Margaret Tietz Center for Nursing Care. (Design Center).

TYPE OF FACILITY/SETTING: Inpatient Hospice Unit

PRESIDENT/CEO: Kenneth M. Brown

DESIGN FIRM: Paul Verardi, Inc. [phone]

RESIDENT UNITS: 23 inpatient hospice beds

TOTAL AREA: 12,000 sq. ft.

RECONSTRUCTION COST: $566,700

COST/SQ. FT.: $47.23

ADMINISTRATOR'S COMMENTS

Kenneth M. Brown, President/CEO, Margaret Tietz Center for Nursing Care: "Recognizing that growth, maintenance of a stabilized admission census and the enhancement of a continuum of care are predicated on consumer needs, administration of the Margaret Tietz Center for Nursing Care, a 200-bed residential healthcare facility, explored service areas that we believed to be new to the delivery of care in the traditional long-term care setting in our area. The concept of providing inpatient hospice care within a discrete, segregated unit in a residential healthcare facility has proven to serve as a revenue enhancement to the facility's operations, as well as a unique and needed service that adds instant credibility to the nursing center's integrative approach to the delivery of palliative and end-of-life care.

"The facility's executive, financial and clinical staff met with representatives from hospice home care agencies in the area to ascertain their perspective on referring patients to a nursing home environment. We reviewed the availability of patients who might be eligible for this type of service and the environmental modifications that would have to be done to receive New York State Department of Health approval.

"The initial challenge we faced was to refurbish eight existing private skilled nursing patient rooms to meet the requirements of hospice care without disrupting resident care or infringing on patients' personal rights in the process. To meet this challenge, a work schedule was designed that permitted access by the construction team to resident care areas during designated hours only, and the nursing staff set up a temporary triage area for all residents directly affected by the refurbishment process. Meeting safety and resident care needs was the pre-eminent requirement for the success of this venture and, at all times, both were met.

"The initial reconstruction phase commenced in September 2000 and took three months, at a cost of $216,000. In addition to the refurbishment of the eight patient care rooms, two lounge areas, a nursing station and a kitchenette area were constructed. The first hospice patient was admitted on November 30, 2000.

"The success of the reconstruction phase, coupled with the signing of inpatient contracts with Hospice of New York and Hospice Care Network, plus the fact that all the beds were filled (average length of stay: 13 days), prompted conversion of another six private resident care rooms beginning in April 2001 and completed six weeks later. A signed agreement with Calvary Hospital (Bronx, New York), the largest acute-care provider of hospice care in New York, to be their facility of choice to receive Queens-based hospice patients prompted conversion of an additional nine private patient care rooms, bringing the expanded refurbishment of skilled care rooms to a total of 23 hospice beds, as of May 1, 2002.

"The success of our new venture is predicated on the professional capabilities of a very dedicated and conscientious hospice staff. The uniqueness to this area of a hospice unit located in a traditional skilled nursing environment has developed as an integral part of the nursing center's operation, mission and service delivery. We have become a focal point and Center of Excellence for the delivery of a nontraditional long-term care program."