by Kimberly Fuson, Chief Executive Officer
Three years ago, our trustees offered me the privilege to return to Cedar Sinai Park to help steer the organization on to a path of sustainability. With all my heart, I want Cedar Sinai Park to find and take steps to a solid future that will adapt maturely to the changing times and carry us into our next century.
At the core of our mission,
by Kimberly Fuson, Chief Executive Officer
Three years ago, our trustees offered me the privilege to return to Cedar Sinai Park to help steer the organization on to a path of sustainability. With all my heart, I want Cedar Sinai Park to find and take steps to a solid future that will adapt maturely to the changing times and carry us into our next century.
At the core of our mission, always, is caring for our beloved elders, with no compromise. That was the intent of our forebears when they met for the first time on January 4, 1920, to plan for the Jewish Old People’s Home—the first iteration of assisted living—and the Jewish community can be proud of the gemstone that was created and is dearly cherished.
Across the nation, single-site, faith-based, not-for-profit elder care communities are being challenged. Many are failing; hundreds closed last year in the United States. Others are merging or affiliating with bigger corporations.
Decades before the Covid pandemic, the 103-year-old Robison Jewish Home (dba Cedar Sinai Park) has contended with decreasing Medicaid reimbursements. Medicaid does not cover overhead, and only reimburses a certain percentage of each resident’s stay, per day. The reimbursement rate has ranged from 60 to 80 percent over the past decades. Given that the majority of our residents at Robison Jewish Health Center and Harold Schnitzer Center for Living utilize Medicaid, there is a significant gap in what we are paid, and what we have to spend to meet our high standards of care.
Our supportive community has subsidized resident care and services to offset some of the losses. Cedar Sinai Park received significant PPP (Paycheck Protection Program) funds during Covid, which directly subsidized staff wages.
We’ve also known since 2007 that the number of individuals approaching retirement age was rapidly increasing while the available population of caregivers was steadily decreasing. There are not enough nurses in the pipeline because Oregon has the third fewest graduates in nursing programs, and we rank last in the country for degrees awarded from public institutions. Nationwide, we are in a care crisis of monumental proportions.
Despite the ever-changing regulations of short- and long-term nursing care, historically, Robison stayed ahead of the labor curve, thanks to its excellent wages and benefits and terrific culture of community.
However, roughly 15 percent of the national nursing home workforce left the sector when the pandemic began. Finding qualified staff for Robison Jewish Health Center who want to work has been a major hurdle, despite a wage study we conducted during the summer of 2022, which resulted in substantial wage increases for our health professionals. With lower than desired numbers of staff, we haven’t been able to utilize all of the 44 beds in Robison Jewish Health Center short-term skilled nursing since the pandemic hit.
To maintain the quality care for which Robison is known, we have been relying for the past few years on “agency” health professionals, that is people contracted temporarily as nurses, licensed nurse practitioners, and certified nursing assistants. Agencies demand salaries for their professionals two to three times higher than what our employees receive, depending upon the shift they are asked to work.
Our significant staffing shortage coupled with the crushing cost of agency labor means Cedar Sinai Park is facing critical shortfalls monthly. If we continue on our current path, we determined our expenses would soon exceed our cash reserves and given the current climate, we believe we must act now.
With strong support from our trustees, on March 6, we suspended admissions to our post-acute and rehabilitation services at Robison Jewish Health Center until further notice. All of the short-term residents currently at Robison Jewish Health Center are recovering well, and will soon go back to their full lives at home. The five long-term residents in Robison Jewish Health Center have been invited to select an available private suite in the Harold Schnitzer Center for Living.
The 48 private suites in the four households of the Harold Schnitzer Center for Living will remain open, and skilled nursing referrals will continue to be accepted on a very limited basis. We are consolidating all of the Robison Jewish Health Center clinical staff into the Harold Schnitzer Center for Living, and have virtually eliminated all agency health professionals.
All of our Robison Jewish Health Center nursing department positions are preserved. All staff wages have been preserved.
We are consolidating culinary services, and all food production will occur at the Rose Schnitzer Manor kitchen, which will return us to an all-kosher campus.
Seven important humans, who will always be part of our Cedar Sinai Park family, are affected (reduction of hours/lay-off) by the suspension of Robison post-acute care services. We love all our staff and have made every effort to ensure they are cared for and supported during this transition. All staff affected by the suspension of admissions will be offered coaching/counseling, job referrals and letters of recommendation.
