St. Vincent plans to build 'micro-hospitals' throughout area

August 22, 2016

St. Vincent will expand its footprint in central Indiana by opening eight small hospitals where patients can get treated for medical conditions that aren’t life-threatening.

The move will give the 136-year-old hospital system a push into the growing movement for so-called “micro-hospitals”—small-scale inpatient facilities, often with eight to10 beds for emergency, urgent care and observation, typically with a short stay. Micro-hospitals are springing up in Denver, Phoenix and other cities, as well as in rural and medically underserved parts of the country, but are still rare in Indiana.

St. Vincent said Monday that the first four hospitals are planned for Noblesville, Plainfield, Avon and the Castleton area of Indianapolis. The first is expected to open next summer.

The hospitals will be developed by the Embree Group of suburban Austin, Texas, which filed applications earlier this year with the Indiana Office of Homeland Security. IBJ reported on those applications in July, but the company did not say at the time that it was working with St. Vincent.

According to the applications, the company plans to construct buildings measuring about 19,000 square feet. That’s much smaller than the typical, full-service hospital, which can often span more than 100,000 square feet.

The health system also plans to open three ambulatory care centers next year in Brownsburg, Crawfordsville and Plainfield. They will offer primary care, urgent care, imaging and physical therapy.

Altogether, the new facilities represent the largest capital expense for St. Vincent in several years, although officials declined to release a cost. Nationally, the average cost of a micro-hospital ranges from $7 million to $30 million, depending on the location and the types of services offered, according to the Advisory Boards Co., a health care and educational consulting firm in Washington, D.C.

St. Vincent said the small hospitals will help meet the demand for emergency services that aren’t serious enough to require a trip to an acute-care hospital, such as a stomach bug that causes a patient to vomit throughout the day. That patient could be seen quickly, to get the fluids and medicine to stop vomiting and be stabilized, but would not need the resources of a traditional, acute-care hospital, said Jonathan Nalli, CEO of St. Vincent.

“That would be the perfect patient to visit one of the St. Vincent emergency hospitals,” Nalli said.

The goal, he said, is for the medical staff to see patients within 20 minutes, and get them treated quickly and back home as soon as possible. In some cases, patients could stay overnight until they can get in touch with a primary-care physician.

By contrast, emergency rooms in acute-care hospitals sometimes have lengthy waits, as physicians might be working on serious medical cases, such as gunshot wounds or vehicle injuries. Those kinds of life-threatening cases wouldn’t be suited for the new hospitals, Nalli said. Around the country, an increased demand for emergency services has led to longer wait times for patients, he said.

Each of the new hospitals is expected to treat about 20 patients a day, he said.

Nationwide, hospitals are increasingly building lower-cost, more-convenient-care settings in response to demand from patients and because of pressure from payers, who don’t want to foot the bill for high-cost, full-service hospital services for less-serious cases.

But it’s not clear if there will be any significant savings to patients and payers at St. Vincent’s new hospitals. Nalli said a patient’s bill “is going to be similar” for treatment whether it’s at the small hospitals or at an acute-care hospital.

The primary benefit to the patient will be quicker medical attention, he said.

The move is part of St. Vincent’s strategy to provide more convenient access to care. Earlier this year, St. Vincent and the Little Clinic, a subsidiary of Cincinnati-based Kroger Co., announced a collaboration to provide care at 10 in-store clinics.

The micro-hospitals will have seven emergency room beds, with eight inpatient beds for short stays. That compares with 20 to 40 beds at a typical acute-care hospital’s emergency room.

The new locations will be open 24 hours a day, seven days a week, staffed by board-certified or board-eligible physicians and emergency-trained registered nurses, St. Vincent said.

The locations for the first four hospitals are:

— 8602 Allisonville Road, in the Castleton area;

— 146th Street and State Road 37, Noblesville;

— 2412 E. Main St., Plainfield;

— 9613 E.  U.S. 36, Avon.

The locations of the four other hospitals are still in the early planning phases, St. Vincent officials said.


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