As health systems seek to provide cost-effective care in appropriate settings, one avenue used is launching neighborhood hospitals.
Neighborhood hospitals are primarily located around larger metropolitan areas, and provide a local option to patients in need of low-to-moderate acuity services. These facilities typically provide emergency and inpatient care as well as pharmacy services. Patients who need higher-acuity services are often transferred to a nearby location.
San Francisco-based Dignity Health viewed neighborhood hospitals as a way to provide improved access to ED-level care and add to their current care continuum that includes urgent care and physician clinics.
The health system's subsidiary, Las Vegas-based Dignity Health-St. Rose Dominican, partnered with The Woodlands, Texas-based Emerus approximately two years ago to open four neighborhood hospitals in the greater Las Vegas area. The first site opened in July 2017, and the last site opened in December 2017. All of the hospitals consist of about 40,000 square feet of space and average between 10 and 12 patient and ED beds per location.
"So they're relatively fresh out of the ground but showing incredibly strong performance overall [as far as volumes], and a great deal of activity and patient acceptance and appreciation," says Peggy Sanborn, Dignity Health's vice president of partnership integration.
According to Dignity Health, its four neighborhood hospitals in the Las Vegas area now handle 21 percent of the health system's total ED volume in Nevada, and less than 6 percent of the neighborhood hospital ED volume requires transfer to another facility that can treat more complex cases.
Why Las Vegas?
Ms. Sanborn says the move to value-based care prompted Dignity Health to expand its Las Vegas footprint. She says Dignity Health's previous footprint in the area consisted of three locations in the southeast quadrant: the Henderson, Nev.-based Rose de Lima Campus, which was aging, the Siena Campus, also in Henderson, which was more of a quaternary facility, and the Las Vegas-based San Martin Campus, which is focused on more complex care.
As Dignity Health started to move more toward value-based care and value-based contracts, it knew it needed to have a more significant geographic presence within the Las Vegas area to better serve patients it would be at risk for, she says. The health system ultimately chose to build the neighborhood hospitals on Las Vegas' west and northeast sides, where it saw a need for such facilities.
Next steps
Dignity Health plans to add a fifth neighborhood hospital in Nevada via its partnership with Emerus, which operates 28-plus facilities nationwide. That site is expected to open in early 2019.
Dignity Health also expects to expand its Emerus partnership outside of Nevada, and over the next year to 18 months will look at new locations where it wants to partner with them.
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