Twenty years ago, the nonprofit built a state-of-the-art end-of-life caregiving facility on Oak Valley Dr. As part of the fundraising campaign, supporters donated $100 to $1,000 each to sponsor 1,565 memorial bricks in honor of their loved ones. The bricks line a pathway in a garden. But no patients live there anymore–it’s now an office building for Arbor Hospice and its new partner Hospice of Michigan, the state’s largest hospice provider.

State-mandated changes barring Medicaid reimbursements for hospice room and board are behind the move. The insurance program for the poor still pays for skilled nursing care, but Arbor Hospice wasn’t set up to provide that. When the rules took effect at the start of 2015, it transferred its eligible Medicaid patients to four beds at Glacier Hills and two units at Henry Ford Village in Detroit.

Without the Medicaid patients, half the beds at Oak Valley went unused. Maintaining the facility only for private-pay patients was “cost prohibitive,” says Brooks, so last month, the thirteen remaining patients were transferred to a dedicated new hospice unit at the former Saline Hospital, now owned by EHM Senior Solutions (formerly Evangelical Homes of Michigan). The new unit is still private pay, costing $280 a day.

Arbor Hospice also maintains a pediatric bed at C.S. Mott Children’s Hospital. And EHM also operates its own separate twelve-bed hospice unit in Saline, which qualifies for Medicaid reimbursement because it provides skilled nursing care.

Brooks, who fought the funding cut in the state legislature, describes the reorganization as “making lemonade out of lemons.” The renovation of the new unit in Saline used $1 million originally raised for renovations at Oak Valley as part of a capital campaign that started in 2012 and ended up exceeding $7 million when it recently ended. Another $2 million is being spent to remodel the Oak Valley building for administrative staff, clinical and program space for care teams, and community education efforts.

While the building was its symbolic heart, most Arbor Hospice services involve caregiving at home and programs in the community. Brooks says its mission has not changed–including its mission to serve the uninsured and underinsured. The money saved by moving to Saline, she says, will support one “charity bed” there. She doesn’t know if that will be sufficient to serve the needs of those who cannot pay or get reimbursed for a hospice bed elsewhere–but it’s a start.

Brooks acknowledges that the repurposing of the Ann Arbor residence is “sensitive because it involves people’s memories.” She says hospice leaders were encouraged when a patient visited the new unit in Saline in November and pronounced the facility better than Oak Valley.

“The board handled [the funding cut] as well as could be expected,” says Bill Holmes, the chair of the capital campaign. “What happened was in the best interests of the patients, and that’s what’s most important.”

Brooks notes that with the looming changes in the Affordable Care Act, “we’re in uncharted territory,” but says she’s certain Arbor Hospice will be able to continue to provide services with the help of community donors and volunteers.

The annual memorial service held in the garden at Arbor Hospice on Oak Valley Dr. will continue, Brooks says. “The grounds are really important.”

Calls and letters, March 2017

“While we appreciate the writer’s efforts in crafting a concise update about Arbor Hospice for Observer readers [Inside Ann Arbor, February], we feel it’s important to reach out to you to clarify a few inaccuracies and express our specific concern with regard to the headline,” emailed Franco PR vice president Pat Adanti-Joy.

Gloria Brooks, whom we identified as CFO of Arbor Hospice, is actually president of the Arbor Hospice Foundation as well as vice president and chief strategy officer of Hospice of Michigan. Henry Ford Village is located in Dearborn, not Detroit, and it does not accept Medicaid patients.

Adanti-Joy was also concerned that our headline–“Hospice Departs”–might leave readers with “the incorrect impression that Arbor either no longer serves Washtenaw County or is no longer in business … Arbor Hospice continues to serve patients wherever they call home throughout Washtenaw and surrounding counties.”