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by President/CEO Larry Zook in conversation
with Eva Bering, Vice President of Operations

BeringEvaWe are aware health care in the United States is changing, and Landis Homes seeks to actively anticipate these changes so we can serve residents well. I asked Eva Bering, Vice President of Operations for Landis Communities, about these changes and how we are responding.


Q: How is health care changing?

A: The Affordable Care Act of 2010 had several important goals. Among those were:
1) to improve the quality and efficiency of health care by creating systems that link payment in hospitals and nursing homes to quality while reducing overall costs,
2) to prevent chronic disease and improve public health,
3) to provide quality, affordable care for all Americans,
4) to provide consumer transparency / information so that patients could take more control of their health care by making informed decisions.

The population continues to age as the first of the baby boomer generation has just turned 70. Health care costs, and particularly Medicare, are projected to be unsustainable at the current rate of use in the United States. A large portion of health care costs are concentrated on redundancy in the health care system resulting from unnecessary hospitalizations and emergency room admissions and on chronic illnesses such high blood pressure, heart disease and diabetes. Between 2010 and 2050, the United States population ages 65 and older will nearly double, the population ages 80 and older will nearly triple, and the number of nonagenarians and centenarians—people in their 90s and 100s— will quadruple. The aging of the population has important implications for future Medicare spending because beneficiaries ages 80 and older account for a disproportionate share of Medicare expenditures.

Q: How do these goals impact Nursing Homes and Providers of Senior Services?

A: The goals of the Affordable Care Act offer an unprecedented opportunity for senior service providers to gain recognition as a key partner in managing overall health care costs and particularly Medicare spending. As health care systems address the overall health of a population in a geographic area, senior service providers are a key partner in meeting these goals in very unique ways. The goals are being addressed through several initiatives aimed at improving or maintaining quality and lowering costs by reducing unnecessary care both in hospitals and in nursing homes, by reducing unnecessary readmissions to the hospital after a discharge, by decreasing the number of days a person spends in a nursing home, by better management of care when a person transitions from the hospital to either a nursing home, a rehabilitation center or home, and by improved management for end of life care.

Q: How will Landis Homes meet the challenges?

A: Landis Homes has been preparing for this impact for the past several years. Along with nine other Lancaster County senior services organizations, Landis Homes has been invited to participate in a preferred provider network with Lancaster General Health System. This invitation is based on several factors, including our consistent 4 or 5 star rating by the Center for Medicare and Medicaid Services (CMS), knowledge of the health care industry, our consistent high quality outcomes, low hospital admission and readmission rates, low staff turnover, and the presence of a geriatrician physician as our medical director among other factors.

As individuals are being discharged either to health care or home directly from the hospital, based on their insurance, Landis Homes has increased services. This includes the addition of registered nurses in health care and the addition of registered nurse case management to Landis at Home, our home care service. Physician and nurse practitioner hours were increased in residential living. Rehabilitation services are provided in residential apartments. A specific area is being designated in health care as a short stay center to improve quality and consistent care to those individuals who are discharged and require care for a limited period of time.

 Q: Why a short stay unit?

A: Designating an existing wing, Oregon North, as short term stay or rehabilitation provides a concentrated area for care of those individuals who will be returning home. The average stay in short term health care in a nursing home varies from two weeks to one month which is in sharp contrast to stays of several months or years in other areas of health care. In this area, registered nurses are being educated with higher skills to better care for residents who are very ill. Improved coordinated discharge planning lessens the risk of re-hospitalization. The team better understands planning for home transitions and discharge. The nursing staff establish increased partnership with physicians and are better able to provide consistent care and improved communication to each other, to residents and to families, thus improving overall quality. Landis Homes will continue to position ourselves strategically as we stay abreast of the dynamic changes in health care.

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