Just how deep into the hole is a hospital willing to go to invigorate referrals, lift sagging bottom lines and buff operating margins to a luminous glow?
Well, Hackensack (N.J.) University Medical Center, for one, has sunk about $1.2 million into its latest for-profit venture and is now up to its chin in full-body seaweed wraps, French white clay and papaya sauna masks, and honeysuckle algae scrubs.
In June, the 629-bed hospital in affluent Bergen County launched a full service day spa--called Beyond--on the penthouse floor of its nine-story ambulatory facility. With a sage leaf as its logo, Beyond offers facials ($50-$85); body treatments ($75-$85, plus $20 when combined with a Vichy shower); massages ($40-$85); nail treatments ($12-$45); hair removal, which eschews wax in favor of a soy-based antimicrobial method ($8-$60 and up); and personalized make-up applications ($40-$60).
Amenities include a relaxing tea garden that features a soothing, babbling waterwall and complimentary valet parking. Physician consults can be scheduled in advance.
Don't bother wondering whether insurance will reimburse the spa's treatments.
"We don't even go there," says Doreen Santora, Hackensack's vice president of operations and a former operating room nurse.
Although hospitals are routinely venturing into the fitness business and spas are nuzzling up to medical professionals for the credibility they bring, Hackensack officials believe their hospital is among the first--if not the first--medical center to offer an onsite spa. Describing the venture in their advertising as "a new horizon in beauty and wellness," they say a spa perfectly complements the hospital's mission as a center for care and wellness.
It also can't hurt if the spa turns a profit and captures a whole new market for the medical center.
The 5,500 square feet of stress-reducing, stimuli-numbing, womb-like space is partitioned into six treatment rooms for women and two treatment rooms for men, each with its own towel-warming drawer. In addition, Beyond features a "relaxing and massaging" Vichy shower room; a six-table manicure salon; four pedicure stations with black leather, heated massaging chairs and built-in whirlpool baths for tired feet; and men's and women's saunas, steam rooms and showers.
The decor, designed by the hospital's full-time interior designer, Suzen Heeley, is described as "minimalist Asian." Everything--from the walls to the plush carpeting to the muted, indirect lighting, flattering to even the most time-worn complexions--is anointed in rich ebony, brown and gold tones.
Of course, Beyond is available for private parties. Gift certificates and the spa's complete line of carefully chosen products can be purchased in the front reception area.
A sampling of the products for sale: Shea butter soap wrapped with fine wire in Italian paper, each with its own gem stone ($9); soft Beyond signature robes ($145-$175); Amy Jo Gladstone slippers ($70-$90); Fresh Milk Lotion and Fresh Sugar Lotion baths and soaps ($6.50-$28); and J.F. Lazartigue scalp products from Paris ($16-$52.)
If pressured, spa personnel probably could even be induced to sell any of the selection of New Age musical tapes, Santora admits. "We're not opposed to selling anything," she says with an ironic smile.
Obviously, no one is varnishing the fact that the spa is a moneymaking venture for this relatively healthy New Jersey hospital. (In 1998, the hospital earned $14 million in income on $468 million in revenue, a 3% profit. In 1999, income dipped to $11 million on $514 million in revenue, a 2% profit.)
Everything at Beyond is strictly cash on the barrel and instant gratification. Santora is even debating the pros and cons of installing an automatic teller machine nearby.
It is also no accident that Beyond is down the hallway from the hospital's newly constructed Center for Cosmetic Medicine, designed from sheets to ceilings in beige tones with a panoramic view of the Manhattan skyline from the waiting room. Like the spa, the cosmetic center is a for-profit enterprise with no delusions about qualifying for insurance reimbursement. Every patient pays for the privilege of going under the knife in one of two operating rooms with their own panoramic picture windows, these facing the open spaces of western New Jersey.
The idea is that plastic surgeons will refer patients to the spa for after-surgery massages, facials and camouflage make-up techniques, Santora says. On the other side of the corridor, spa technicians will be at the ready with physician names for clients who are looking for something a little more aggressive than the fleeting effects of a revitalizing facial. But rather than patients beating a straight path between the cosmetic surgery center and the spa, Santora says she likes to think of it more as a circle.
"Once you get in the system," Santora explains, "you don't leave."
With its competitive pricing and Hackensack cachet, Beyond is being marketed well beyond the medical center's patient community to families and friends of patients; the hospital's 6,000 doctors, employees and volunteers; and the general public.
Santora says she wants to reverse the migration to Manhattan spa destinations. To that end, she targeted a direct mail advertising campaign at the 18 or so luxury high-rises that share Prospect Avenue with the medical center. Many of the New York-commuting professionals who live there are keeping Beyond busy Fridays and Saturdays, Santora says. And if the clientele demand it, Santora says she happily will open on Sundays.
