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85 Executive Briefing Revolutionizing Transitional Care: How Hospitals Save Money, Improve Outcomes With Short-Stay Care Facilities A ll too often, hospitals and health sys- tems neglect to recognize the impor- tance of transitional care. Not only can the post-acute care patients receive influence satisfaction, it also has the ability to reduce unplanned readmissions — a significant drain on hospital finances. To better align with value-based care delivery models and address this oversight, more hos- pitals are reevaluating their post-acute care plans and partnering with organizations that specialize in transitional care, such as Main- street — a real estate development, value in- vestments and healthcare company. In 2007, Mainstreet officials identified a major nationwide problem with the infrastructure of the facilities where aging Americans are being treated, including assisted living and nursing homes. "Often, the product in the market was barely tolerable and, in some cases, intolerable or even tragic," said Mainstreet Founder and CEO Zeke Turner. In the process of reinventing the nursing home, Mainstreet recognized another area of healthcare that was woefully overlooked. They found a growing patient population had begun using nursing homes, which are syn- onymous with long-term care, for shorter and shorter stays, despite the fact that the facilities aren't equipped to provide that type of care. "We uncovered an entirely new population in the industry. These patients require short- term rehabilitation or therapy, but are either stuck in inpatient beds in a hospital or are be- ing sent home inappropriately early," said Mr. Turner. "If they are over 65, they can techni- cally go to a nursing home, but no one wants to do that, and if they are under 65, their only options are the hospital bed or home." Mainstreet remains focused on its original goal — the company is expected to launch a new long-term care product to truly re- invent the nursing home in 2017 — but it continues to be thoughtful and intentional as to how it approaches the needs of this new short-stay population. The company has transformed the short-stay only model nationwide, providing rehab and therapy for people who are going to get well and go back to their lives, typically in fewer than 20 days. Mainstreet has branded the fa- cilities that offer this type of post-acute care Rapid Recovery Centers™. How Mainstreet's Rapid Recovery Centers are innovating post-acute care Data from the Center for Health Information and Analysis suggests the cost of prevent- able readmissions for Medicare alone is ap- proximately $17 billion every year. Patients' length of stay can also impact a hospital's bottom line, with an average stay costing $10,400, according to the Healthcare Cost and Utilization Project. Needless to say, many hospitals could ben- efit financially from partnering with a Rapid Recovery Center, which helps get patients out of the hospital sooner and prevents them from returning. Care at Mainstreet's Rapid Recovery Centers is delivered under the medical supervision of a physician with a high level of acuity with short-stay transitional services in physical en- vironments that support the recovery and re- cuperation process, according to Mainstreet COO David Stordy. All of the facilities embrace and integrate technology, sustainability and infection con- trol into their physical architecture and op- erational practices, according to Mr. Stordy and Senior Vice President of Mainstreet Health Gary Smith. Patients (or as Mainstreet calls them, guests) can expect amenities such as private rooms and bathrooms, dining facilities similar to restaurants and cafés, computer and game rooms, reflection spaces, theaters, private dining rooms for catered events, spa treat- ments, community rooms and various con- cierge services. The goal of improving outcomes is built into both the physical buildings and the operations as well. Under Mainstreet's model, Rapid Recovery Center guests fill out a questionnaire within 24 hours of their arrival to the facility regarding their care and preferences so adjustments can be made accordingly to the recovery plan. This individualized and comprehensive ap- proach to care yields excellent outcomes and reduces the chance of unplanned re- admissions, according to Mr. Smith. The benefit of investing in transitional care According to Mr. Stordy, three macro trends have driven hospital partnerships with tran- sitional care centers: The passage of the Af- fordable Care Act and evolution in payment models, a new precedent of investor involve- ment in the operations and health IT of hospi- tals and the emergency of healthcare services that cater to consumers. Hospitals and health systems interested in revamping their transitional care offerings, should know that partnerships with Main- street can be as customized as the individu- alized care guests receive at the post-acute facilities. "One thing that sets Mainstreet apart is that our Rapid Recovery Centers are really ori- ented to the needs of the local market," said Mr. Smith. "We're not just an orthopedic rehabilitation center, we're truly a recovery center for multiple diagnoses — be it respira- tory issues, cardiovascular problems or neu- rological conditions." What hospitals should know about partnering with Mainstreet The partnerships between hospitals and Mainstreet can be customized to align with the needs and culture of any hospital, as well as how financially involved or not they care to be. Hospitals can enter into a joint venture with Mainstreet or a risk-based arrangement similar to a bundled payment, according to Mr. Stordy, or they can choose to not put in any capital at all. Mainstreet's business mod- el is built to plan, design, finance and fully execute the entire process. Some hospitals choose to invest in the facility's real estate or operations if they want to be in a shared- risk scenario. For hospitals that want to have greater influence over the post-acute care setting, Mainstreet offers a turnkey ap- proach to developing the property. Ultimately, the goal is to ensure patients re- ceive five-star care after being discharged from an inpatient hospital, without the dis- advantages of many existing post-acute care facilities and nursing homes. n Sponsored by: Mainstreet is a national company specializing in real estate development, value investments and health care. As the nation's largest developer of transitional care properties, Mainstreet has been recognized by Senior Housing News, winning the Architecture & Design Award in 2013, 2014 and 2015, and has been named to the Inc. 500l5000 five times since 2010.