terms of bringing in money, Wesley Woods Center is a loser—big time.
In 2005–2006 alone, it lost more than $1.6 million. But in terms
of services provided to the elderly and the chronically ill of many ages,
it is hard to imagine a more successful organization, as illustrated in
the stories that follow.
The reasons that this key component of Emory
Healthcare loses money each year are fairly straightforward. Seniors are
the most rapidly growing segment of the population, the ones most likely
to have complex, overlapping health problems, the ones least likely to
have either personal resources or adequate medical insurance. Although
some Wesley Woods patients and residents do have adequate insurance or
ample resources, the center receives little or no reimbursement for services
it provides to the majority of more than 30,000 older adults and chronically
ill patients served each year in its hospital, outpatient clinics, and
nursing care and retirement facilities.
Waking up at Wesley Woods
Jorge Fernandez, 36, worked as a cook in a small restaurant until his
long-standing diabetes severely damaged his vision, making handling hot
pots and pans too dangerous. Let go from his job, he was still looking
for other work when double vision and blinding pain suddenly brought him
to his knees. The emergency department at a north Atlanta hospital transferred
him to Emory University Hospital. There, before doctors had even finished
evaluating him, Jorge suffered cardiac arrest and possible cerebral injury.
For the next five months in the neuro ICU,
Jorge was surrounded by a swirl of people, a frenzied pace, and a buzz
of incomprehensible English words. With around-the-clock care, he appeared
to regain function, but he remained on a ventilator. His clinicians believed
that he needed to be transferred to a long-term acute care facility. Other
patients—some paying, some not—badly needed space in the unit,
and the neuro ICU clinicians believed they had done all they could for
Jorge's Medicaid benefits had long
since run out, and he and his wife had never had health insurance, despite
their having always worked two or more jobs since arriving in the United
States 15 years earlier. The unreimbursed costs of his care in the neuro
ICU were approaching $1 million.
A team of physicians, nurses, hospital administrators,
social workers, and chaplains worked with the family to determine what
should happen next. Every long-term acute care facility that Emory asked
to take Jorge said no. The facility at Wesley Woods Hospital said yes.
Emory Healthcare would continue to cover the costs of his care, which
administrators anticipated would go on for years. But even they had not
fully appreciated the experience and skill of the ventilator care team
at Wesley Woods. Jorge arrived there on a Thursday afternoon. By Saturday
morning, he was breathing on his own. After a week, he began physical
rehabilitation, where the earlier accomplishments of his neurologists
began to shine through. Three weeks later, he was able to return home
to his wife and two children.