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In
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.
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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.
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.
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