.”

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