Recuperation Center Fills Its Niche

March 22, 2002
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GRAND RAPIDS — It’s not a nursing home or an assisted-living facility, nor is it a medical or long-term care center.

The Recuperation Center in Grand Rapids falls in between those labels, serving a niche group of “medically fragile” people leaving the hospital who still need a certain level of care but can’t get it. The frequent problem is that they live on their own, lack a family or other sources of help, or they’re homeless.

The center works to not only provide a safety net for those patients to continue receiving care, potentially preventing a recurrence of their condition that lands them back in the hospital, but also generates cost savings by providing a lower-cost alternative care setting for patients who may otherwise end up staying longer than needed in the hospital because they have no other place to go.

“We work with folks who don’t fit in elsewhere and they need to heal. If they don’t, it’s costly. It’s costly to them as individuals and to the health care system,” said Dawn Brouwers, the center’s executive director who sees the service becoming an increasingly vital part of the health care system in Kent County.

“It’s a real niche market. We’re not servicing everybody on the health care system, but we provide a service that affects all the pieces,” Brouwers said.

Some of those pieces are giving more attention to The Recuperation Center, which moves this month from leased quarters on Lafayette Avenue to renovated space at the nearby former Ferguson Hospital, now known as the Ferguson Renaissance Center. The move doubles the center’s capacity, from 12 to 24 beds, to provide care for people recovering from wounds, surgery, broken bones or illnesses, and whose conditions still require daily attention after they’ve been discharged from a hospital.

Founded in 1992 by a coalition of community groups and Saint Mary’s Mercy Medical Center, The Recuperation Center serves about 130 to 150 patients a year, while turning away about an equal number of people because it previously lacked the capacity. Client lengths of stay average about a month.

Spectrum Health and Saint Mary’s Mercy Medical Center both provide funding and in-kind support for the center and Brouwers hopes to secure additional community support, as well as participating agreements in the future with commercial insurers and HMOs.

She’ll need it, with the additional capacity pushing the center’s annual operating budget from $535,000 to an expected $625,000.

As recently as 1998, hospital grants accounted for 53 percent of the center’s revenue. Today, after three years of tight hospital budgets brought on by cuts in Medicare and Medicaid reimbursements, hospitals grants represent 25 percent of the center’s annual budget.

Philanthropy has helped to make up the difference and now covers half of the center’s operating costs. Serious financial constraints facing hospitals beginning in 1998 forced the center to reach out for support elsewhere, Brouwers said.

“We had to change as an organization. We could have closed or we could have gotten real serious about fund-raising, which we did,” she said.

Brouwers estimates that The Recuperation Center alone saves the state of Michigan $1 million a year through the care it provides Medicaid recipients who otherwise may have remained in a higher-cost hospital setting. While independent analyses have not verified those estimates, a recent Spectrum Health review concluded that the center, through averted emergency room visits and reduced inpatient hospital days, is a wise investment.

“They do supply a value and it’s something that should be supported in the community,” said John Mosely, Spectrum Health’s vice president for strategic and business development.

The center’s costs for providing care to patients referred from Spectrum was $134 per day, which compares to a rate that is “considerably higher” if those patients remained in the hospital so they could continue receiving care. The Recuperation Center is an “excellent” alternative for the relatively small number of patients who require continued care but don’t belong in an inpatient hospital setting, Mosely said.

“It’s very economical and a great program,” Mosely said. “The indicators are very favorable at this point.”

Brouwers hopes others in the health community will reach the same conclusion, most notably HMOs and commercial insurance carriers that she’d like to see pay reimbursements to the center for the care provided to their subscribers. She believes the center can eventually prove its case for receiving reimbursements and further carve out a niche role for itself as a cost-effective and quality care provider in an increasingly complex and costly health care system.

“Why should people stay in the hospital when they don’t need to, and why should they keep going back with preventable conditions?” Brouwers said. “The question is how do we fit” into the system.

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