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Trinity Care Center adds physician coverage for residents

Trinity Care Center of Farmington can now provide in-house physician care for residents, addressing a gap in the medical system that meant many residents couldn't choose the facility for short- or long-term stays while recovering from an illness, fall or disability.

Trinity recently contracted with Genevive, a physician group specializing in providing primary care services to residents in long-term care facilities like Trinity.

"Our goal is to be able to offer care to any senior citizen who wants to choose Trinity Care Center," said Campus Administrator Elizabeth Letich. "Genevive allows us to offer short- and long-term physician coverage for any local resident or patient who is referred to our facility."

The coverage complication at Trinity was a result of several factors, including the facility's size and location.

Nursing homes like Trinity maintain contracts with physicians and clinics so that residents who come to the facility for either short- or long-term stays can have their care supervised by a physician. Under state law, a doctor must agree to follow a patient through their stay at a nursing home facility, meeting with the resident once every 30 days for the first 90 days.

Over time, networks and other providers stopped renewing contracts with Trinity, often based on the location "on the fringe" of their coverage area. If patients wanted to recover at Trinity, they needed to seek primary care from providers with a contract with the facility, Letich said.

Robin Bisel, director of admissions for Farmington Health Services, said this disconnect would most often affect people who hoped to come to Trinity for short-term care while recovering from something like surgery or a fall. Because this issue isn't well-known, Trinity staff were often put in the position of telling patients and families they couldn't come to Trinity for their recovery period because there was not a contract in place for them to continue seeing their physician during that time.

"What we were trying to do was educate our families up front, that this could be an issue — most families had no clue," said Bisel.

Many larger nursing home facilities have an in-house medical director who can supervise patient care. A facility the size of Trinity needed to look at more creative solutions, in this case contracting with an outside provider, Genevive, for in-house physician services, said Bisel.

"We now have a doctor that will essentially treat anyone that comes into the building, regardless of who their insurance carrier is," said Letich.

Under the contract, a nurse practitioner with Genevive will be on site two days per week to handle most medical needs for patients. A physician will also visit regularly, at least once per month.

In addition to giving Farmington residents more flexibility to recuperate at Trinity, having medical care on site means patients don't need to travel to a clinic to see their physician. The nurse practitioner can also more easily meet with patients' families and coordinate care with the trained staff at Trinity, Bisel said.

"Our nurse managers meet with our nurse practitioner weekly to find out what is happening with patients," said Bisel.

"It's nice to get all disciplines in the same spot to talk about what's best for the patient," agreed Letich.

Bisel emphasized that patients who choose to see a doctor with Genevive during a short-term stay can return to seeing their community physician after they leave the facility.

"We have a whole discharge packet that doctor can look at so they know what happened when the patient wasn't in their care," said Bisel.

Letich said it's also important for children with aging parents to have a plan for what to do when medical issues develop and have a sense of what kind of long-term care their parents may want.

"You can even go to medical appointments with your mom or dad — you may hear what your mom and dad are telling you, but what the doctor is telling them is very different," agreed Bisel. "Sitting down and having a plan is definitely important."