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Posted on Sat, May 25, 2013 : 5:58 a.m.

Specialized unit for older hospital patients opens under University of Michigan, St. Joseph Mercy collaboration

By Julie Edgar

An exclusive geriatric inpatient unit developed jointly by the University of Michigan Health System and St. Joseph Mercy Ann Arbor will open Tuesday at St. Joe in Superior Township.

The Acute Care for Elders (ACE) unit marks a full-scale collaboration between the two hospital systems and introduces southeast Michigan to an integrative model of care that is making inroads nationwide and appears to improve patient outcomes. There are about 25 such units across the country.


The East Tower of St. Joseph Mercy Ann Arbor.

Photo courtesy of St. Joseph Mercy Health System

The 32-bed unit (the unit will start with 16 beds) will serve acutely ill adults 70 years and older who are admitted to either hospital. It will feature a homey atmosphere with private, spacious rooms, along with state-of-the-art apparatus that assist patients in showering, toileting, and getting out of bed, ample handrails and other assistive devices throughout, pressure-relieving mattresses and low-set beds. There are sleeping amenities for family members, too, and regular times for them to meet with their loved one’s attending physician.

‘’We have the opportunity to define an actual physical space, and the space is beautifully set up for older patients,’’ says Karen Hall, a clinical professor in U-M’s Department of Internal Medicine, division of geriatric and palliative medicine. She’ll serve as the ACE unit’s medical director.

Acute geriatric unit care is defined as having at least one or more of these components: medical review, early rehabilitation, early discharge planning, a conducive environment, and patient-centered care.

U-M Hospital is typically full, and there is no dedicated space for older patients, who require a different level of care, Hall says. St. Joe’s had the space on the 10th floor of its East Tower, 5301 McCauley Drive, and a new initiative between the hospitals was born.

‘’It was the sun, moon and stars coming together,’’ says Rob Casalou, president and CEO of St. Joseph Mercy Ann Arbor and Livingston hospitals. ‘’You have the Turner Geriatric Center at U-M, St. Joe’s legacy of fine nurses and the available space; we have the perfect alignment.’’

The unit will be run under a joint operating agreement between the two hospitals.

The initial investment of both hospitals in the ACE unit was $125,000 each to cover equipment and staff training, says Robin Damschroder, associate hospital director of operations and clinical services for U-M Hospitals and Health Services.

The interdisciplinary model of care means a team of specialists will develop a care plan for and be assigned to each patient. That includes social workers, physical therapists, a pharmacist, nurse practitioners, and dietitians from St. Joe’s - all trained in geriatric care and all of whom asked to work in the unit, says Hall. Three physicians, two from U-M, will treat patients, along with two U-M geriatricians. The ratio of nurses to patients will be 3-1.

Hall says patients will likely stay no more than 5 days. To be admitted, patients must meet the Medicare criteria for being acutely ill. After treatment, they would either go home or to a subacute facility.

“We’re hoping to do a better job of transitioning them out of the hospital,’’ says Hall. A key objective, she says, is lowering hospital readmission rates among patients (also a federal mandate), but research has not shown that ACE care significantly reduces them.

However, a review of more than a dozen studies into the outcomes of ACE care, published in the Journal of the American Geriatric Society this month, found that patients generally fare better following their stay in ACE units. The review showed fewer falls, less delirium, less functional decline, a shorter length of hospital stay, and fewer discharges to nursing homes.

Julie Edgar is a freelance writer for


Barbara Clarke

Sun, May 26, 2013 : 1:50 a.m.

Will this new arrangement meet the needs of the elderly with dementia who need acute care? Right now, this population does not fare very well in our acute care settings. With special emphasis on the reception and handling in the ER.

Gretchen Ridenour

Sat, May 25, 2013 : 10:29 p.m.

Julie, St. Joe's is located on McAuley Dr, not McCauley.

Michigan Man

Mon, May 27, 2013 : 1:40 p.m.

Catherine McAuley - Foundress of the Religious Sisters of Mercy (RSM's).


Sat, May 25, 2013 : 5:26 p.m.

I'm sure they'll charge extra for all the special care. I just got a bill from Michigan for OT treatment: and I quote "15 minutes of consultation" $96. Since when do people get paid $400 per hour for OT work.


Sat, May 25, 2013 : 2:42 p.m.

Does this mean that if you're admitted to UM, you'll be transferred to St. Joes?


Sat, May 25, 2013 : 3:33 p.m.

One could only hope!


Sat, May 25, 2013 : 1:50 p.m.

This is a great idea, just wonderful. UMMC took excellent care of my Mom in every way except how to handle her in the ER. Despite my letting ER staff know that Mom had dementia and they should not ask questions that would confuse her ("rate your pain on a scale from 1 to 10") they did so, several times each visit. If staff didn't want to take my word for her condition, they could have looked it up on what they used to call Careweb.


Sat, May 25, 2013 : 12:53 p.m.

Ah,ha! Granny Death Panels....just what Sarah Palin warned us about! I'm only being ironic here...don't send me any hate mail.

Linda Peck

Sat, May 25, 2013 : 11:39 a.m.

This will be a great transition place for elderly patients and their families to transition back to home after surgery and illness.


Sat, May 25, 2013 : 10:57 a.m.

Academic medical centers are reimbursed by Medicare at a higher rate than other hospitals. Will the new center get the academic rates? The Joint Operating Agreement may just be a scam to get more money from the taxpayers.