New Anchorage hospital designed with longer stays in mind

PHOTO Courtesy of St. Elias Specialty Hospital
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The new St. Elias Specialty Hospital, designed for patients needing extended stays, incorporates large windows in its design for a more appealing environment.
PHOTO Courtesy of St. Elias Specialty Hospital
   
A $20 million long-term acute care hospital to treat patients with complex medical conditions that require a longer than usual hospital stay plans to open its doors Dec. 18 in Anchorage.

Specialized treatment programs at the 60-bed St. Elias Specialty Hospital, in Midtown Anchorage, will include medically complex conditions, cardiopulmonary, wound care, trauma and neurological conditions and infectious disease.

The two-story, 65,000-square-foot for-profit hospital is a joint venture of Providence Health Care Systems and BridgeCare Hospitals, of Birmingham, Ala. Davis Constructors and Engineers worked with the Anchorage architectural firm Kumin Associates on the contemporary design project.

Chief executive officer Chad Carpenter, a 35-year-veteran of the U.S. health care system, including 13 years in Alaska, said the need is clear in Alaska for such a facility, particularly for patients who have been in hospital intensive care units for 10 to 12 days and are simply not progressing.

This is a facility for patients who could not go home from the hospital and thrive with home health care, he said. “The idea is to get the patients a lot better before they go home.”

While the concept of long-term acute care hospitals, known in the industry as LTACHs, is somewhat new to Alaska, there are some 300 such facilities nationwide, Carpenter said.

The interdisciplinary approach at St. Elias will be directed by the physician and includes nursing, case management, nutritional services, pharmacy, physical therapy, speech therapy, occupational therapy, respiratory therapy and social services. Ongoing educational programs and team conferences will focus on the special needs of each patient, hospital officials said.

The average stay is will be 25 days, compared with four to five days at most other hospitals, he said.

Patients are admitted to the long-term care hospitals following treatment in a traditional acute-care hospital, once they no longer require intensive diagnostic procedures. Instead, they get more individualized and resource-intensive care than that provided in a nursing home.

Potential patients might include folks who are not progressing well after 10 to 12 days in an intensive-care ward, stabilized vehicle accident victims, stroke patients and others suffering from trauma injuries or in need of severe wound care.

“We are taking the patient after intervention, after the big work-ups,” Carpenter said.

“We can rapidly diminish the intensity of the care and the cost just because of the aggressiveness of our model,” he said. “If the patient has been on long-term ventilator care, the quicker we get the patient off the ventilator, the quicker the cost goes down.”

“We’ll have to prove what we can do,” said Ray Stastny, chief financial officer. “It’s good to have the success stories early.”

“The objective,” noted Carpenter, is “to transition them out, hopefully to home.”

Under Medicare guidelines, patients admitted to the LTACHs must be in need of hospitalization for more than 25 days and typically have multiple or complex medical complications.

For the first six months of operation, St. Elias Specialty Hospital will be in a demonstration period, to prove to Medicare officials that the average length of stay is 25 days. Since Medicare is set up to pay hospital facilities based on the patient’s diagnosis and geographic location, rather than length of stay, and since Medicare will pay St. Elias at the same rate as a short-term acute care hospital for that period, the facility expects to lose money for the first six months, Carpenter said.

“After six months, Medicare will hopefully start considering we need to be paid for longer lengths of stay and factor in the cost changes,” Carpenter said.

Ultimately, the cost of a stay at St. Elias will be higher because the length of stay is longer than in an average short-term acute care hospital, about $30,000 to $35,000 for an average 25-day stay, he said. Carpenter and Stastny said Medicare, Medicaid and private health insurance should cover most patient costs.

One of the obvious differences at St. Elias, with its wide hallways and spacious rooms are the large daylight break rooms, with windows that actually open. Outside are large cement patios for patients and visitors to get a breath of fresh air.

There is also the homelike decor of the patient rooms, which are about 22 by 15 feet, according to architect Jean Funatkae of Kumin Associates. Each bed is equipped with a comfortable air pressure relief mattress, and patients lying in their beds will each have a huge picture window to see the world outside the hospital’s confines.

The larger room size also allows more space for family members and other visitors, and sufficient room for physicians and other hospital staff to work with the patient in the room. “It makes it nice for the staff to be around the patient,” Carpenter said.

There are 54 private rooms and six semi-privates, divided by a partial wall, but again spacious, and with large picture windows.

Another difference will be in meal service. Forget those hospital menus that rotate back to the same choices every seven days. Patients at St. Elias will have room service, within dietary restrictions, so they can choose from a broad menu for each meal.

Their executive chef will be Gary Bratten, formerly of Anchorage’s famed Fly By Night Club, Carpenter said.

But no, Spam, the Fly By Night Club staple, is not on the menu.

St. Elias is currently recruiting staff, but Carpenter said he was confident they would find the right kind of people — nurses and technicians who can form a relationship with the patients during their long-term stay. Carpenter said he expected the more informal atmosphere of the small hospital environment to be a selling point, because executives would mingle more readily with other staff.

Margaret Bauman can be reached at [email protected].

Updated: 
12/09/2006 - 8:00pm