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One goal of long-term care policy is to keep disruptions to daily life as short as possible. In Hawaii, where nearly one-fifth of residents are 65 years old or older, this focus requires greater emphasis in the healthcare sector.
It is this need that Islands Skilled Nursing and Rehabilitation, in partnership with Queen’s Medical Center, hopes to address through its 42-bed facility in Honolulu. So-called “short-term recovery” is a capability that Alexander Street Centre has developed during the pandemic, although the need does exist independently of COVID-19.
The problem is scale: Outside of a hospital setting, this type of specialized care is difficult to deliver sustainably in a small, isolated market like Hawaii.
But Queen’s Hospital sent its first patient in need of short-term recovery to the facility this week, freeing up hospital space that will require more acute cases as the wave of virus infections starts to rise again.
Otherwise, the first patient, Enriqueta Yacas, 80, will have to stay in the hospital or spend a short period of recovery away from home, such as San Francisco, Los Angeles or Seattle. This is not the outcome a loved one or anyone concerned with an aging population wants.
This niche has been part of the mainland’s skilled nursing sector for some time: Providers have looked to short-term rehabilitation centers as a way to get a bigger share of the health insurance pool. Short-term rehabilitation is covered by Medicare as a course of treatment prescribed by a doctor.
In addition, officials responding to the early stages of the pandemic across the country relied on the facilities to open more beds so hospitals could discharge more patients.
In some Midwestern and Southwestern states, the boom has led to overbuilding, according to the 2019 Healthcare and Senior Residential Commercial Real Estate Trends Report, published by Integra Realty Resources.
Hawaii faces the opposite reality. People like Yacas were either placed in an acute care setting or relocated entirely to a location that could provide the more participatory care they needed.
In her case, what was needed was dialysis, tracheostomy and ventilator treatment, a group of services not usually available outside the hospital setting.
When COVID-19 first started to stress the health system here in March 2020, Queen’s University was looking for an alternative location to provide ventilator care. Islands Skilled Nursing and Rehabilitation does offer this service, taking in some patients. The expansion to short-term rehabilitation was completed in discussions with Queen’s University in the following months.
According to its website, the center can assemble a program that can also include physical, verbal and other types of therapy, social work, nutritional counseling and basic critical care care. While some patients do require long-term hospital stays, the aim is to help patients transition to “as normal a life as possible.”
If this trend continues to build in the state when needed, it is imperative that patients and their families be fully trained for proper care in a home setting.
Spokesman Craig Gima said the AARP Hawaii stance has been one of the concerns about how patients are being discharged, who are well-trained to adapt to the new normal. But if short-term rehabilitation can be carried out successfully, the results will be commendable.
“We encourage efforts to get people back to where they want to be,” Jimma said.
we are the same. During the continuum of care, anything that illuminates recovery in a familiar setting deserves support.
