Pender Memorial Hospital is a 25-bed hospital with 43 skilled nursing beds in Burgaw. Since 1999, the facility has been managed by New Hanover Regional Medical Center.
The facility converted to a critical access hospital in 2001. Rural hospitals and critical access hospitals with swing bed approval increase Medicare patient access to skilled nursing level care.
Pender Memorial is staffed for sixteen beds on the acute/swing unit and thirty-nine beds in the skilled nursing facility. However, on an average night in 2018, staff cared for eight or nine patients in the hospital wings, and about 33 skilled nursing patients.
At the same time, NHRMC experienced a significant and increasing need for beds in Wilmington, about 30 minutes away.
This project was initiated to address the under-utilization of beds at Pender Memorial Hospital to help alleviate the significant need for beds at New Hanover Regional Medical Center’s 17th Street campus.
To accomplish this, NHRMC and Pender implemented the following steps:
- Daily coordination between NHRMC and PMH of bed availability, referrals, offers, and admissions.
- The Case Management team was instructed to offer all patients the opportunity to go to PMH without pre-screening with previously understood criteria.
- Establish and utilize tele-sitters at Pender to enhance ability to handle patient load.
- Enhance Pender’s ability to support special needs of patients such as those requiring dialysis and those with bariatric needs.
- Develop an electronic dashboard in EPIC that would accurately reflect Pender’s census and bed availability.
- Provide additional education, training, and resources to staff to increase acceptance/admission rate of a higher acuity and complexity of patient.
- Continue to develop relationships and educate referring physicians on the benefits of utilizing the Swing/SNF beds at PMH to reduce readmissions and ultimately reduce the length of stay at New Hanover Regional Medical Center.
Six months into this project, the results are tremendous.
- First, the referrals are up sixty-seven percent (67%).More referrals, combined with a slight increase in the percentage of offers, have been the main drivers in our increased census.
- Second, the occupancy rate has exceeded goal.The occupancy rate for the Acute/Swing Unit has increased from 53% to 83%. The occupancy rate for the Skilled Nursing Unit increased from 85% to 94%.
- Since January of 2019, the number of skilled nursing residents admitted from the NHRMC system have increased as well.
- A significant, positive impact on the financials of our critical access hospital.
- Additionally, we have been asked to work with the other critical access hospitals (Dosher Memorial Hospital and Bladen County Hospital) in New Hanover Regional Medical Center’s service region to replicate this work.
“Increased Role of a Critical Access Hospital” earned a Silver Touchstone Award from Atrium Health, which has a services agreement with NHRMC. The Touchstone Award was one of seven earned by NHRMC in 2019.
- Sarah Brannan, Administrator, Hospital Operations (NHRMC)
- Kathleen Flynn-Childs, Coordinator, Case Management (NHRMC)
- Heather Davis, DO, Hospitalist, Hospitalist Medical Director and Chief Medical Officer (PMH)
- Cynthia Faulkner, RN, MSN, Chief Nursing Officer, Pender Memorial Hospital
- Ruth A. Glaser, FACHE, President, Pender Memorial Hospital
- Sejal Patel, MD, Medical Director of Clinical Resources Services (NHRMC)
- Julie Spicka, Manager, Case Management (NHRMC)
- David Parks, Vice President of Cardiac/Clinical Support Services (NHRMC)