nursing home trends -usa

Nursing Homes Luring Short-Term Patients
By MARC LEVY, Associated Press Writer
Sunday, March 25, 2007


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(03-25) 16:11 PDT Hatboro, Pa. (AP) --
John Smyth needed more than the big flat-screen TV, towel warmers and homelike furniture offered at the Willow Ridge Center to persuade him to stay in the nursing home's rehab unit following knee-joint replacement.
What sold the 70-year-old retired plumber was the ability to sleep, eat and exercise in space separate from the suburban Philadelphia home's long-term patients — "the really older people," he calls them.
"Both parents died in a nursing home and I guess that sort of put me against it a little bit," said Smyth, a six-inch stripe of metal staples still adorning his garishly swollen right knee.
With billions of dollars at stake, nursing homes across the nation are rushing to reinvent themselves to compete with hospitals and affiliated rehabilitation facilities for short-term, higher-paying patients like Smyth. They are spending hundreds of millions of dollars on renovations and additions and new features like aromatherapy, brightly colored decor, spacious therapy gyms and Internet cafes to try to create a new, warmer, less institutional image.
Most often, they are providing postoperative rehabilitation for knee- and hip-joint patients, but heart attack and stroke victims are also coming in for therapy. Though many are retirees, others are still in the work force and some patients are as young as their 20s.
Offering treatment at lower costs, nursing homes are undeterred by criticism that they do not have the expertise that hospitals do, and that some data show a decline in the quality of their rehab care.
One of the nation's largest nursing-home chains, Toledo, Ohio-based Manor Care Inc., has been among the most aggressive in seeking out short-term patients.
Several Manor Care nursing homes, including one in Boca Raton, Fla., now handle primarily rehab patients and about half of all the patients in the company's 280 nursing homes are now discharged in under a month, said chief operating officer Stephen Guillard.
In its 2005 annual report, Manor Care credited its shifting focus to rehab patients for its revenue growth, which exceeded 6 percent that year.
The prospect of bigger payments has spurred a pace of building unusual for an industry with many properties dating to the 1970s, and which has seen home-based care and assisted-living facilities compete for the older, sicker patients who, while less profitable, have been their core customers for decades.