Monarch Landing_Ext Entrance 2_Copyright Sarah Mechling

CCRC Expands Continuum of Care with On-Site Medical Clinic

Wellness. It’s popular phrase in senior living, and research shows that continuing care retirement communities (CCRCs) are leading the charge on implementing in-house initiatives to promote wellness and well being.

But as industry providers compete to roll out the latest and greatest programming focused on supporting mind, body and spirit, one CCRC says on-site medical care is a key component of its wellness offerings.

Naperville, Ill.-based Monarch Landing, a Life Care Services LLC community, has leased space on its campus to Edward Medical Group since becoming managers of the property in April 2012. Life Care Services stepped into its management role of the property following the purchase of the CCRC by Senior Care Development from Erickson Senior Living in 2010.

Of the CCRC’s 450 independent living residents, about 70% amount see Edward Medical Group’s board certified, full-time physician Dr. Gus Wonais and his staff for their primary health care needs. And, an even greater number utilize the practice if those who use the practice for lab work and other needs in addition to an outside primary care doctor are counted. The practice is also open to employees.

“If someone isn’t feeling well they can visit Dr. Wonais, even if he’s not their primary care doctor,” says Katie McGovern, administrative director of physician practice management at Edward Hospital, adding that the practice also meets with Monarch Landing staff members to talk about residents’ health on a weekly basis.

Edward Medical Group is the primary care practice of Edward Hospital. There are over 20 primary care medical offices in the surrounding areas and Wonais’ practice within Monarch Landing is one of these. However, the medical office at Monarch Landing is currently the medical group’s only office in a senior living setting.

“If someone in dining services is noticing someone starting to have some issues, for example with mobility, we can say, ‘Is everything going OK? Do you need an evaluation?” says Jennifer Enright, manager of operations at Edwards Medical Group, about the benefit of operating within a CCRC. “Or, maybe someone could benefit from seeing the social worker.”

Monarch Landing employs a full-time licensed clinical social worker who has an office next to the medical practice.

Wonais only sees the CCRC’s residents, which gives residents personalized attention they might not get from a primary care physician off site, says Monarch Landing Executive Director Renee Garvin.

“Benefits include easy accessibility, dedicated time and overall continuity,” she says. “Dr. Wonais is available to make house calls if a resident just came home from the hospital or is in rehab. Overall, it enhances the relationship between physician, resident and the full care team.”

But the symbiotic relationship between senior living provider and medical practice is unique, and one that CCRCs should carefully consider before trying to emulate Monarch Landing’s wellness model, says Rick Cumberland, senior vice president of management services and operations at Greystone. Irving, Texas-based Greystone advises senior living organizations in strategic planning, project planning, marketing and management of CCRCs and more.

Greystone, which does not currently lease space to a medical practice at any of its communities, says proximity to nearby health clinics and resident preferences are both important variables that can deter providers from considering an on-site full medical practice.

“Getting residents to transition to a new doctor is difficult,” Cumberland says. “Especially if the physician they see is close to the campus.”

In addition, some communities may not have enough space or be able to generate enough revenue for the physician to move his practice on site to exclusively serve CCRC residents, he says.

But for Monarch Landing, those factors are exactly what make having an on-site practice a success. Edward Medical Practice is a familiar health organization to many area residents — with Edward Hospital less than five miles away from the CCRC. So for many residents, seeing Wonais does not necessitate a switch in health care providers.

And Monarch promotes the health care organization’s presence in the community through its marketing materials.

“We highlight this relationship during tours, in certain direct mail pieces, advertisements and public relation stories,” Gavin says.

An on-site medical practice can also play well into the full-spectrum of care a CCRC offers.

While Wonais primarily treats independent living residents, he follows residents as they move into assisted living, or temporarily for rehab. Monarch Landing is currently looking to add another physician or nurse practitioner, which would allow the practice to also see other residents admitted to The Springs — the short-term rehabilitation, nursing care and memory support arm of Monarch Landing, she says.

The practice also hosts monthly roundtable sessions for residents on various health topics, which often inspires residents to ramp up their exercise and nutrition efforts, McGovern says.

One challenge for the practice has been adjusting to an influx of drop-in visits by residents.

“If someone walks in, it can be challenging to be efficient with time,” she says. “But the office has adapted. As residents walk the halls they will peek their head in and say, ‘Hi,’ and we say, ‘Hi.’ We know each other by name. It’s a very friendly relationship.”

Written by Cassandra Dowell