When Libby Bowerman retired late last year as chief executive officer of Keswick Multi-Care Center, she said the long-term and memory care facility was well-positioned for "whatever health care is going to become."
But what that would be exactly was still "murky," Bowerman said, predicting a move toward short-term, specialty care, some of it in community-based satellite offices.
"It's the end of an era as I know it, and the future is just not clear," she said.
Now, the future of Keswick falls to Bowerman's successor, Carmel Roques.
And community-based health care, including cardiac rehab and better relations with a once-cantankerous Roland Park community, are in her plans.
Roques, 56, a 20-year Columbia resident, came to Keswick last December after serving as chief operating officer of Richmond-based Virginia United Methodist Homes, a mid-size, multi-site, nonprofit senior living organization. She previously worked for Episcopal Ministries to the Aging, in Eldersburg, the Fairhaven retirement community in Sykesville, the Copper Ridge dementia center in Sykesville, and Catholic Charities.
Unlike Bowerman's 13-year legacy — a $50 million construction spree on the 286-bed Keswick campus and the addition of a memory care unit for dementia patients — Roques said she and Keswick's board of directors have no immediate building plans and that there's really no room to grow anyway at 700 W. 40th Street.
Instead, Keswick "will refocus on community-based health services," Roques said in an interview May 16.
One of the most noteworthy aspects of that new approach is that Keswick plans to take in some former heart patients from Union Memorial Hospital for rehabilitative care.
Roques and Union Memorial officials are working on a plan for Keswick to accept some of the nearby hospital's heart patients. As Roques understands it, the plan calls for Keswick to provide "cardiac rehab" for Union Memorial patients. The nursing staff would be upgraded to include nurses specially trained in cardiac care, Roques said.
For Keswick, "this is a new specialty," Roques said.
Union Memorial spokeswoman Debra Schindler said the hospital would refer congestive heart failure patients to Keswick for "post-acute care," in an effort to reduce readmissions to the hospital.
Keswick and Union Memorial officials were in talks last week and early this week about the plan, and Roques said it would be summer before details are worked out.
Taking in cardiac patients would deepen their relationship. Union Memorial has long referred orthopedic patients to Keswick for rehabilitation after operations such as knee and hip replacements.
"We've been sending our ortho patients there for years," Schindler said. "It's a proven facility. We've had such a good relationship with them over the years."
Roques is also planning to institute a program in which each outpatient at Keswick would be assigned a "wellness coach," who would be the point person for that client's needs, she said.
And she plans to expand the role of Keswick's subsidiary, Keswick at Home, to provide non-nursing services such as providing meals, shopping assistance, transportation and housekeeping, as well as nursing supervision.
"I'm really envisioning that our community services are going to come through our Keswick at Home subsidiary," she said.
She said that if home services become a bigger part of Keswick's business, Keswick might open a satellite office.