The skilled nursing care alternative. Interview by Amanda G. Watlington.

With inpatient utilization declining, hospitals today must examine alternative means of serving their communities beyond the provision of inpatient care or face the consequences of idle capacity. Health administrators, in their search for a profitable and needed service to offer their community, are increasingly examining strategies for successfully vertically integrating along the continuum of care. For some, this has meant an expansion into walk-in treatment and diagnostic centers; for others, the strategy of choice is subacute and long-term care. Medicare reimbursement policies are encouraging physicians to rapidly discharge patients from the acute care hospital and utilize other appropriate levels of care. The development of subacute units is, therefore, an important industry response to cost effectively meeting the health needs of the elderly. This month HCSM discusses the skilled nursing alternative with Roger S. Garrick, the president of Merrick, Young & Company, a firm specializing in assisting acute care hospitals in this type of diversification.