Erlanger North considers expansion

A proposed subacute care unit at Erlanger North could fill a treatment gap for patients with medical needs too complex to be addressed in a skilled nursing facility like a nursing home, but who no longer need intensive hospital care, officials said Wednesday.

"These patients are complex, critical patients [for whom there's] nothing more we can do on the acute side," said Joe Winick, Erlanger's senior vice president of strategic planning. "Erlanger has a large volume of patients of this type. ... What's important for us is that these patients have access to a full continuum of care. That's what's prompting us to go in this direction."

WHAT IS SUBACUTE CARE?Subacute care is for patients who don't need intensive hospital care, but who require a greater level of skilled nursing care than is provided in a typical skilled nursing facility.

The health system has requested permission from the state to convert 30 acute care beds to skilled nursing beds and to initiate skilled nursing services at the Red Bank facility.

The estimated $1.47 million cost includes renovations of the facility, Winick said.

The proposed change, which will require approval from the hospital's board of trustees, follows the hospital's strategic plan to create a niche for each of the hospital's five campuses, including a focus on geriatric care at Erlanger North.

In Red Bank, about 30 percent of the population is 55 and older, hospital officials have said.

But not all the patients in the subacute unit will be geriatric. Nonelderly patients with complex needs, multiple chronic conditions or who need a ventilator to breathe could be candidates, Winick said.

Referrals to the subacute unit likely will come from acute care units at hospitals such as Erlanger's downtown Baroness campus.

Erlanger North stopped taking admissions for medical and surgical services in 2009 because of low patient volumes. North still operates a busy geriatric psychiatric unit, which often has a waiting list, and offers a sleep center, digital imaging and an emergency room, officials said.

Developing the focus on geriatrics at Erlanger North is a natural move, Dan Quarles, chairman of Erlanger's board of trustees, said Wednesday.

"It just makes sense," he said, noting that a number of senior living facilities are near the hospital, including Life Care Center of Red Bank and Alexian Village on Signal Mountain.

Board members have been briefed on the proposed unit at Erlanger North, but haven't been informed of details yet, he said.

The unit could fill a need for elderly patients whose needs cannot always be handled in a long-term care setting, said Matthew Whitley, administrator of Manorhouse Assisted Living, also located near Erlanger North.

"There is a time as seniors become more frail that they're going to need a higher level of care," he said.

Erlanger Health System purchased Erlanger North, formerly Red Bank Community Hospital, for $2.4 million in 1988. The hospital invested in two expansions: a 30,000-square-foot addition in 1996 and the 2001 purchase of the Red Bank Professional Office Building near the hospital for $575,000, according to Chattanooga Times Free Press archives.

Getting state approval for the conversion at Erlanger North likely will take four months, Winick said, but he hopes a resolution to move ahead with the plan will come before board members by summer 2011.

The closure to acute care admissions at Erlanger North last year resulted in about half of North's 100-person staff being cut, but the new beds would bring some of those jobs back to the hospital, Winick said.

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