Kentfield Rehabilitation and Specialty Hospital: Finding a Niche
Rehabilitation
Written by Don Sadler   
Monday, 01 October 2007
Kentfield Rehabilitation Hospital: Finding a Niche - Health Executive - RedCoat Publishing
The transition from acute rehab hospital to long-term acute care hospital has paid off for this San Francisco-area facility.
In the late 1990s, Kentfield Rehabilitation and Specialty Hospital was struggling to find a niche in the highly competitive, acute rehab market of Northern California. The facility had a great reputation but was having financial difficulties, said CEO Ann Gors.

Kentfield Rehabilitation Hospital: Finding a Niche - Health Executive - RedCoat Publishing
Ann Gors, CEO
Gors and her team decided to grow the facility by narrowing their focus. “Changing our designation to a long-term acute care hospital (LTACH) enabled us to expand the types of patients we could accept by narrowing our focus to patients with complex medical conditions who require longer hospital stays,” she said. “These patients have unique care requirements that go beyond the admission diagnosis; for example, there might be multiple medical issues involved, such as diabetes, pulmonary disease, and chronic renal failure.”

LTACH facilities bridge the gap between the critical care units and the medical/surgical units of general acute care hospitals, which aren’t specifically designed to meet the needs of patients facing extended hospital stays. The criteria for LTACH designation is an average length of stay of at least 25 days for the hospital’s Medicare patients.

Kentfield provides a clinical setting capable of treating long-stay, acute patients with medically complex and often fragile conditions. Patients may be suffering from acute exacerbations of chronic and other illnesses, such as cardiac and renal disease, respiratory illness, and serious wounds and infections. Services provided by Kentfield include dialysis, TPN, ventilator and tracheostomy tube weaning, IV antibiotics, respiratory therapy, wound care, rehab, OT, PT and speech therapy.

The clinical criteria for admission to Kentfield requires that patients are no longer in the crisis intervention stage of treatment, have completed their initial diagnostic work-up, have no planned major invasive surgical procedures, and have a prognosis of a long stay (typically at least 25 days) in an acute setting.

Filling a need
The lack of LTACH facilities in the area was another reason the switch to LTACH made sense for Kentfield, which is located 20 minutes north of San Francisco in tranquil Marin County. Kentfield is now one of only three LTACHs in Northern California.

This provides both an opportunity and a challenge, said Gors. “While we face less competition from other LTACHs, we have had to educate acute care hospitals and physicians about what we do and how we can help patients. Our dedicated interdisciplinary teams provide a coordinated, comprehensive treatment approach to a wide range of neurological, orthopedic, pulmonary, and complex medical problems.”

For example, some Kentfield programs are designed to help wean patients with respiratory failure off ventilators and to treat chronic wounds and infections that are common with long hospital stays. The facility also offers catastrophic rehab programs for patients with traumatic brain and spinal cord injuries and strokes.

“What makes us unique is that we started out as an acute rehab hospital,” explained Gors, who has a physical therapy background and joined Kentfield nine years ago as the director of clinical services. “Since our foundation is in rehab, we have created the kind of positive, healing environment that’s so critical to patients with multi-faceted, long-term, complex needs.”

Meeting the demand
There’s a large demand in the Bay Area for the kind of specialized services Kentfield provides, Gors said. “The Marin County and Greater Bay Area’s populations are aging, and as people live longer with chronic illnesses, there is a growing need for facilities like ours that are specially equipped to help them.”

Given the high level of specialists required, physician and nurse recruiting is one of Kentfield’s biggest ongoing challenges. “We’re competing with acute care hospitals for the same level of nurses, but we’re not a huge university teaching hospital, which is a disadvantage for us,” said Gors. Kentfield has hired a full-time recruiter, which is paying off as they recently brought infectious disease and wound care specialists onboard.

Eventually, it all comes back to education efforts. “Many hospitals and physicians don’t really understand what the LTACH designation is and what we can offer patients,” said Gors. “Since our transformation to an LTACH, we’ve worked hard to educate hospitals and physicians about our services and expertise.”

The best education, said Gors, is Kentfield’s success stories. “When a physician sees a patient who has spent time with us and is now back home and enjoying a high quality of life again, that’s the best testament to what we can help accomplish.”

One example is a 65-year-old man named Ian who was diagnosed with respiratory disease as a young man. Following abdominal surgery, he required prolonged ventilator support and was having difficulty coming off the breathing machine. Following intense medical treatment at an acute care hospital, he was transferred to Kentfield’s ventilator weaning program. Under the care of Kentfield’s team of physicians, nurses, and other clinical specialists, Ian recovered returned home to his family this spring.

Kentfield’s financial success as an LTACH has enabled it to make plans for constructing a new facility to be completed by 2013. “We’re going to have to comply with California Senate Bill 1955, which requires seismic retrofitting for single-story, wood-frame structures, and we decided to build a new state-of-the-art facility,” said Gors. “We have been running at over 90% occupancy in our current 60-bed hospital, so our new facility will expand to 70 beds.” Gors believes that Kentfield’s mission is what really sets it apart: To provide compassionate care to patients with complex medical conditions in a patient- and family-centered environment.

“We have to treat the whole patient,” she said. “Since we’re a small facility, we know each of our patients well, which helps us create customized care programs. These, in turn, accelerate the recovery process and help patients through the many difficulties involved in longer hospital stays.”

Don Sadler is a writer and editor specializing in issues of interest and relevance to businesses and executives. He can be reached at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
 
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