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In another sign of the decline of the urban nursing home industry, New Haven’s hallowed Jewish Home For The Aged is struggling to pay the bills and on the verge of sale to a for-profit company.
Like other city-based nursing homes with mostly low-income patients, the 226-bed not-for-profit home on Davenport Avenue in the Hill neighborhood has wrestled with deficits for years because of low Medicaid reimbursements.
Now the home is on the verge of drawing up a contract to sell to a for-profit company, board Chairman Jay Kossman reported Monday.
“It’s tragic. It’s sad that after 96 years, we have fallen on such difficult times,” Kossman said.
“There is a buyer. There are negotiations underway. We would hope to sell the Jewish home in the near future.”
Kossman declined to name the potential buyer. A name change and mission change are likely, he said: “It will not be run by a board of lay leaders. It will likely be for-profit.”
And if the sale falls through?
“I would not be optimistic on the future of the home,” Kossman said.
The Home reported losing $845,000 in 2009, $830,000 in 2008, and $953,000 in 2007, according to the state’s Department of Social Services (DSS).
DSS helped the home stay afloat this year by advancing it $1.5 million from an emergency fund to help struggling homes continue to care for long-term Medicaid patients “pending a sale,” according to agency spokesman David Dearborn. Dearborn said DSS is to receive the money back upon a sale of the home, as part of the proceeds.
He also said DSS negotiated in talks earlier this year on a potential sale that fell through. (He said DSS is doing the same in negotiations with a potential buyer for Stamford’s Courtland Gardens.)
Kossman stressed that the Jewish Home has not had to sacrifice on quality of care during tight fiscal times.
Last Thursday workers reported not receiving paychecks. Kossman attributed that to a “computer glitch” that was fixed, and said workers were eventually paid.
“At first I thought it was a holiday. Then I said, ‘It’s no holiday,’” said one grounds assistant on Thursday.
The home has 189 unionized workers represented by District 1199/SEIU. Union spokeswoman Deborah Chernoff said the union is considering legal action to recover dues that the home extracted from paychecks but failed to forward. She said the home owes $36,000 for five months’ worth of withheld dues.
Kossman said he didn’t know about that. The home’s director, Beth Goldstein, failed to return repeated phone messages left over several days.
The union’s pension fund has also gone to court to try recover $250,000 in delinquent pension contribution and health insurance premiums, Chernoff said.
Those debts could complicate a pending scale.
Chernoff noted that the Jewish Home, like all urban nursing homes in the state, faces a state reimbursement crisis. Like its counterparts in other cities, the Jewish Home relies almost exclusively on state Medicaid reimbursements for its patients — over 90 percent, according to Kossman. The statewide average is 69 percent, Chernoff said. Nursing homes lose an estimated $18 a day on Medicaid patients, meaning the Jewish Home loses in the neighborhood of $1 million a year just from Medicaid underpayments, according to Chernoff.
The Jewish Home has few paying patients to make up the difference. She also said the most recent census at the home showed occupancy down to around 77 percent, well below the industry minimum of 94 percent needed to stay profitable in the face of fixed overhead costs.
A Broader Crisis — & An Evolution
The state earlier this year shut down another New Haven nursing home experiencing funding woes, West Rock Health Care.
The crisis facing urban nursing homes became an issue in the Democratic gubernatorial primary; click here to read what the candidates had to say about it.
Kossman noted that the home’s fate coincides with broad changes in the industry, not just in cities, but everywhere. Federal and state government budgets are only getting tighter, meaning Medicaid reimbursements are likely only to dry up further. Meanwhile, more of an effort is being made to keep elderly people in their homes longer, with the help of nurses as well as new technology like “telemedicine devices that can monitor various functions.”
“There’s a lot that can be done without institutionalizing people,” Kossman said.
The challenge of caring for frail elderly patients who do need institutionalized living will remain a challenge.
The Jewish Home’s volunteer leaders have wrestled for years with how to address an increasing Medicaid patient load, as its original prime population — Jewish families, many of whom could afford the care without government help — moved to the suburbs. Its location on Davenport Avenue discouraged some families from placing elderly relatives there, rather than in suburban locations, partly because some didn’t want to come to the neighborhood to visit.
Originally the Jewish Home’s board explored transitioning to a “continuing care” community on land adjacent to the Jewish Community Center in Woodbridge. It would include some frail elderly rooms but also apartments for people who can live more independently with some nursing help. That plan never materialized. A “separate entity” is now pursuing a version of it, according to Kossman.
Back in 2007 the home was in discussions to sell its Davenport Avenue facility to Amistad Academy charter school as part of such a move. The plan failed to attract the needed support of some key politicians.
I cannot seem to understand this. They LOSE $18 a day on each and every Medicaid patient? And most patients are Medicaid? Does that mean that this is a budget crisis, a Medicaid issues, or a sign of the times?
Is there a way to fix this? Can they reorganize, cut back, layoff a few employees? Install solar panels, anything?
We have to do better than this. Our elderly population is exploding, and living longer than anyone thought they would. This is just the tip of the iceberg.