Walk down a certain corridor in Century City Hospital in Los Angeles and you would think you were at the nearby Century Plaza Hotel.
Soothing triptychs adorn the hallway walls. The carpeted rooms are partitioned with Asian-style screens, the beds have mahogany-colored headboards, and the bathrooms are trimmed in pink marble. Patients are served gourmet meals on china or have the option of ordering out from nearby restaurants. Concerned family members can doze overnight on sofa beds in the large rooms . Even those cooling their heels in the waiting room do so on Chippendale-style furniture.
The sumptuous arrangements adorn the Century Pavilion, a block of luxury patient suites that cost a bundle of century notes. Patients can spend upward of $2,000 a day for a room like this, and no insurance carrier in the world will pay even a penny of its cost.
Yet medical Shangri-Las like the Century Pavilion are fairly common. No one is keeping statistics on their number, but many of the country's major urban hospitals discreetly operate a block of such rooms. They do so because, unlike their pampered patients, the hospitals need the money, having been squeezed the past decade by insurers and Medicare.
Suburban Hospital in Bethesda, Md., established its 16 Signature Suites two years ago out of the need to "respond to competitive pressures," says Ronna Borenstein-Levy, director of communications at the 250-bed hospital. Borenstein-Levy notes that nearby facilities such as Sibley Memorial Hospital in Washington and Johns Hopkins Hospital in Baltimore have also established their own luxury rooms. Signature Suites patients and visitors have valet parking and their own doorman. Along with the ubiquitous gourmet meal service, each cherrywood-trimmed room gets fresh flowers daily, beds swathed in high-thread-count sheets and medical equipment tastefully stowed behind wall panels. Suburban charges an average of $600 per day for the extras.
"Hospitals are just trying to scramble for whatever makes their bottom lines work," says Rob Hunter, president of Healthcare Environments, a hospital architecture firm in Pasadena, Calif.
Hunter adds that large cities contain enough patients willing to pay for mixing their acute care with tender loving care, while the amenities are inexpensive to add, usually adding no more than $20 per square foot to the cost of a typical room. And because luxury rooms send HMOs and HCFA running the other way, the hospitals keep virtually all of the huge out-of-pocket prices they charge.
In some cases, the cash flow is more like a gush that can rinse away gallons of red ink: Mount Sinai Medical Center in New York will net about $1.2 million this year from 11 West, the 11th floor luxury rooms it has operated since 1993. That represents a profit margin of 50%. Occupancy at 11 West has been running at nearly 90% this year-up from 75% in recent years-and there have often been weeks with a waiting list, says its director, Lisa Hogarty, who attributes the demand in part to the booming economy.
For 1997 Mount Sinai reported operating earnings of $1.9 million on revenues of $850.4 million.
"Within a 40-block radius of Mount Sinai happen to be the two highest per capita income (neighborhoods) in the world on the Upper East Side, and there is no reason why we should not be catering to them," says Hogarty, who was recruited to run 11 West from the swank Pierre Hotel, a cab ride down Fifth Avenue from the hospital.
The luxury wing has a 52-employee staff, including a concierge who arranges for massages and manicures, buys pajamas and doles out videos from a 900-title library; a full-time nutritionist; and chefs trained at such posh Manhattan establishments as Aquavit and the Mark Hotel. Some 85 menu items-including mushroom ravioli, brie and turkey sandwiches, rack of lamb and a chef's daily feature ("something special reflecting the season")-are prepared in a $1.5 million kitchen that services only the wing.
For the super rich, Mount Sinai charges upward of $3,000 a day for acute care's equivalent of "Bonfire of the Vanities": A 2,000-square-foot suite with panoramic views of Central Park.
Who stays in such rooms? Hospital executives say mostly celebrities, business executives, diplomats, politicians and wealthy foreigners who seek treatment in the U.S., with the latter heavily weighted toward Middle Eastern royalty. A corpulent Saudi sheik is so regularly ensconced at the Century Pavilion for weight-control regimens that he practically lives there, healthcare sources say. The hospital won't confirm his presence.
Stories also abound about other high-powered patients strolling the floors. A celebrity had to hide in an adjoining room to evade a paparazzo who sneaked into the Century Pavilion to take unauthorized photos.
An Arab prince was so insistent that fresh goat be served with his couscous that an 11 West chef dashed the 100-plus blocks to Chinatown to arrange for one to be slaughtered and dressed. "He loved it-thank God," Hogarty recalls.
With hospitals clamoring to give such enormous attention to patients with means, critics charge that such excesses merely widen the gap between the rich and the poor. Published reports have questioned whether hospitals should be preparing gourmet fare for a select few when many hospitals-including Mount Sinai-have abandoned hot breakfasts for their other patients.
While acknowledging that money can buy better accommodations, Hogarty and others deny that the patient care is any different.
"It's democratic; our key is never to have differentiation in care," Hogarty says.
Some statistics bolster that view. At Suburban Hospital's Signature Suites the average length of stay is 3.9 days, compared with 5.8 for the rest of the hospital. Although hospital spokeswoman Borenstein-Levy says the contrast can be traced to differing patient acuities, it can also be argued that less-privileged patients receive as much care as anyone else.
Pampering of the elite can also lead to trickle-down bonanzas for everyone. Two high-powered businessmen were so impressed by the services they received at 11 West that each gave Mount Sinai a $10 million endowment.
And the middle class isn't frozen out of the luxury room market. At Mount Sinai's 11 West, a patient and a visitor can have some rooms for as little as $350 per day. Given the cost of putting a family member in a Manhattan hotel, many middle-class patients are opting for 11 West so that a loved one can stay for the duration. The hospital charges an additional $100 a day per visitor for three meals, comparable to the cost of eating in New York restaurants.
For those with smaller pocketbooks, Mount Sinai also has $130-per-day hotel-level apartments on property adjoining the hospital.
Like luxury rooms, the on-site hotel idea is quietly spreading to other hospitals to give middle-class patients a pleasant alternative accommodation. In 1996, St. Francis Medical Center in the Indianapolis suburb of Beech Grove opened the 28-room Inn at St. Francis on its fourth floor. Rooms include kitchenettes and a living area with a sofa bed, and amenities and services are about the equivalent of those at an Embassy Suites hotel, says manager Mike McKay. They cater mostly to patients having minor procedures, he adds. The cost is $60 per day.
"People are a little bit freaked out that all of a sudden they're walking from a hospital to a hotel, but they're really pleased," McKay says.