Community involvement offers opportunity

Plan would benefit community and hospital

When a local citizens' committee was formed to attract a developer of assisted-living centers to Battle Creek, MI, David Mungenast, president and chief executive officer at South-west Rehabilitation Hospital, was quick to join. He saw his participation as "a wonderful opportunity for us to expand our mission and approach to the patient population we are already serving."

The committee, which includes city leaders, employer representatives, health care providers, attorneys, and financial institutions, wants to bring assisted-living and congregate-living centers to the area to serve Battle Creek's low- and middle-income elderly population. Mungenast volunteered to be involved in planning and asked to be considered as a partner to provide services at the centers.

The committee's original idea was to contract with a rehab nurse to treat residents a few hours a day. However, Mungenast saw an opportunity for his hospital to provide a wider variety of services by setting up a Comprehensive Outpatient Rehabilitation Facility (CORF) on site. He has proposed that space in the new facilities be set aside for health care services and leased by a provider. The committee has scheduled a target opening of the new facility for late summer.

If his facility is chosen, Mungenast favors a CORF designation as opposed to typical outpatient program because Medicare will reimburse for social work, psychology, and nursing interventions as well as therapy in a CORF.

"In our community, people are being considered for placement in a skilled-nursing facility because there is no other option. Assisted living gives them an opportunity to go into a setting where they can be more independent but still have support services such as meals and housekeeping," Mungenast says.

The committee is working with a developer who wants to locate both assisted-living and congregate-living facilities in Battle Creek.

Because the majority of the city's population falls in the middle-income range or below, the committee is seeking private and nonprofit funding to help make the cost of living in the centers as low as possible. If plans to develop a non-profit facility don't pan out, the committee has an offer from an outside firm to develop a for-profit facility on a joint-venture basis.

"We don't see private developers being anxious to come into the community and provide these services. If they did, we are looking at a cost structure that would not serve a significant portion of our population," Mungenast says. Because it could show community support, the committee was able to attract a developer, he adds.

Working on the committee fits in with Southwest Rehab's mission to serve the elderly population, he says. "We often experience frustration because of the difficulty in finding appropriate placement for our patients as they leave the inpatient facility. They either have to go back to the family or to a nursing home. Not having a setting that gives them greater independence is a major obstacle for us in discharge planning."

Southwest Rehab discharges a number of patients to nursing homes who could be in a less restrictive environment if one were available, he says.