Home' Australian Ageing Agenda : AAA Spt-Oct 2014 Contents WHEN LOU PASCUZZI took the
top job at TLC late last year, the
senior executive with 20 years'
experience in primary healthcare
set about doing his homework on
his new sector.
After months of research,
including mystery shopping his
competition, he concluded there
few signs of the kind of innovation
that would ultimately ensure the
sector could meet predicted
A key issue, he felt, was the
provision of quality medical
care in residential
more focused on their
ensuring continuity of
care, he said.
"All I saw and read
in the industry were
people's claims of the
GPs and residential
facilities being broken
-- this is the terminology
being used," said Mr Pascuzzi,
a former head of the Medical
Centres Division at Healthscope
and founder of Peak Health
Mr Pascuzzi bemoaned the
current system of relying on
GP visits: "GPs are domicile
to a medical centre; they have
a significant patient base to
look after. When they're not
compensated to venture out to
residential aged care then there's
a significant opportunity cost."
GPs often made appointments
to visit residential facilities, but due
to the "double booking process"
at medical centres, were delayed
and never turned up, he said.
Residential facilities were forced
to rely on locum GPs, who were
equally problematic, he added.
The other crucial issue he
encountered was the lack of
local engagement with residential
facilities, which seemed to
exacerbate the relative isolation
of aged care within the
health system and the
To respond to both
these issues, to give
residential aged care
facilities a "greater
purpose" and ensure
they were providing the
kind of medical care
required by the older,
frailer resident cohort,
Pascuzzi proposed TLC
develop a series of 'community
healthcare hubs' at its 10 facilities.
Integrating aged care with
primary healthcare was the only
way residential facilities could
ensure continuity of care, he
believed. The hubs would also
benefit their local communities,
by providing a range of services
"It was part of my pitch to the
[TLC] board; I outlined this vision
and ultimately the board was sold
on it," he said.
The centres will be staffed
by GPs, chronic disease nurses,
physiotherapists and other allied
health professionals. Along
with primary care, the centres
will house retail pharmacies,
telehealth, day respite, radiology
and pathology facilities.
TLC is building eight
community healthcare hubs in
total; its two facilities at Wallington
will share a combined centre,
as will Noble Manor and Noble
Gardens, which are similarly close
to each other, Mr Pascuzzi said.
Discussing the business
model, Mr Pascuzzi said TLC
would own the primary care
business and, as such, engage
GPs on a subcontracted basis.
However, TLC is offering doctors
80 per cent of the fee split,
compared to the current industry
average of 60-65 per cent, he said.
"Because this service is
primarily geared to service our
residents, I'm not looking to make
copious amounts of money;
single digit EBITDA contributions
is all we need," he said.
Mr Pascuzzi said the 80 per
cent rate was "unheard of in the
market" and TLC had already
received unsolicited approaches
from GPs. Additionally, unlike
typical medical centres, doctors
at the community healthcare hubs
would be supported by specialist
chronic disease nurses.
The onsite pathology centres
will be run by Sonic Healthcare,
while the pharmacies will be
operated by Quality Pharmacy.
"They will operate those
services for us and pay rent to
us," he said.
Physiotherapists will be
employed directly by TLC,
and when not providing care
to residents they will provide
services to the community out
of the hub, he said. The hub will
also provide dedicated rooms to
TLC's visiting geriatricians on a
gratis basis, he added.
The first two medical centres
are due to open at Noble Manor
and Forest Lodge in November
and December this year, followed
by TLC Homewood in Hallam
"We've already commissioned
the builders, the designs are
done, they're now applying for
permits," Mr Pascuzzi said.
The creation of the hubs is
part of a $120 million expansion
and development program being
undertaken by the family-owned
provider, which will see its bed
numbers increased by 515 to a
total of 1,751.
It includes a new 140-bed,
eight-storey facility at Clifton Hill, a
new 180-bed facility at Armstrong
Creek, and more than 210 extra
beds at its facilities at Wallington.
TLC also recently moved into
its redeveloped corporate
headquarters in St Kilda Road.
"The reason a lot of providers
are selling right now is because
their costs are becoming
untenable... However, by being
innovative you can add multiple
additional revenue streams to your
business, and that's exactly what
we're doing," Mr Pascuzzi said.
He said to expect a further
announcement later in the
year as TLC sought to tackle
another significant problem
facing the sector. n
Artist's impression of the Clifton Hill facility
By Darragh O'Keeffe
8 | SEPTEMBER -- OCTOBER 2014 | AAA
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