Wednesday, December 19, 2012

Industry representative: Senior care must be flexible

Says facilities should adapt to growing need for assisted living

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By KATHERINE WUTZ
Express Staff Writer

The executive director of the Idaho Health Care Association urged Blaine County commissioners on Tuesday to make sure that any new senior care facility in the county be built to adapt to changing needs and federal reimbursement rates.

Robert Vande Merwe, executive director of the Idaho Health Care Association, was invited to come before the commissioners last month and speak on what they should consider when deciding which of three senior-care proposals would be the best fit for the county. The association is a trade association for health care facilities and provides education and information on Idaho health care regulations to its members.

Vande Merwe said the nature of senior care has been “evolving” even in the 12 years since he joined the organization. Idaho sees 100 fewer total skilled-nursing beds across the state per year, even as the number of seniors in the state grows.

The reason, he said, is that patients are more likely to turn to skilled-nursing only for short-term rehabilitation or for behavioral problems associated with conditions such as dementia.

Vande Merwe said more seniors are turning to assisted living and in-home care, just getting help with day-to-day activities such as taking medication. He said that whereas many facilities decades ago were simply “rest homes” with only skilled nursing care, more senior-care facilities are incorporating assisted living into their business models, as well as adding more provisions for short-term skilled nursing.

“The number of assisted-living [beds] has skyrocketed in the last 20 years,” he said. “Even older facilities that cannot change their footprint are changing operations. Hospital patients are leaving the hospital sooner, and the same with the nursing homes. You don’t stay [long-term] unless you have really acute needs.”

The three proposals before the county—one from Pocatello-based TanaBell Health Services, one from Pocatello-based Safe Haven Health Care and one from locally based Croy Canyon Ranch Foundation—include assisted living as part of their business models.

TanaBell Health Services would add assisted living to the existing facility at Blaine Manor in Hailey, and Safe Haven and Croy Canyon Ranch Foundation would build new assisted-living and skilled-nursing homes.

Despite the need for assisted living—which Vande Merwe said often involves longer-term patients who consider the facility their new home—the commissioners and Vande Merwe agreed that there would always be a need for skilled nursing, not only in the county, but throughout the state. Vande Merwe pointed to an increasing rate of dementia patients compared to all other types of patients in skilled nursing.

“The number of [baby] boomers who are going to have dementia is staggering,” he said. “We have a huge problem with dementia, and unless we find a cure … there will always be a need for assisted living and skilled nursing.”

One major concern brought forward by the commissioners has been how to determine the quality of a senior care facility—whether through state-conducted surveys, customer satisfaction or the number of industry awards given.

Vande Merwe said during his presentation that determining quality using any particular measure is difficult, as facilities vary widely depending on size and the type of care given. Blaine Manor has won eight L. Jean Schoonover Awards for Excellence in Caring in as many years, an award that he pointed to as an indicator of quality of care even in the face of limited resources.

“Some of the oldest facilities that are desperately in need of a remodel have 15 to 20 of [these awards],” he said. “But bricks and mortar don’t take care of patients. They know Mrs. Jones and what she likes, and the quality of care might be better than at the Taj Mahal-type [facilities].”

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Kate Wutz: kwutz@mtexpress.com

 

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