The kinds of housing and health care options one generation wants as it reaches its older years can be quite different from what the next generation wants. Two representatives of the consulting firm Wipfli presented this and other revealing facts to the North Shore Hospital board Friday, March 19, 2010.
Last October, the hospital hired Wipfli to conduct an analysis of Cook County’s market for senior housing, assisted living, and long-term care.
Wipfli’s Mike Edwin, presenting from Wisconsin by speakerphone, and David Brenne, in the room with a corresponding Powerpoint presentation, compared the “traditional” generation with the Baby Boomer generation. According to their research, the traditional generation, born between 1922 and 1945, believes more in conformity, tends to respect authority figures and rules, and is more regimented. Baby Boomers, the next wave of senior citizens, were born between 1946 and 1964 and tend to value individuality, believe in individual choices and freedom, and be more adaptive.
Thewave of the future is to offera continuum of care as people get older, including in-home services, assisted living, skilled nursing facilities (traditional nursing homes), and hospice care. The most cost-effective array of services, Edwin said, consists of five “nonskilled” beds for every one skilled nursing facility bed. Skilled nursing facilities may be short of workers as Baby Boomers leave the work force and eventually need more care.
The average monthly cost of assisted living is $2,969. A household would need an annual income in excess of $35,000 in order to pay for it. The average cost of care for dementia patients is $4,400. Dementia care is the fastest growing area of need in the field of elder care, Edwin said.
Factors that would affect the type of facilities that could be successful in Cook County include the downturn in the national economy, the housing market bubble, geographic remoteness, a tendency among seniors to stay in their own homes longer, the cost of housing and services, maintaining staff, and the challenge of marketing.
Cook County residents age 65 or older comprise 19.9% of the population, higher than the state average, and the percentage of seniors who are potentially able to pay out-of-pocket for assisted living is greater than the statewide average. Forty-three percent of Cook County households with people age 75 or older have annual incomes of $35,000 or greater.
The North Shore Care Center may have more beds than it needs, Edwin said, and this would be the case even more if an assisted living facility were available. Wipfli’s analysis suggested that an assisted living facility of up to 18 units and a memory care assisted living facility with eight to 16 beds would be feasible in Cook County at a “moderate” financial risk. A portion of the Care Center could be remodeled into memory care assisted living, Edwin said.
Communities need to provide “the right services to the right people at the right time,” Brenne said. The challenge in Cook County will be to make each service the right size as well.
& Care Partners of Cook County
A program slightly nearer to being up and running is Care Partners of Cook County. It is a reworking of what started out as an attempt to bring hospice care to the community. Program Coordinator Kay Grindland gave the board an update.
Hosting a licensed hospice program would have brought financial risks the hospital board was hesitant to take on, and the number of people needing end-of-life care in Cook County at any given time is small. Instead, the people pursuing the program have broadened their vision and are suggesting a collaboration that would provide not only end-of-life services and palliative (painreducing or comfort) care but also companionship and assistance in finding the right services for frail elderly citizens.
A proposal by Grindland and North Shore Health Care Foundation board vicechair Judy Meath states that area physicians estimate that the community has 80 to 100 palliative care or elderly patients who could benefit from a program offering care coordination and companionship. “Without these services and assistance in the home,” the proposal states, “patients are not able to stay in their own community.”
The North Shore Health Care Foundation has contributed over $20,000 to the program so far and would like to be part of a collaboration with North Shore Hospital, Sawtooth Mountain Clinic, the over 30 volunteers who have already been trained, and various community groups including churches, service groups, and Cook County Public Health & Human Services.
“This is a service that benefits the community, and the community really needs to support it,” Grindland said, adding, “I think it really is a fundable program.”
Grindland said the volunteers have been providing assistance in the hospital and Care Center but liability insurance and supervision would be needed in order for them to go into homes. She proposed that the hospital hire a two-to-fivehour a-week registered nurse, funded by the North Shore Health Care Foundation, to oversee the program and its volunteers. Funding for this position is in already place for one year, she said.
The board approved of the idea and passed a motion to hire an RN under a pilot program.
& Hospital finances
Controller Yvonne Gennrich said she is expecting a $300,000 loss for 2009.
With an investment of $9,600, the new documentation forms–“T-sheets”–used in the emergency room have brought in an extra $105,000 in the first 10 months of use. Gennrich expects the forms to result in a net gain of $100,000 a year over the previous tracking method.
The board approved a spending request of $6,500 for an elliptical trainer in the physical therapy department. Gennrich expects the hospital to recoup the cost in about six weeks through income from patients who use it.
& Health Information Exchange
The board voted to be part of the Health Information Exchange that will enable the hospital to access a database that will tell them where else patients have received care. This could be useful when the hospital needs to request patient histories in order to provide the most appropriate care.
Patients who do not want to be part of the exchange can opt out. The program is regional right now but is expected to eventually link to databases throughout the state and the nation, although some laws would need to be in place to support such a program.
Board member Tom Spence expressed surprise that Sawtooth Clinic had joined the program without the hospital knowing about it. Clinic board member Bev Johnson said the clinic started participating recently in conjunction with a collaborative with other clinics.
Spence said he would like the information technology staff at the hospital and the clinic to meet regularly to discuss new protocols and then report to the board. Hospital Administrator Diane Pearson said she would discuss this with Clinic Administrator Rita Plourde.
& Administrator search
The hospital, with assistance from St. Luke’s Hospital, continues to work on finding a replacement for Diane Pearson, who will be leaving her position later this year. One candidate is scheduled for an interview on April 14, but St. Luke’s recommended that the hospital run another ad for the position.
& Roof repair
The board passed a motion to have the roof membrane replaced. The work will be done by the same company and at the same time the clinic’s roof is repaired, saving about $6,000.
& Off-hours radiology reading
The board voted to pay Radiology Associates Group to provide radiology readings during offhours. The group will provide a 20-minute turnaround time.
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