Two L.A. Health-Care Firms to Open AIDS-Only Institutions
Two Los Angeles-area health-care firms are moving to open institutions exclusively for the care of AIDS patients.
Beverly Enterprises of Pasadena said it intends to open a nursing home in Los Angeles devoted to AIDS patients. Meanwhile, American Medical International of Beverly Hills said it is converting a Houston hospital to treat AIDS patients and do research.
Both Beverly and AMI believe that these institutions will be the first devoted to the care of only AIDS patients. San Francisco General Hospital was the first hospital to open a ward for AIDS patients, and it has been operating for nearly three years.
The nursing home will be open to patients with acquired immune deficiency syndrome and with ARC, or AIDS-related complexes, who need a few weeks of care after a hospital stay for the disease, or for patients who are near death.
“We feel there is a gap in service between the hospital and the next available thing for AIDS patients, which is home health service,” said Kay Lehman, project analyst with Beverly Enterprises.
An opening date for the nursing home is uncertain, Lehman said, because Beverly is still searching for a 100-bed facility. The nursing home will open four to six months after a site is found, she said. Officials don’t know yet how much the project will cost, she said.
In Houston, AMI’s Citizens General Hospital is changing its name to the Institute for Immunological Disorders and will begin accepting AIDS patients who are “viable research candidates” in late August or early September, a spokesman said.
The 150-bed hospital is a joint project between AMI and the University of Texas. AMI will contribute $250,000 a year for the first four years to fund research by UT faculty.
“We saw a profound need for something like this,” the AMI spokesman said. “It’s not going to be in and of itself the solution by any stretch of the imagination, but it’s one of a number of things that are needed to deal with this scope of diseases which are AIDS.”
The fatal AIDS virus is sexually transmitted through body fluids, particularly blood and semen. There is no evidence that it can be transmitted through casual contact. Medical authorities say high-risk groups include homosexual men and intravenous drug users.
Members of the health-care and gay communities said they welcome increased research into AIDS and better care of patients with the disease. But some worry that AIDS-only institutions might create an even greater stigma associated with the disease and that they might become a dumping ground for patients.
“At a time when there’s a real move to decentralize, why are they treating this syndrome differently? You don’t see tuberculosis hospitals anymore,” said a member of the Houston gay community familiar with the AMI project, who asked not to be named. If a patient checks into the AMI hospital, “there would be no doubt about what’s going on with you.”
Concern Expressed
When San Francisco General opened its AIDS ward, “there was a lot of concern that it would become an AIDS ghetto or a stigmatized kind of place, and in that case, it didn’t become the case. . . . It became a model of care that other hospitals are trying to emulate,” said Peter Arno, an economist with the Institute for Health Policy Studies, part of the University of California, San Francisco.
The AMI spokesman said the neighborhood surrounding the hospital and Houston’s gay community had expressed concern early on, but, following extensive public discussion, they “think it’s a good idea.”
Spending time in a nursing home can drastically cut the cost of AIDS care, but AIDS patients contend that they often find themselves forced to stay at more expensive hospitals because nursing homes will not admit them. Rep. Henry A. Waxman (D-Los Angeles), chairman of the House Energy and Commerce subcommittee on health, said the panel has received some complaints that nursing homes are not accepting AIDS patients for treatment.
“Many nursing homes that are essentially for frail and elderly people haven’t wanted to take AIDS patients,” he said. “I’m at a loss to tell you whether it’s because of discrimination, because of misunderstanding of the disease or because they think they cannot provide services.”
Lehman said that most Beverly nursing homes as well as most of the nursing homes nationwide don’t accept AIDS patients because of the cost of specially training their staffs and because of “the terrific fear of AIDS” by the general public, which could bring an adverse reaction from the families of other nursing home patients.
Profit Picture Unclear
Neither Beverly nor AMI made projections on how profitable their proposed institutions would be. “They obviously think there’s a market for it,” Arno said.
“There are just too many unknowns to talk about what the profit opportunities will be,” Lehman said. The AMI spokesman said the company anticipates “making a reasonable return.”
Beverly Enterprises is the largest owner and operator of long-term health-care facilities in North America, with 1,000 nursing homes in the United States and Canada. AMI is the nation’s second-largest hospital management company and operates about 150 hospitals and other health-care centers.
