By Margaret Sheridan, Senior Editor

Hold the Demerol, nurse, and pass the beluga caviar. Welcome to the posh world of hospital VIP floors, where hotel-style foodservice and amenities cater to patients sophisticated tastes.

For medical providers, upscale service yields both market appeal and financial benefits. Almost all hospitals are under pressure to improve margins; those that offer premium-care floors market them to a well-heeled segment of the population able to afford the extras. Who knows? There could be a future benefactor between those luxurious sheets.

Complementing these high-end rooms is a concerted effort to raise foodservice quality and patient satisfaction. Over the past decade such focus throughout the hospital has produced 24-hour foodservice, late-hour trays, hostesses and guest-service crews, and room service with foods from burgers and nachos to fresh cookies and pizza. Hiring chefs with hotel and restaurant backgrounds has improved plate presentations and raised flavor profiles.

Patients who can afford the lofty room rates that bring carpeting, period furniture, spectacular views, table linens and china are not limited to movie stars or CEOs.

You dont have to be a celebrity to stay here, says Cristi Knee, director of guest services for Eleven West, the 19-room VIP floor in New York Citys Mount Sinai Hospital. Some families splurge for a loved one. Daily out-of-pocket expenses on Eleven West range from $595 to $1,600 per patient beyond the standard single-patient room rate of $525. The rooms are available to anyone willing to pay the incremental cost. Its a way families can improve a situation over which they have little control, she adds.

Privileges such as views of Central Park instead of the atrium and meals of fresh lobster or aged imported cheese do not, however, include a higher caliber of medical care. All patients are treated equally, Knee explains.

Maintaining Eleven West costs $1.2 million a year. About 35% pays for its chef, kitchen staff and equipment. The floor, however, generates $2.2 million in annual revenues.

King For A Stay
At Methodist Hospital in Houston, healthcare VIP rooms took hold in the mid-1970s, when Dr. Michael DeBakey attracted international attention for the facility with his groundbreaking work in open-heart surgery. Kings, celebrities and prime ministers with entourages and security details arrived, necessitating private spaces, extra rooms and expanded responses to special diets.

Today, the 23 rooms in the Sue Fondren Trammell Pavilion at Methodist Hospital are used by anyone who can afford the tariff, two to three times that of a standard room. They attract a segment of the population with high disposable income, says Alice Baker, administrative liaison for Trammell Pavilion. They want the best they can afford, a higher comfort level.

A chef and three assistants manage the kitchen. Menus in several languages with specialties from Middle Eastern, Mexican and European cuisines reflect the international profile of many patients and visitors.

Patient Equality
Some healthcare facilities have opted not to go the way of VIP floors. In the early 1990s, Rush Presbyterian-St. Lukes Medical Center in Chicago converted 800 shared rooms to singles. Instead of upgrading some rooms with special décor and amenities, the hospital refocused priorities to improve foodservice and patient satisfaction. They hired chefs from the hospitality industry and culinary schools. Over 10 years, they reduced the number of beds to 500 for a better staff-to-patient ratio.

We raised overall food quality and emphasized personal care instead of going VIP, says Linda Lafferty, director of food and nutrition services.

Some foodservice managers question how the added expenses of VIP service are recouped. Unless you have a way to bill VIP [food] services separately, you have a hard time recapturing those costs, says Mary Angela Miller, director of nutrition and dietetics at The Ohio State University Medical Center (OSUMC) in Columbus. She oversees 650 rooms in five hospitals.

In OSUMCs culture, VIP means very important patient. It applies not only to guests willing to pay for privileges, but also to those with diet preferences or cultural traditions or limitations. It has nothing to do with economic status, says Miller. Each patient scripts his or her own needs in food and services. They can ask for anything. That includes a stocked mini-refrigerator and a visit by Seasons Fresh Express, a mobile cart with diet-appropriate foods.

A veteran of hospitals with successful VIP programs, Miller says an unpretentious, Midwestern mindset prevails in Columbus. The patients arent fussy or demanding. What they want is privacy and good medical care.

Niche Fulfillment
Marburg Pavilion at The Johns Hopkins Hospital in Baltimore (a Sodexho USA account) uses fine cotton sheets for its 15 private rooms. Restaurant-trained chefs prepare seafood, rack of lamb and, if approved by a patients doctor, dessert tasting plates. Tuxedoed waiters serve multicourse meals on imported china from linen-covered carts. The hospitals VIP-room tradition dates to the turn of the 20th century when Marburg featured separate floors for men and women, and special rooms with marble fireplaces for dignitaries.

With a $325 premium above the standard rate (from $800), VIP rooms average 60% occupancy, says Carole Blakely, a Marburg nurse-manager. In slow periods some of the 12-person kitchen staff are reassigned to other units in the hospital. All patients staying at The Johns Hopkins Hospital may order meals from Marburg. Meal charges are identical for guest diners and VIPs: around $10 for breakfast; $15 for lunch; and $35 for dinner. The pavilion caters about 200 meals per month.

Marburg is not a profit center, Blakely adds. We usually break even. The costs of operating are high. For many years, international clients accounted for 25% of business, but since Sept. 11, 2001, overseas patient admissions have dropped about 10%.

Future Demand
As healthcare needs increase with an aging population, there will be more demand for VIP-level patient care, says Russell Coile, a healthcare consultant from Washington, Texas. Todays consumer has more choices in healthcare coverage. With some plans, they can shop around. Hospitals know this. They market VIP floors to boost the bottom line. Some pleased patients even turn into benefactors.

The ability to court patients with round-the-clock dining, designer décor and original art raises the level of satisfaction and results in extra revenue. That enables some hospitals to broaden services to the needy and balance costs for those unable to pay.

Five years ago, hospitals were putting out vacancy signs. Now, more beds are full and profits are up, adds Coile.

Top Toque

Juliet Da Silva-Inniss plays two roles. One is registered dietitian, the other executive chef for Eleven West, the 19-room VIP floor of New York Citys Mount Sinai Hospital. She works with an annual food budget of $153,000 to supply whatever the patient wants, whether a favorite brand of ice cream or cheese or cut of meat, as long as the doctor approves, she says.

She procures ingredients from her own vendors instead of the hospitals, resulting in food costs that run about 30%. Requests for filet mignon, organic chicken, caviar, diabetic cake and even wine are not unusual. Eleven West diets are prepared on the floor in a restaurant-style kitchen.

My biggest challenge is to be creative yet realistic. This is still a hospital, says Da Silva-Inniss. If I use curry or ginger, I usually mellow it. If I do shrimp with tamarind sauce, we describe it carefully to the patients. Sometimes, all they want is comfort food.

Wow Appeal

Julie Schmidt describes the service and rooms at Woodwinds hospital as compassionate care with wow appeal. Some observers regard the 70-bed hospital on the 30-acre Woodwinds Health Campus in Woodbury, Minn., as a boutique healthcare facility. All 70 rooms are equal in décor, amenities and service. Each costs $1,500 daily, according to CEO Schmidt.

Patients stay at Woodwinds for traditional medicine as well as integrative health services, including water birth, healing touch, essential oils and music therapy. We appeal to a younger population of professionals, Schmidt says. They want the guest services of a hotel. Everything is equal. The design and amenities put peoples comfort first.