Harold Schnitzer Center for Living, Rose Schnitzer Independent and Assisted Living, Adult Day Services, and Sinai In-Home Care are fully functioning and open to the community. We continue to find ways to enhance our care and services, and to improve the quality of life for our residents.
Above all else, Cedar Sinai Park must remain viable for the elders and vulnerable who rely upon us. We have a long tradition of high-quality care and staffing, and we want to maintain that reputation in the community. The decision to suspend Robison admissions was not made lightly; we believe it is the best way to achieve our long-term goals.
Cedar Sinai Park is working with two expert advisory firms to help develop scenarios for sustainability. HJ Sims is an investment banking and strategic consulting firm specializing in senior housing financing. Clifton Larson Allen is an accounting firm whose focus is market analytics for senior care and other industries. We are also consulting with our industry peers and trade associations.
Once those analyses are conducted, Cedar Sinai Park will be in a better position to make decisions about its path to sustainability. We are a strong and sound organization. Cedar Sinai Park must change in order to be responsible and serve the needs of the Jewish community.
Thank you for your generous support of the Home for all of these years. We appreciate your gifts, your guidance, and your grace as we go through this important transition.
Staff who have a question about caring for residents with dementia need to look no further than Heather Hess. The Interim Sinai In-Home Care Director is the only Positive Approach to Care (PAC) Certified Independent Trainers in the Portland-area, having recently completed the intensive certification process.
“The certification courses were really kind of awesome because I got a true understanding of the brain and why dementia is happening,” said Hess, 44, who joined Cedar Sinai Park nearly eight years ago as a caregiver in the Harold Schnitzer Center for Living.
Staff who have a question about caring for residents with dementia need to look no further than Heather Hess. The Interim Sinai In-Home Care Director is the only Positive Approach to Care (PAC) Certified Independent Trainers in the Portland-area, having recently completed the intensive certification process.
“The certification courses were really kind of awesome because I got a true understanding of the brain and why dementia is happening,” said Hess, 44, who joined Cedar Sinai Park nearly eight years ago as a caregiver in the Harold Schnitzer Center for Living. “You have pre-coursework before the certification classes, and then the coursework, and then lots of hands-on afterwards to put on a workshop for others about what you’ve learned. And I was working full-time on top of those responsibilities.
“To gain certification, I ended up training all of our caregivers for In-Home Care, so now all of our staff has advanced training in dementia care and they understand the expectations,” added Hess. “Our caregivers now have a level of education in dementia care that sets us apart from everyone else in the local senior living industry.
“The knowledge and skills our staff have are challenging to learn, but they said they now feel like they have a toolbox to work from and can handle clients with Alzheimer’s and behavioral issues much better. They get so excited and proud of themselves when the techniques they’ve learned work.”
PAC is an organization founded by nationally-recognized dementia expert Teepa Snow, who has developed a widely-respected person-centered and engagement-driven philosophy designed to support those living with brain change in a more positive and respectful way.
An estimated 6.2 million Americans age 65 and older were living with Alzheimer’s dementia in 2021 and that number was projected to rise to almost 13 million by 2050. One in three seniors dies with Alzheimer’s or another dementia—more than breast and prostate cancer combined.
“Learning how the brain works and advancing your knowledge as the disease advances is so critical,” says Hess. “There is so much we still don’t know. There are more than 250 types of dementia! We need to be prepared and ready to handle the influx of people who will need care.
“I’m so excited that we now have a consistent tool for us to use.”
Hess wanted to be a caregiver from a young age. “I was in and out of foster care as a kid so I did not have a stable family. Family and taking care of people was the only way I could connect and give back for a loss that I was feeling growing up.”
She started out at age 15 as a hospital candy striper in Ukiah, California, through an ROTC program, changing bed pans and re-positioning catheters among other patient duties.
“Those positions don’t even exist anymore,” said Hess, with a laugh. “It was a very emotional job and it really impacted me at 15. I learned that what we do from when people get sick to when they die is what matters in life.”
Hess earned a bachelor of arts in early childhood development while pregnant with her first child, who is high-functioning autistic, desiring extra skills to help her daughter.
“And then my husband and I moved to Oregon to take care of my elderly in-laws, so caregiving professionally was already kind of naturally lining up with what I was doing at home.