On Monday, a typically slow day for spas, hospital employees get a 10% discount .
Vendors also are "informed of the opportunity to come and form a partnership" when they visit the hospital, says Marijane Hubbell, the spa's director and a registered nurse. One drug company recently treated eight allergists to a presentation of their product, which included a spa treatment and a healthy light lunch. Three or four other vendors have reserved spa time this month, and last week the UPS driver purchased a gift certificate for his wife, Hubbell says.
The spa also is offering its services for bridal showers and Sweet 16 parties, Santora says. Physicians have discovered a handy way to lavish patients and others with spa gift certificates.
Stephanie M. Cohen, M.D., a plastic surgeon with offices in the building, just keeps her credit card on file at the spa.
"I think there will be a direct line between my office and here," Cohen says.
One of Beyond's biggest promoters is Manuel Alvarez, M.D., chairman of the Department of OB/GYN and Reproductive Services, whose laboring patients have been known to send their over-stressed husbands for massages, Santora says.
On a recent Thursday, Liz Fisher, an Alvarez patient, stopped in at the spa with her husband, Ken. The couple is expecting three girls in mid-October. Fisher explained that when she was four months pregnant, Alvarez ordered her to bed, only allowing her out of the house for regular doctor visits and twice for massages at Beyond. That day she was scheduled for a blood test, but she had an extra half-hour, so she came in for a manicure first.
"Smart, eh?" she smiled, waving her hand, the nails freshly coated with "sheer bliss" polish.
The idea for a spa was the brainchild of the hospital's president and chief executive officer, John P. Ferguson, Santora says. Ferguson "wanted to take patient care to the next level--not only to provide quality medical care, but (also to) provide this whole business of complementary medicine."
It was up to Santora to research how best to accomplish that goal. Much of this was done by visiting other spas.
It was hard work. Really.
"Going to the board of governors and saying the hospital is going to open a spa-it wasn't easy," says Santora, who has not had the time to get a massage herself but has bought plenty of gifts for family and friends. "We did a lot of research to get to that point."
The cost of building the spa was $830,000, with an additional $380,000 outlayed for equipment. First-year projections are that the business will turn a $52,000 profit on $972,000 in revenue. By the third year, hospital accountants project a $259,000 profit on $1.2 million in revenue.
Although Hackensack is nonprofit, profits from Beyond are taxable as unrelated business income, says Gus Mongiello, Hackensack's senior vice president for finance.
Between when the spa opened on June 22 and the end of September it had logged 825 visits.
Shira Forman accounts for at least a dozen of those visits. Employed for five years as an administrative clerk in the hospital's pediatric hematology unit, she was so moved by Beyond's services she wrote a letter to Ferguson praising him for it. Forman comes by every Friday so she can have a fresh manicure for the weekend.
At $12 (plus a $4 tip), Forman pays more than double what she paid elsewhere, but it's worth it, she says. She usually relaxes during the treatment with either lemon tea or filtered ice water with a fresh slice of orange.
"I like having the same person every week, and it really lasts," says Forman, who also has become addicted to monthly facials. She recently signed on for a package of six 60-minute glycolic facials for $405.
Even the medical staff seems to be on board with the idea. Louis Evan Teichholz, M.D., the chief of cardiology and director of the hospital's center for complementary and alternative medicine, discusses the medicinal benefits of spa treatments over a cup of Red Flower green tea. Teichholz is seated in a black leather and rattan chair in the tea garden, a clay Tibetan princess smiling in the corner behind him.
A proponent of mind and body medicine, Teichholz says he routinely prescribes stress reduction to his heart patients, advising them to do whatever works for them.
"We've decided (the spa) fits in with the mission and ambiance of the medical center, which is not only to cure the illness, but to heal the patient," Teichholz says. "If you feel good about how you look and feel, it is going to keep you healthy."
Besides the wellness and money-making benefits, Santora says perhaps the biggest dividend is the way the spa exposes the entire medical center to a whole new market of patients.
"It spins off to other areas of the hospital," she says. "It's all about relationships. Maybe someone who would normally go to (another hospital) will see our spa and form a relationship, see how nice it is, and it's easy from that for them to come and ask for a doctor. Otherwise, they may never have been introduced to this medical center."
As yet, Beyond's closest competitor, the Fountain Day Spa, about 15 miles away in Ramsey, N.J., is not feeling the effects of competition, according to Joyce Fontaine, its executive director. "It's a totally different concept with doctors connected," Fontaine says. "We're very large--14,000 square feet--and more of a pampering, holistic and well-being place. We're a rival for destination spas and resort spas."
Nevertheless, even Fontaine can't deny that baby boomers like herself are changing the spa landscape.
"This is the way it's going," she says. "It's all about wellness."