By October, 1973, arrangements were made for laying the cornerstone of the new building. Finally in April, 1974, the new Long Term Care Facility was opened for occupancy. All the patients were moved from “N” Building to the new facility, thus solving a complex problem that had existed for the County since the adoption of Medicare. The building consisted of six patient floors, each containing 18,000 square feet. The seventh floor, consisted of an equal amount of space and contained mechanical equipment, such as the elevator panel house, and rooms containing machinery for the operation of the building, such as the air-conditioning units. The first floor contained the administration wing of approximately 15,000 square feet. The basement consisted of kitchens, emergency generators, mechanical rooms, and the Physical Therapy Department of 18,000 square feet. The exterior of the building was a brown brick, and the building was connected directly to “N” and “O” Buildings by means of underground tunnels under the road traversing between the buildings.

Effects of Medicare and Medicaid and the Development of a Long Term Care Facility

On July 1, 1965, as the Federal Medicare/Medicaid amendments to the Social Security Law were passed by Congress, the Board of Institutions requested that it be advised to date of progress of what the future held for Wayne County General Hospital when the program took effect. By December 16, 1965, the Hospital had completed all forms to qualify approximately 700 of its patients over 65 years of age to take advantage of the Medicare program – and the transfer of its patients from the Infirmary to private facilities continued. With the adoption of the provisions of Medicare, the Federal authorities (HEW) charged with the program established standards for the housing and care of patients (including a maximum of six beds in a unit). Inspections revealed that “N” Building could not meet these standards since the building had been contructed 34 years before another for another purpose in another time. The questions for County authorities then became threefold whether to: (1) Renovate “N” Building to meet these standards; (2) Build a new building; or (3) close the facility for extended-care patients, leaving it to the private nursing home sector. The County Social Welfare Department and the Hospital felt the need for a 1,000-bed facility since the type pf patient serviced by the County could or would not be adequately cared for in private facilities nor were the latter interested in caring for the acutely ill patient. Approval was then sought from the Greater Detroit Area Hospital Council for the construction of such a facility, a requirement under Federal rules to prevent the over-building of hospital facilities.

While this debate went on, the Federal authorities granted temporary approval which allowed the Infirmary Division to participate in the Medicare program because of the high level of skilled patient care provided but with stipulations that definite plans be devised to replace the existing building in the near future.

In the same year, an affiliation in Oral Surgery with the University of Michigan was effectuated. At the beginning of 1966, plans began for developing special care units in the General Hospital. Among those proposed were an Intensive Care Unit, a Shock Unit, a Hyperberic Unit, a Burn Unit, a Coronary Care Unit, a Dialysis Unit, Pulmonary and Metabolic Units, and a Family Planning Clinic with grant funds from the Wayne County Health Department. These resident physicians providing the professional medical service were to be paid by the department grant.

Later in the year, the Hospital began planning with the Detroit-Metropolitan Airport to form a disaster plan which the Hospital would respond to Airport emergencies by furnishing a triage team aided by the installation of radio equipment for rapid communication between the Hospital and the Airport.

By 1966 plans were afoot by the County to phase out the County Department of Social Welfare, and the Hospital began planning to take over some of the admission and the billing functions which were performed by that department. By July, 1967, approximately 40 Social Welfare Department positions
were transferred to the jurisdiction of the Hospital, mostly in connection with the billings and the collections functions.

The Infirmary Division, after inspection by State and Federal authorities, was given provisional status due to many defects and deficiencies in the building in which it was housed. Its temporary approval was recieved on the high caliber of care being affored to patients. The dilemma then facing the County was whether to invest money in updating “N” Building or to build a new building. The latter required approval from the Greater Detroit Area Council, this area’s Health Plan Council. Dr. Wells communicated with the Greater Detroit Area Hospital Council suggesting the establishment of a Long Term Planning Committee regarding the need for the County’s continued participation in an Extended Care Facility, which would consist of a member from the County Board, the Medical Staff, and the adminstration.

On February 8, 1967, the County Board of Institutions met with the Wayne County General Hospital Committee of the Board of Supervisors to decide whether the County should operate an extended care facility in view of the great changes taking place due to Medicare and, if it should so decide, to plan for a new building in order to meet accreditation standards. It was finally decided that the Wayne County General Hospital should stay in the extended care field because, while it was theoretically possible for all the patients to go to private nursing homes under Medicare, in practice, the kind of cases in the chronic disease section of the Infirmary were the type that convalescent homes for the most part were unwilling to accept.