“I did my homework and Cedar Sinai Park was the only place I could find where I knew I could grow in my career. Also, Cedar Sinai Park had a reputation for having long-term employees, which is really what you’re looking for in a company. When a place has a lot of long-term employees, that says something solid about the company, and that’s what led to my decision to start here.”
Hess was client caregiver for Sinai In-Home Care for several years, training all the new hires. Even as Interim Director of Sinai In-Home Care, she is out in the field conducting client intakes, and develops and updates care plans, troubleshoots, and has quarterly client monitoring visits. She also attends job fairs, handles paperwork, coordinates staff in-services, and sits on several Cedar Sinai committees. Some of her clients are residents at Rose Schnitzer Manor where she is remembered as the “Flower Lady” for the various colorful flowers stuck in her up-do.
“I think we have a higher level of respect here than you get in any other outside senior agency,” said Hess. “It’s easy to talk to anybody here. If you have an issue, it’s dealt with; you’re not stuck waiting for a solution because of the comfortability level amongst staff and supervisors.
“Our residents and clients are truly are so important to me because they are an extension of our loved ones,” said Hess. “We might not be blood-related, but they live here long enough that they are family, and I love them like family. I really do.”
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When the Newmark Dining Room is busy, there’s nothing like having extra hands!
To the amusement of Rose Schnitzer Manor residents and the gratitude of servers, two new robots in the dining room—dubbed Lucy and Ethel—are now carting food to tables, leaving servers to manage other essentials.
“They are very helpful, especially during breakfast and dinner when it’s busier,” said server Adam. One shift, Adam said, the team was down a team member,
When the Newmark Dining Room is busy, there’s nothing like having extra hands!
To the amusement of Rose Schnitzer Manor residents and the gratitude of servers, two new robots in the dining room—dubbed Lucy and Ethel—are now carting food to tables, leaving servers to manage other essentials.
“They are very helpful, especially during breakfast and dinner when it’s busier,” said server Adam. One shift, Adam said, the team was down a team member, but with the addition of the robots, two servers were able to successfully help everyone.
Finding staff to fill server positions was difficult before the pandemic and Covid has made the labor shortage even more challenging, said Cedar Sinai Park Chief Executive Officer Kimberly Fuson.
“The idea of using robots as extra hands originated from team members in Life Enrichment and Culinary Services. Then, with support from Rose Schnitzer Manor Administrator Vivian Villegas, the team made it happen,” said Fuson. “We are actively seeking creative ways to face the challenges of Covid.”
Villegas agrees. “Lucy and Ethel have improved morale during a time when our staff was stretched thin. It is important for our staff to know we are willing to try anything to support them!”
Each robot has three tiers that can hold up to six plates, said Executive Chef/Director of Culinary Services Andy Staggs. Lucy and Ethel can also potentially be used for bussing tables.
“We are an early adopter of the robot technology in the senior living industry,” said Staggs. “I can only think of one other senior living facility in Oregon that uses them.”
Lucy and Ethel have their own name badges on the front and photos on the back to tell the robots apart. The photos depict television actresses Lucille Ball and Vivian Vance in uniform at a chocolate factory where they went to work, one of “I Love Lucy’s” funniest episodes.
Lucy and Ethel were named by an anonymous resident during a contest at Rose Schnitzer.
“I love it when they get to the doorway of the kitchen and then it looks like they might hit the door, and then they just barely miss,” said resident Gloria. “I enjoy watching them.”
May 1, 2020
Watch our CEO, Kimberly Fuson, in a Fox 12 Oregon special feature showcasing the amazing generosity of Sew to Save Oregon! They donated nearly 1,000 hand-made cloth masks to our Cedar Sinai Park residents and caregivers! We feel so blessed by our wonderful community. Thank you Sew to Save Oregon for helping to keep our residents and staff safe!
To learn more about Sew to Save,
May 1, 2020
Watch our CEO, Kimberly Fuson, in a Fox 12 Oregon special feature showcasing the amazing generosity of Sew to Save Oregon! They donated nearly 1,000 hand-made cloth masks to our Cedar Sinai Park residents and caregivers! We feel so blessed by our wonderful community. Thank you Sew to Save Oregon for helping to keep our residents and staff safe!
To learn more about Sew to Save, visit www.sewtosave.org. Our appreciation goes out to Fox 12 Oregon for creating and sharing this wonderful video!