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WESTSIDE COVER STORY : Supplying Compassion : Health: At Country Villa South, the elderly and AIDS patients receive care under one roof. Experts say that kind of integration will grow as the number of nursing home beds shrinks.

August 21, 1994|LINDA FELDMAN | SPECIAL TO THE TIMES

Chris Reece, a 52-year-old woman who contracted the AIDS virus after receiving a blood transfusion in 1981, is fighting for her life.

So is her roommate--Margaret, a 94-year-old preparing for colon surgery.

The two women live at Country Villa South, a pastel-shaded, 87-bed nursing home in Palms. There, in a 30-bed special-care unit, the elderly and patients with AIDS coexist, side by side.

An unusual mix? Perhaps. But in many ways, Country Villa South might be considered the nursing home of the future.

Nationwide, experts say, there is a fast-escalating demand for the type of long-term care nursing homes provide--sub-acute services such as skilled nursing, intravenous therapies and specialized drug treatments.

Not only are more and more elderly people seeking such care--the result of demographics and growing life expectancy--but so are the nation's burgeoning number of AIDS patients who, thanks to new drug therapies, are able to live longer with the disease. To complicate matters, the number of nursing home beds has remained static since the 1980s, and home caretakers are in short supply.

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The result, experts say, is that AIDS patients and the elderly will increasingly find themselves under the same nursing home roof.

"It's time to look at the mutualities of the chronically ill, rather than to continue to categorize people according to disease," said A.E. Benjamin, a UCLA associate professor of social welfare policy who is doing research on the subject for the Robert Wood Johnson Foundation. "There's no question that Country Villa South is part of the future."

The trend is sure to cause tension. In fact, it already has: Activists and hospital-discharge planners in several states have claimed that nursing homes have denied admission to AIDS patients. More than 600 such complaints were filed with government agencies from 1986 to 1991, according to a report last year by the U.S. Inspector General's Office. Small surprise, then, that Country Villa South is attracting attention from health experts as far away as China. Country Villa not only accepts AIDS patients--one of three known to do so in Los Angeles County--but it also integrates them with the elderly, creating a unique atmosphere in which the two groups share rooms and recreation.

"As far as I know, it is the only facility of its kind where the two populations are integrated," said Sharon Werbel, regional director of the 1,200-member California Assn. of Health Facilities, a nursing home association. Said Barbara Joseph, Country Villa's director of nursing: "Country Villa is cutting edge."

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Country Villa South, on Overland Avenue just south of the Santa Monica Freeway, is operated by the Country Villa Health Service Corp. The for-profit company owns 1,200 nursing-home beds in the Los Angeles area. It was company president Stephen Reisman who decided four years ago to open the sub-acute care unit for people with AIDS.

But Reisman never intended for AIDS patients and the elderly to room together. The original concept was that there would be a separate wing. But there were not enough referrals of AIDS patients to sustain the unit, Reisman said, and there were numerous elderly patients who needed the skilled nursing care.

The decision was made to consolidate: Those who needed sub-acute care, AIDS sufferers and the elderly, would share the same staff and the same space.

Currently, 23 of Country Villa South's 30 sub-acute unit beds are filled--16 with AIDS patients and seven with the elderly. Room and board is $250 a day, which might seem steep--especially since it doesn't include medication and other ancillary services. (For an AIDS patient, medicine costs an additional $1,500 to $8,000 per month.) Still, it is only a fraction of the cost of a hospital stay. And Medicare and health insurance coverage can be used for much of the cost.

The unit is largely the responsibility of Michael Torgan, Reisman's cousin. Reisman made Torgan administrator of Country Villa in December, 1993. Torgan, 30, has a graduate degree in business administration and health-care management. He supervised another nursing home before coming to Country Villa, but admits: "Nothing prepared me for this."

Torgan had three challenges: turn a profit at Country Villa, maintain quality patient care and confront--every day--the fear of AIDS.

The profits, Reisman says, have been slow to materialize. But the quality of care has been high, according to health officials and relatives of patients. And visits to the nursing home suggest that patients have forged strong bonds, unfazed by the issue of AIDS.

Consider Reece, who has been living with AIDS for 13 years. She clearly feels a connection to her roommate Margaret.

"If she makes a wrong move during the night, I call out to her, 'Margaret, are you all right?' " said Reece, who is 52. "I want to know what's happening to her. We have our ups and downs, but I'm just glad I've got her."

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