In April, the Michigan Department of Public Health again pointed out that the Infirmary Building fell below the standards according to Medicare and that it was below accepted modern standards for inpatient care facilities of any type. It was further stated that the high level of patient care provided the patients in “N” Building, in spite of the extremely unfavorable physical plant, was a great asset. And it further felt that the Social Security Administration would be willing to grant some form of temporary approval, but this would only be on the basis of a need for the services and would be conditioned on the County making definite plans to revise or replace the existing building.

By the end of April, the Greater Detroit Area Hospital Council recommended that “N” Building be replaced by a facility for housing 250 to 350 patients limited to four beds per unit and a maximum of six. By May 14, 1969, the Board of Supervisors formally endorsed the concept and the need
for the construction of a Long Term Care Facility building. In the following month, the Detroit Council of Hospitals approved the building and the initial plans for the construction of a 350-bed hospital. Mr. Bresnahan, former Superintendent of Maintenance at the Hospital and later Superintendent of 
County Buildings for the Board of Auditors, outlined the approximate cost for the project to total $10,211,600 for a 167,917 square foot building which would consist of a 358-bed, 6-floor facility. By May 20, 1970, the Wayne County Commissioners approved a bond issue proposed by the Wayne County
Building Authorities to finance this facility, with a proposal that contracted for the new facility, to be let by February, 1971. The amount of $1,670,000 to assist in building the new Long Term Care Facility. In the meantime, word was recieved from the Federal authorities that 360 beds in N-109, N-111, 
N-209, and N-211 would be certified as Medicare providers.

The ground breaking for the new Hospital took place in July, 1971. In October, 1971, the Michigan Hospital Services advised the Hospital that the Michigan State Department of Social Services was going to assume full responsibility for administration Title XIX (Medicaid Program) and was 
designing a system phasing in the operations by April, 1972. By October, all the patients in the Long Term Care Facility were classified as Medicaid recipients.

At that time, the census in that unit was running between 220 and 230 patients; and the level continued at this pace for the next two years.

In the meantime, communications from the Health, Education, and Wlefare Federal Bureau continued to stipulate that the Wayne County General Hospital was qualified to recieve Medicare payments.

By October, 1973, arrangements were made for laying the cornerstone of the new building. Finally in April, 1974, the new Long Term Care Facility was opened for occupancy. All the patients were moved from “N” Building to the new facility, thus solving a complex problem that had existed for the 
County since the adoption of Medicare. The building consisted of six patient floors, each containing 18,000 square feet. The seventh floor, consisted of an equal amount of space and contained mechanical equipment, such as the elevator panel house, and rooms containing machinery for the 
operation of the building, such as the air-conditioning units. The first floor contained the administration wing of approximately 15,000 square feet. The basement consisted of kitchens, emergency generators, mechanical rooms, and the Physical Therapy Department of 18,000 square feet.
The exterior of the building was a brown brick, and the building was connected directly to “N” and “O” Buildings by means of underground tunnels under the road traversing between the buildings.

In 1978, the County began facing budgetary problems due to the inflationary spiral that was previaling throughout the national economy and because it operated with a more or less fixed tax base. A review began of many of the services supported by the County General Fund that was not required by law. All County departments were notified to reducestaf and functions; among them were the operations of the Long Term Care Facility and the Psychiatric Hospital.

In June, 1977, the State of Michigan began tendering an interest in purchasing the Long Term Care Facility building for the purpose of housing its psychiatric patients. The County Board of Institutions went on the record opposing the same. On October 5, the Board cited several specific
reasons for the oppostition; among them, the impact on the operation of the General Hospital. However, on October 14, the Board of Commissioners passed a resolution calling for negotiations to
begin between the County and the State.

On November 7 of the same year, the Board took action to cease admissions to the Facility pending the discussions with the State and also due to the lack of funding for the operation of the Facility in the new 1977-78 County budget beginning December 1. The Board of Commissioners, however,
temporarily extended funding until December 18, 1977, and again until May 31, 1978. In the meantime, the State Legislature called for a gradual phase-out of the Facility between August 1, 1978, and August 1, 1979. Again, the County agreed to fund the operation through November 30, 1978, during the phase-out program and extended funding to January, 1979.

In July, 1979, the State commenced covering costs for all Facility patients. In the meantime, all patients were evaluated for tranferability to nursing homes or for complete discharge. Finally, the transition was completed; and the sale consummated, effective October 1, 1979.

Thus, after 147 years of continuous service to the poor and medically indigent, the County ceased operation of what, at one time, was the largest operation in the county – starting with a few patients in the First County House, reaching a high of 7,500 during the Depression, and finally 
operating a 358-bed modern Long Term Care Facility before its closing in 1979.

[ This information presented in whole from “A History of the Wayne County Infirmary, Psychiatric, and General Hospital Complex at Eloise, Michigan” by Alvin C. Clark; pages 37-40. ]