April 15, 2016
By KATHLEEN NELSON
Ministry members in the West and Southwest seem to believe that good things come in small packages. Three CHA members have found a partner in Emerus, a for-profit company with a business model devoted almost exclusively to “micro-hospitals” located in suburban or underserved areas, some with low-income populations.
- In November, SCL Health and Emerus opened the first of four facilities in the Denver area that they own and will manage together. Branded as SCL Health Community Hospitals, the others are scheduled to open later this year.
- In December, Emerus and Trinity Mother Frances Hospitals and Clinics broke ground on a facility in south Tyler, Texas, about 90 miles east of Dallas. Since then, Trinity Mother Frances has signed a letter of intent to become part of CHRISTUS Health. The deal is expected to be completed in late spring. The micro-hospital — a concept Emerus created and trademarked — will be branded Mother Frances Hospital South Tyler and is expected to open late this year.
- In January, Dignity Health–St. Rose Dominican announced plans to partner with Emerus in building and managing at least four micro-hospitals in the Las Vegas area over the next two to three years. Each will carry the Dignity Health-St. Rose Dominican name.
In each case, the goals are to bring services closer to neighborhoods, and to shift patients with less-severe illnesses and injuries from large emergency rooms. Many of the facilities are situated near exits on the inner and outer ring highways.
“People want the convenience of having advanced care close to home,” said Brian Newsome, a spokesman for SCL Health, based in Broomfield, Colo. “The smaller hospitals are equipped to respond to almost any medical issue.”
Brian Brannman, senior vice president of operations for Dignity Health Nevada, estimated that about 250 people a day visit the emergency department at St. Rose Dominican’s main campus but that 60 percent have medical concerns that are at a “lower level of acuity” that would not necessitate emergency room care. “The reason for the visit is urgent to the patient but not life-threatening,” Brannman said. “The micro-hospitals are the perfect fit for those patients.” He estimated that combined, the four neighborhood hospitals planned for the Las Vegas area could handle a total of 50,000 to 60,000 patients a year in their emergency rooms.
Blueprint of efficiency
Emerus’ small hospitals range from 36,000 to 60,000 square feet. Each has an emergency department, six to eight inpatient beds, imaging and lab equipment. Some offer surgical suites for inpatient or outpatient procedures. Many include primary care offices, which can share imaging and lab equipment with the hospital. According to Emerus’ website, the hospitals are equipped to treat such conditions as overdoses, allergic reactions, altered mental status, asthma and breathing problems, burns, chest pain and heart attacks, dehydration, head injuries, pneumonia, seizures, sprains and broken bones. All are designed for short stays, overnight or for observation, and allow around-the-clock visiting hours.
Led by its co-founder and chief executive, Dr. Toby Hamilton, Emerus opened its first micro-hospital in 2006 in Tomball, an outer ring suburb of Houston. It included six rooms in 3,500 square feet and promised patients they would see a physician within 15 minutes or their care would be free.
“It was a simple idea, but it had far-reaching implications: Deliver acute, episodic emergency and inpatient care more efficiently, and more compassionately, than larger hospital emergency rooms or urgent care emergency rooms,” said Richard Bonnin, director of communications for Emerus, based in The Woodlands, Texas.
Dignity’s Brannman noted that Emerus President Dr. John Buck and Chief Operating Officer David Stillwell have military experience. Brannman, who served in the Navy for 33 years, sees similarities between Emerus’ model and the military’s portable hospitals in terms of efficiency.
“We don’t want people lingering in the ER for three to four hours,” Brannman said. “Emerus set a goal of getting the patient in, doing an assessment, treating and getting them back on the streets in 70 to 90 minutes.”
Artist renderings for each of the micro-hospitals in the Denver and Las Vegas areas look strikingly similar. Bonnin said, “Slight variations include being three-story, rather than two-story, depending on needs of a particular market.” Dignity’s hospitals in Las Vegas, for example, also will house physicians group and community outreach programs, such as diabetes and hypertension management.
The model seems to have struck a chord. Bonnin said Emerus co-owns and manages 16 micro-hospitals and is in various stages of developing more than 30 hospitals across the nation, each with a similar footprint.
Partnership structure
Each of Emerus’ three new partners also share market attributes that make for an easy fit. None of the states require certificates of need, and none of the facilities plan to reduce the number of beds at other facilities. Though Emerus is a for-profit organization, the facilities in these three partnerships will operate as not-for-profits. Emerus’ other partners include Baptist Health System in San Antonio and Baylor Scott & White Health, founded as part of a Baptist university.
“So they have experience with not-for-profit and faith-based organizations,” Brannman said. “To us that was very important. We don’t want patients to see a distinction” in services or mission between the Emerus hospitals and Dignity’s other facilities in Nevada.
Emerus’ emphasis on services situated close to the growing population and its familiarity with Texas made it a good fit for Mother Frances Hospital South Tyler, according to William Knous, public information officer and director of internal communications for Trinity Mother Frances Hospitals and Clinics.
“The community is growing, and it makes sense for Trinity Mother Frances to grow with it,” Knous said in an email. “Emerus is familiar with the region, as well as the demands of the patient population here.”
The micro-hospitals built in the Emerus partnerships with all three ministry members will not be Catholic, according to Bonnin. All will follow The Ethical and Religious Directives for Catholic Health Care Services.
Emerus, Trinity Mother Frances/CHRISTUS and SCL Health declined to comment on the structure of their partnerships. Brannman said Dignity would retain a majority stake in the partnership with Emerus in Las Vegas, “but it’s close to 50-50. We wanted to be in charge to make sure these facilities reflect our values.”
Early feedback from patients at the first SCL Health Community Hospital has been positive, Newsome said, with patients giving high marks to “short wait times; close proximity to where they live, work and play; and the comprehensive services we offer.”
Adaptability
“Health care has changed in many ways since the founding Sisters of Charity of Leavenworth first arrived in Colorado,” Newsome said of the order that founded the system 140 years ago. “These new hospitals reflect that change … making its healing ministry more convenient and accessible to those it serves.”
Brannman said that St. Rose Dominican could expand the micro-hospital concept to as many as eight locations and that its parent organization, Dignity Health, has considered further expansion with Emerus in its markets in California.
“We want to see ourselves as less of a hospital company and more as a health business,” Brannman said.
