David S. Chernow, President and CEO
Photography: Ann Johansson
UCLA Health and Cedars-Sinai Medical Center have joined together in a partnership to open the California Rehabilitation Institute. David Chernow, of Select Medical, was instrumental in bringing the two rivals to the table for this unique joint venture.
Seeing the names of UCLA Health and Cedars-Sinai together on one hospital building might catch some people off-guard, but that’s exactly what they’ll find at the California Rehabilitation Institute in Century City. After three years of collaboration and planning, the new 138-bed facility opened in July 2016.
Helping to nurture this partnership between UCLA and Cedars was Select Medical, a Pennsylvania-based healthcare company that independently and in partnership with such institutions as Cleveland Clinic, Emory University and Ohio Health operates specialty hospitals and clinics around the United States. David S. Chernow, president and CEO of Select, was key to bringing the hospitals’ leadership together to build the joint venture.
For Chernow, the opportunity to build this partnership in Los Angeles was something of a homecoming. He grew up in the San Fernando Valley, worshipping the basketball teams of Coach John Wooden (a photograph on the wall of a well-known student hangout in Westwood captures a young Chernow sitting on the floor under the basket gazing up as Bruin-great Bill Walton leaps and stretches to block a shot), and he graduated from UCLA in 1979 with a degree in history. He then went on to earn his law degree from Pepperdine University. “I think maybe it was fate that I would come back here to work on this with UCLA and Cedars,” he says with a wide smile during a recent visit to Los Angeles. Though he began his career in real estate, Chernow gravitated to healthcare and co-founded an oncology-resource company, American Oncology Resources, which later became US Oncology. He always has felt a strong commitment to public service, and from 2001 to 2007, he was president and CEO of JA Worldwide (formerly known as Junior Achievement). Chernow spoke with U Magazine editor David Greenwald about the UCLA-Cedars joint venture and building partnerships.
The Los Angeles healthcare market is very competitive, and among its chief players are UCLA and Cedars-Sinai. How did these two rivals come together to create this partnership?
David Chernow: It is true that UCLA and Cedars, each with its own inpatient rehabilitation service, are competitive in this healthcare-service area, as well as in many other service areas. UCLA has had its 11-bed unit and Cedars had its 29-bed unit. They both were very good services, but both were smaller programs and usually full. There was limited capacity, and there weren’t economies of scale.
The two hospitals together were having to send more than 90 patients to facilities outside of their systems or to out-of-state facilities in Colorado and Arizona and Texas because they couldn’t accommodate them. It became clear after some initial conversations that Select was having separately with both UCLA and Cedars that there was a real opportunity here to create something — a more integrated and comprehensive resource to serve the broader community. After we did an analysis of each hospital and looked at the numbers of patients they were sending for rehabilitation after discharge, it became evident that there was a much larger need. Looked at individually, the numbers appeared to be small, but taken together, they were enormous. There was an acute need for a regional resource such as this.
The need may have been acute, but still, you have two distinct entities that you need to bring to the table to even consider an idea like this.
David Chernow: Yes, that, of course, was a key question: Would UCLA and Cedars even want to partner? To be honest, I was, perhaps, a little naïve about it. My thinking was, it’s a beautiful thing, why wouldn’t we all want to do this together? It was challenging, but the leadership of UCLA and Cedars — it truly was enlightened leadership on both sides — recognized the need, and that by working together, with a common vision, purpose and goals, they could address a significant issue and build a legacy project for this community, a state-of-the-art regional and national center of excellence. When we identified a viable location — the then-vacant Century City Hospital — that would not require building something entirely new, that was the last piece that needed to fall into place. The result is fantastic; California Rehabilitation Institute, with 138 beds, is the largest comprehensive rehabilitation hospital west of the Mississippi.
Having successfully collaborated for this project, do you see the door open to future partnerships?
David Chernow: Many large healthcare systems understand what they’re really good at and focus on that and maybe, also, what they’re not so good at. They might be excellent in areas like oncology, cardiology and orthopaedics, but post-acute care was not, perhaps, really where their focus was. In a situation like that, they have a choice if they want to improve: Build something themselves, buy it from outside or partner with someone else. I am in the business of working collaboratively with healthcare institutions and building partnerships, and I look at the relationship like a marriage. There’s the four “C”s: communication, compassion, collaboration and compromise. There needs to be trust between the partners, that each is in it for the benefit of all and for the broader good of the community. This gets us to the larger question: Why would you duplicate services, spend money and build buildings if you didn’t have to in an environment where value-based practices and efficiencies are rewarded? The creation of the California Rehabilitation Institute is a wonderful example of this, and it is very possible that this is a model that can translate for other post-acute-care services as well.
In the case of the California Rehabilitation Institute, what expertise does each of the partners bring?
David Chernow: UCLA has exceptional expertise as an academic institution with a mission of both teaching and research, as well as excellent patient care and community engagement. Cedars, too, has tremendous strength in clinical care, research and training. In that regard, they are very complementary. Along with the great clinical care they will provide, their combined expertise will have great value in the area of research. Together, these two institutions will be able to conduct groundbreaking research in the area of rehabilitation medicine that will be far-reaching. In addition, Select can draw upon experts from some of our other partners, like Kessler Rehabilitation Center, in New Jersey, which is the largest rehabilitation hospital in the United States, to work together with our UCLA and Cedars partners. That, to me, is one of the really exciting aspects of this collaboration. For us, fostering these kinds of relationships among institutions is a part of our vision to develop a network, like what exists in cancer care and research, for example, to share research and knowledge and develop a higher level of sophistication and clinical expertise to focus on rehabilitation and address issues of spinal-cord and traumatic brain injury and stroke.
That would seem to fit well within the goal that the reach of the California Rehabilitation Institute extends beyond the Los Angeles region.
David Chernow: Absolutely. As I mentioned, the vision of the UCLA and Cedars leadership is that this be a national center of excellence. In addition to the immediate Los Angeles region, much of the draw will be from throughout the West Coast. There aren’t many facilities that can offer the caliber of care and clinical expertise that will be provided here. And just as UCLA and Cedars now attract patients from overseas, we believe that also will be the case with this new rehabilitation hospital.
What will success look like?
David Chernow: At its most basic level, as with any aspect of healthcare, it will be patients and their families receiving optimal care. As more and more patients experience the benefits of this new facility, we will see that we are providing great quality care and efficiency and will be meeting the needs of the community. But beyond that, success also will be, in my mind, our ability to expand what we are doing beyond rehab to other post-acute services. That, I think, is the next opportunity — to continue to provide, through our partnerships and joint-ventures, other post-acute-care services, including ongoing therapy once the patient has left the acute-care hospital setting and returned to his or her home. That, to me, would be the ultimate success.
How will the needs of a growing population of older Americans be addressed by a facility like California Rehabilitation Institute?
David Chernow: People indeed are living longer, and as that population ages, the need for facilities like this becomes even more critical. Our current healthcare environment demands that patients be shifted to the lowest-cost setting; that just is the reality at this time. But those settings can’t always meet the increasingly complex needs of certain patient populations. To achieve the best results for these patients — patients who may be post-stroke or who have been injured by a fall or who are experiencing symptoms of dementia, for example — requires a facility that not only provides skilled nursing care, but also expert physician oversight and management. A facility like California Rehabilitation Institute can provide that higher level of expertise and care. This goes to what I’ve mentioned earlier, about expanding this model to other post-acute-care services to create an integrated care-management model that provides the right level of service at the right time for the right patient. That will have significant benefit to elevate the quality of results — optimal care and faster recovery — that can be achieved.
For more information, visit the California Rehabilitation Institute website.